The secure storage of pesticides
World Health Organisation Public Health Initiative:
The Impact of Pesticides on Health – Preventing Intentional and Unintentional Deaths from Pesticide Poisoning.
A person at risk of committing suicide suffers from mental illness, relationship problems and a whole range of distress that leads to suicidal ideation; in extreme crisis, such people could take an impulsive action to take their own life. If the means to kill themselves is not readily available there is a greater likelihood that the period of acute distress dissipates and the suicide does not occur
There are an estimated 258,234 completed suicides a year using pesticides; adjusting figures for likely understatements from India, that figure rises to 371,594. (Gunnell et al, 2007). Experience in rural low income countries and recent pilot studies indicate that restricting access to pesticides where there are vulnerable people will avoid unnecessary intentional deaths and could also avoid unintentional deaths.
Challenge to global leadership and pesticide industry
In developed countries – in cases where suicide attempts are made by self poisoning - prescription drugs are most frequently used. In low income countries, incidents of self poisoning more frequently involve pesticides (see chart). Since prescription drugs are less toxic than pesticides there are many more non-fatal suicide attempts in the developed countries than in under-developed countries. The significance of this is that research shows that in the developed countries, the great majority of people who survive their first suicide attempt are still living after 9 years. The proposal is then, that if easy access to pesticides is removed, the number of suicides is reduced.
Chart showing percentage of completed suicides using pesticides by World Health Organisation (WHO) area
Gunnell and Eddleston (2003) estimate that 150,000 lives a year – most of them young – could be saved by removing access to pesticides beyond the relatively short period of suicidal impulse. And in doing so challenged the global leadership and the pesticide industry to act.
The Response: A Global Public Health Initiative
The response from the World Health Organisation (WHO) was to create a global public health initiative “The Impact of Pesticides on Health – Preventing Intentional and Unintentional Deaths from Pesticide Poisoning.”
“Develop or strengthen commmunity interventions that minimize risks of intentional and unintentional pesticide poisoning” (WHO 2006)
A collaboration of interested parties was set up involving in particular, the International Association for Suicide Prevention (IAPS). The collaboration agreed the overall goal as being “to reduce mortality and morbidity related to pesticide poisoning” and defined five key objectives. The objective of particular relevance to pesticide stewardship is to:
Community Interventions for Safer Access to Pesticides
One of three ‘promising community interventions’ identified by a meeting of experts was: ‘safer storage: locked boxes for storing pesticides in farming households’. The premise being that if pesticides can be locked away in secure storage the number of self poisonings (and accidental poisonings) should reduce.
Turning a premise into a strategy requires evidence. Will the extensive use of lockable storage boxes be effective in reducing the number of accidental poisonings and intentional self-poisonings using pesticides in itself (or will it simply mean that other means of self-harm are found)?
Answering these questions will require a large-scale trial the success of which will rely on people in the farming communities of low income countries using the storage box in the intended manner. An early step was thus to run a smaller study to “assess the acceptability and use of lockable boxes for storing pesticides”. This study was conducted in rural Sri Lanka commencing May 2006 and reported in a paper by Hawton, Ratnayeke, Simkin, Harriss and Scott (2007)
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: