Effects of Paraquat Ban on Herbicide Poisoning-Related Mortality
0
조회
0
다운로드
10
인용
0
참고문헌
키워드
초록
Purpose: In Korea, registration of paraquat-containing herbicides was canceled in November 2011, and sales thereof were completelybanned in November 2012. We evaluated the effect of the paraquat ban on the epidemiology and mortality of herbicide-inducedpoisoning. Materials and Methods: This retrospective study analyzed patients treated for herbicide poisoning at 17 emergency departments in South Korea between January 2010 and December 2014. The overall and paraquat mortality rates were compared pre- and post-ban. Factors associated with herbicide mortality were evaluated using logistic analysis. To determine if there were any changes in the mortality rates before and after the paraquat sales ban and the time point of any such significant changes in mortality, R software, version 3.0.3 (package, bcp) was used to perform a Bayesian change point analysis. Results: We enrolled 2257 patients treated for herbicide poisoning (paraquat=46.8%). The overall and paraquat poisoning mortalityrates were 40.6% and 73.0%, respectively. The decreased paraquat poisoning mortality rate (before, 75% vs. after, 67%, p=0.014) might be associated with increased intentionality. The multivariable logistic analysis revealed the paraquat ban as an independentpredictor that decreased herbicide poisoning mortality (p=0.035). There were two major change points in herbicide mortality rates, approximately 3 months after the initial paraquat ban and 1 year after complete sales ban. Conclusion: This study suggests that the paraquat ban decreased intentional herbicide ingestion and contributed to lowering herbicide poisoning-associated mortality. The change point analysis suggests a certain timeframe was required for the manifestationof regulatory measures outcomes.
Abstract
Purpose: In Korea, registration of paraquat-containing herbicides was canceled in November 2011, and sales thereof were completelybanned in November 2012. We evaluated the effect of the paraquat ban on the epidemiology and mortality of herbicide-inducedpoisoning. Materials and Methods: This retrospective study analyzed patients treated for herbicide poisoning at 17 emergency departments in South Korea between January 2010 and December 2014. The overall and paraquat mortality rates were compared pre- and post-ban. Factors associated with herbicide mortality were evaluated using logistic analysis. To determine if there were any changes in the mortality rates before and after the paraquat sales ban and the time point of any such significant changes in mortality, R software, version 3.0.3 (package, bcp) was used to perform a Bayesian change point analysis. Results: We enrolled 2257 patients treated for herbicide poisoning (paraquat=46.8%). The overall and paraquat poisoning mortalityrates were 40.6% and 73.0%, respectively. The decreased paraquat poisoning mortality rate (before, 75% vs. after, 67%, p=0.014) might be associated with increased intentionality. The multivariable logistic analysis revealed the paraquat ban as an independentpredictor that decreased herbicide poisoning mortality (p=0.035). There were two major change points in herbicide mortality rates, approximately 3 months after the initial paraquat ban and 1 year after complete sales ban. Conclusion: This study suggests that the paraquat ban decreased intentional herbicide ingestion and contributed to lowering herbicide poisoning-associated mortality. The change point analysis suggests a certain timeframe was required for the manifestationof regulatory measures outcomes.
참고문헌 (13)
- 석수진, "Paraquat Intoxication in Subjects Who Attempt Suicide: Why They Chose Paraquat", The Korean Journal of Internal Medicine, 24(3), pp.247~251 (2009), 대한내과학회
- 길효욱, "Diagnostic and Therapeutic Approach for Acute Paraquat Intoxication", Journal of Korean Medical Science, 29(11), pp.1441~1449 (2014), 대한의학회
- Heylings JR, "Identification of an alginate-based formulation of paraquat to reduce the exposure of the herbicide following oral ingestion", Toxicology, 241, pp.1~10 (2007)
- Wilks MF, "Formulation changes and time trends in outcome following paraquat ingestion in Sri Lanka", Clin Toxicol (Phila), 49, pp.21~28 (2011)
- Vijayakumar L, "Does ‘no pesticide’ reduce suicides?", Int J Soc Psychiatry, 55, pp.401~406 (2009)
- Roberts DM, "Influence of pesticide regulation on acute poisoning deaths in Sri Lanka", Bull World Health Organ, 81, pp.789~798 (2003)
- Kervégant M, "Paraquat poisonings in France during the European ban:experience of the Poison Control Center in Marseille", J Med Toxicol, 9, pp.144~147 (2013)
- Cha ES, "Impact of paraquat regulation on suicide in South Korea", Int J Epidemiol, 45, pp.470~479 (2016)
- 이정원, "Common Pesticides Used in Suicide Attempts Following the 2012 Paraquat Ban in Korea", Journal of Korean Medical Science, 30(10), pp.1517~1521 (2015), 대한의학회
- Christensen J, "Multiple change-point analysis of disease incidence rates", Prev Vet Med, 26, pp.53~76 (1996)
- Erdman C, "bcp: an R package for performing a Bayesian analysis of change point problems", J Stat Softw, 23, pp.1~13 (2007)
- Myung W, "Paraquat prohibition and change in the suicide rate and methods in South Korea", PLoS One, 10, pp.e0128980~ (2015)
- Moriarty JP, "Evaluating implementation of a rapid response team:considering alternative outcome measures", Int J Qual Health Care, 26, pp.49~57 (2014)