Department of Community Medicine, Faculty of Medicine & Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka.
South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
Trop Med Int Health. 2023 Dec;28(12):901-911. doi: 10.1111/tmi.13941. Epub 2023 Oct 23.
Data from South Asia indicate that for 15%-20% of suicide attempts, pesticides are purchased from shops; otherwise, pesticides are obtained from an individual's house or nearby environment. We aimed to investigate the difference between individuals who directly purchase pesticides from shops for suicide attempts and suicide deaths versus those related to accessing the pesticides from an individual's house or nearby environment.
We conducted two comparative studies in rural Sri Lanka: (1) non-fatal shop cases (n = 50) were survivors of self-poisoning with pesticides who ingested the pesticides after purchasing them from a shop; non-fatal domestic cases (n = 192) were survivors who accessed pesticides from their house or nearby environment. (2) fatal shop cases (n = 50) were individuals who died after ingesting pesticides they purchased for the act; fatal domestic cases (n = 102) were patients who died after ingesting pesticides they accessed at house or nearby environment. Logistic regression analysis was used to assess the characteristics which distinguished between the shop and domestic cases.
Data indicate that 20.7% and 32.9% of individuals who used pesticides for suicide attempts and suicide deaths had purchased them from shops, respectively. Being a non-farmer was the main distinguishing characteristic of shop cases: adjusted odds ratios (AOR) 8.9, 95% confidence intervals (CI) 3.2-24.4 for non-fatal shop cases, and AOR 4.0, 95% CI 1.5-10.6 for fatal shop cases. Non-fatal shop cases also had higher suicide intent (AOR 3.0, CI 1.0-8.9), and ingesting an insecticide (AOR 4.8, CI 1.8-1.0-8.9) than non-fatal domestic cases.
A high suicide intent of individuals who purchase pesticides for the event explains the high proportion of such fatal cases. Such high suicide intent makes the prevention implications difficult to spell out for those individuals who purchase pesticides for self-poisoning. However, our findings are valuable for clinicians to assess pesticide poisoning cases in hospitals.
来自南亚的数据显示，有 15%-20%的自杀未遂者是从商店购买农药的；否则，他们会从自己家中或附近环境中获取农药。我们旨在调查那些直接从商店购买农药自杀未遂和自杀死亡的人与那些从自己家中或附近环境获取农药的人之间的差异。
我们在斯里兰卡农村进行了两项对比研究：（1）非致命性商店案例（n=50）是指那些从商店购买农药后自行服毒的自杀未遂幸存者；非致命性家庭案例（n=192）是指那些从家中或附近环境获取农药的幸存者。（2）致命性商店案例（n=50）是指那些因摄入从商店购买的农药而死亡的个体；致命性家庭案例（n=102）是指那些因摄入家中或附近环境获取的农药而死亡的患者。采用逻辑回归分析评估了区分商店和家庭案例的特征。
数据表明，分别有 20.7%和 32.9%的自杀未遂和自杀死亡者是从商店购买农药的。非农民是商店案例的主要区别特征：非致命性商店案例的调整比值比（AOR）为 8.9，95%置信区间（CI）为 3.2-24.4；致命性商店案例的 AOR 为 4.0，95% CI 为 1.5-10.6。非致命性商店案例还具有更高的自杀意图（AOR 3.0，CI 1.0-8.9），以及摄入杀虫剂（AOR 4.8，CI 1.8-1.0-8.9）的可能性，而非致命性家庭案例。
购买农药进行自杀的个体具有较高的自杀意图，这解释了此类致命案例的高比例。这种高自杀意图使得针对那些为自杀而购买农药的个体制定预防措施变得困难。然而，我们的研究结果对于临床医生评估医院中的农药中毒案例具有重要价值。
