Van der Hoek W, Konradsen F, Athukorala K, Wanigadewa T
International Irrigation Management Institute, Colombo, Sri Lanka.
Soc Sci Med. 1998 Feb-Mar;46(4-5):495-504. doi: 10.1016/s0277-9536(97)00193-7.
Acute pesticide poisoning is a major public health problem in Sri Lanka. In several agricultural districts, it precedes all other causes of death in government hospitals. Most of the acute poisoning cases are intentional (suicide) and occur among young adults, mainly males. Poisoning due to occupational exposure is also common, but less well documented. In an irrigation area in Sri Lanka a very high incidence of serious pesticide poisoning was observed, with 68% due to intentional ingestion of liquid pesticides. It is argued that the easy availability and widespread use of highly hazardous pesticides is the most important reason for this high number of poisoning cases. The frequent application of highly hazardous pesticides in high concentrations was often irrational and posed serious health and financial risks to the farmers. Sales promotion activities and credit facilities promoted this excessive pesticide use, which was not counteracted by an agricultural extension service. Hazardous practices when spraying pesticides were due to the impossibility of applying recommended protective measures under the local conditions, rather than to lack of knowledge. Current emphasis on programs that promote the safe use of pesticides through education and training of farmers will be ineffective in Sri Lanka because knowledge is already high and most poisoning cases are intentional. Instead, enforcement of legislation to restrict availability of the most hazardous pesticides would result in an immediate health benefit. Improved agricultural extension services to promote alternative non-chemical methods of pest control is the most important strategy, in the long term, to prevent acute pesticide poisoning.
急性农药中毒是斯里兰卡的一个主要公共卫生问题。在几个农业区，它在政府医院中是所有其他死因之首。大多数急性中毒病例是故意的（自杀），且发生在年轻人中，主要是男性。职业接触导致的中毒也很常见，但记录较少。在斯里兰卡的一个灌溉区，观察到严重农药中毒的发生率非常高，其中68%是由于故意摄入液体农药。有人认为，高危险性农药的容易获取和广泛使用是中毒病例数量众多的最重要原因。高浓度频繁使用高危险性农药往往不合理，给农民带来严重的健康和经济风险。促销活动和信贷便利促使了这种过度使用农药的情况，而农业推广服务并未对此加以抵制。喷洒农药时的危险做法是由于在当地条件下无法采取推荐的防护措施，而非缺乏知识。目前通过对农民进行教育和培训来促进农药安全使用的项目在斯里兰卡将不会有效，因为知识水平已经很高，且大多数中毒病例是故意的。相反，执行立法限制最危险农药的可得性将立即带来健康益处。从长远来看，改善农业推广服务以促进替代非化学害虫控制方法是预防急性农药中毒的最重要策略。
