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The secure storage of pesticides


Sri Lankan Research Study: “Evaluation of acceptability and use of lockable storage devices for pesticides in Sri Lanka that might assist in prevention of self-poisoning”

A step along the way

This study is one of a series which will inform the development of a public health strategy by the World Health Organisation (WHO). It is part of the project: “The Impact of Pesticides on Health – Preventing Intentional and Unintentional Deaths from Pesticide Poisoning.” 

Lockable storage box with message: “Poison is not the answer for anger, pain and despair. Talk to a trusted friend about your feelings of anger and sadness. Remember to keep all pesticides and poisons out of reach, safely locked in this box.” (9Kb JPEG)
Lockable storage box with message: “Poison is not the answer for anger, pain and despair. Talk to a trusted friend about your feelings of anger and sadness. Remember to keep all pesticides and poisons out of reach, safely locked in this box.”

The study is now complete and is described in the paper named above.  The authors conclude that the:

  •  “Introduction of lockable boxes for storing pesticides to farming households in Sri Lanka appeared to be acceptable. 
  • Most households used the boxes responsibly, although there was some decline in the proper usage over time. 
  • A large-scale trial of lockable storage devices in farming households in rural areas as a means of preventions of suicide and accidental poisoning is now indicated.”

If the large-scale trial suggested, were successful,  this would support the development of a public health strategy to

  • encourage safer storage of pesticides in
  • rural communities of
  • low income countries suffering
  • high rates of pesticide poisoning

The study in brief

400 households from 4 different villages in rural Sri Lanka received lockable metal storage boxes. Recruited householders had been made aware of the purpose of the study by the staff of Sumithrayo, an NGO, and were given instructions and guidance on positioning boxes. Notable results are:

  • At the time of receiving the box 1.8% of households reported locking up pesticides with just over 70% of households reporting easy access to pesticides for adults
  • Approximately 30 weeks after receiving the box, 89.5% of households reported using the box all or most of the time, 92.8% of whom also reported always locking the box.
  • 18 months after receiving the box, 72.5%  of households reported that the box was kept locked all of the time with 99.4%  considering the box useful.

Some issues arose from the design of the box and a larger, lighter, cheaper box would appear to be helpful. Some households found the box used in the study too small and some found that the boxes too heavy for the mud walls to which the boxes were fixed. If boxes were priced at or above the cost of production the cost of a metal box would be an issue for most households.  The design of the lock also proved problematic with some keys lost or the lock broken.

The reduction in use of the box over time suggested to the authors that guidance on the proper use of the box might encourage its longer term use.

Designing the large-scale study

This is an ambitious project presenting significant resourcing and implementation challenges.

The project team are currently working with Oxford University and the Institute of Psychiatry to develop a workable research design requiring a manageable number of participants as an alternative to using the more traditional randomised control trial. The problem with using this type of trial in this case, is that over 3 million individuals would be needed to take part. By developing a design that more closely defines the population studied as a “predetermined high risk community”, the team will be able to recruit far fewer people yet still be able to properly test the impact of introducing secure lockable boxes in a predetermined high risk community. Currently communities in the State of Karnataka or Andhra Pradesh in India are being considered.

This is an ambitious project presenting significant resourcing and implementation challenges and these pages will be updated as to the project’s progress.

References

Gunnell, D. & Eddleston M.  (2003). `Suicide by intentional ingestion of pesticides: a continuing tragedy in developing countries'. Int. J. Epidemiol. 32(6):902-909. 

Gunnell, D. et al. (2007). `The global distribution of fatal pesticide self-poisoning: systematic review'. BMC Public Health 7:357+. 

Hawton, K. et al (2009). `Evaluation of acceptability and use of lockable storage devices for pesticides in Sri Lanka that might assist in prevention of self-poisoning'. BMC Public Health 9:69+.

Konradsen,F. et al. (2007). `Community uptake of safe storage boxes to reduce self-poisoning from pesticides in rural Sri Lanka'. BMC Public Health 7:13+. 

Owens, D. et al. (2002) 'Fatal and non-fatal repetition of self-harm: Systematic review' The British Journal of Psychiatry 2002 181: 193-199

WHO web publications:

Safer access to pesticides community interventions (565Kb pdf)

The Impact of Pesticides on Health: Preventing Intentional and Unintentional Deaths from Pesticide Poisoning (183 Kb pdf)


 
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