Gyenwali Deepak, Vaidya Abhinav, Tiwari Sundar, Khatiwada Prakash, Lamsal Daya Ram, Giri Shrikrishana
Farming, Health and Environment Nepal Project, Nepal Public Health Foundation, Kathmandu, Nepal.
Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal.
BMC Public Health. 2017 Jul 3;17(1):619. doi: 10.1186/s12889-017-4542-y.
Globally, there is a growing concern over pesticides use, which has been linked to self-harm and suicide. However, there is paucity of research on the epidemiology of pesticides poisoning in Nepal. This study is aimed at assessing epidemiological features of pesticides poisoning among hospital-admitted cases in selected hospitals of Chitwan District of Nepal.
A hospital-based quantitative study was carried out in four major hospitals of Chitwan District. Information on all pesticides poisoning cases between April 1 and December 31, 2015, was recorded by using a Pesticides Exposure Record (PER) form.
A total of 439 acute pesticides poisoning cases from 12 districts including Chitwan and adjoining districts attended the hospitals during the 9-month-long study period. A majority of the poisoned subjects deliberately used pesticides (89.5%) for attempted suicide. The total incidence rate was 62.67/100000 population per year. Higher annual incidence rates were found among young adults (111.66/100000 population), women (77.53/100000 population) and individuals from Dalit ethnic groups (98.22/100000 population). Pesticides responsible for poisoning were mostly insecticides (58.0%) and rodenticides (20.8%). The most used chemicals were organophosphates (37.3%) and pyrethroids (36.7%). Of the total cases, 98.6% were hospitalized, with intensive care required for 41.3%. The case fatality rate among admitted cases was 3.8%.
This study has indicated that young adults, females and socially disadvantaged ethnic groups are at a higher risk of pesticides poisoning. Pesticides are mostly misused intentionally as an easy means for committing suicide. It is recommended that the supply of pesticides be properly regulated to prevent easy accessibility and misuse. A population-based study is warranted to reveal the actual problem of pesticides exposure and intoxication in the community.
在全球范围内，人们对农药使用的担忧日益增加，农药使用与自残和自杀有关。然而，尼泊尔关于农药中毒流行病学的研究较少。本研究旨在评估尼泊尔奇旺地区选定医院中住院的农药中毒病例的流行病学特征。
在奇旺地区的四家主要医院开展了一项基于医院的定量研究。使用农药暴露记录（PER）表格记录了2015年4月1日至12月31日期间所有农药中毒病例的信息。
在为期9个月的研究期间，共有来自包括奇旺及其毗邻地区在内的12个地区的439例急性农药中毒病例到医院就诊。大多数中毒者故意使用农药（89.5%）企图自杀。总发病率为每年62.67/100000人口。在年轻人（111.66/100000人口）、女性（77.53/100000人口）和达利特族裔群体（98.22/100000人口）中发现了较高的年发病率。导致中毒的农药主要是杀虫剂（58.0%）和灭鼠剂（20.8%）。最常用的化学物质是有机磷（37.3%）和拟除虫菊酯（36.7%）。在所有病例中，98.6%住院治疗，41.3%需要重症监护。住院病例的病死率为3.8%。
本研究表明，年轻人、女性和社会弱势族裔群体农药中毒风险较高。农药大多被故意滥用，作为一种简便的自杀手段。建议对农药供应进行适当监管，以防止其易于获取和滥用。有必要开展一项基于人群的研究，以揭示社区中农药暴露和中毒的实际问题。
