*Warning: this article discusses suicide. If you have questions on self-harm or feel suicidal, use this link to find an international helpline – https://findahelpline.com/*
People who self-poison with pesticides after buying them from shops often have a higher suicidal intent, and are therefore more likely to die, than those who self-harm with pesticides stored at home, according to a new study.
There are an estimated 150,000 global deaths from pesticide self-poisoning every year. It is a particular problem in rural communities in South Asia. The majority of self-poisoning cases occur after individuals access pesticides stored in or around their home. However, up to 20% of cases occur directly after a pesticide is purchased from a shop.
The study was conducted in the Anuradhapura District of Sri Lanka. It is the first comparative study to investigate the characteristics of people who purchase pesticides from shops for self-harm, compared with those who use pesticides available in the domestic environment.
Data were collected on 242 non-fatal pesticide poisoning cases. The study found that 86% of people who purchased pesticides from shops for self-poisoning had high suicidal intent, compared with 61% of those who used pesticides found in their domestic environment.
Other characteristics associated with purchasing pesticides from a shop include being male, having a harmful pattern of drinking alcohol, and being a non-farmer. 46% of non-fatal shop cases were non-farmers, compared to just 8.9% of non-fatal domestic cases
The study also showed a higher proportion of deaths for shop cases. One in five cases of pesticide self-poisoning occur after an individual purchases pesticides from a shop. However, shop cases account for a third of all deaths.
Dr Manjula Weerasinghe, who led the study, said:
“In many low-and middle-income countries, pesticides are available for purchase over the counter in pesticide shops, without constraint or need for prescription. This increases their accessibility for acts of self-poisoning.
“We already know that many cases of pesticide self-poisoning are impulsive with low intent to die. However, this study identifies a significant difference between people who buy their pesticides from shops, and those who access pesticides stored at home, prior to an act of self-harm. People using shop bought pesticides are more likely to have planned their suicide attempt and have a higher intent to die. It takes a certain amount of time to travel to a shop, signalling a level of premeditation.
“These findings could be of value to clinicians assessing pesticide poisoning cases in hospital. It may help them to recognise people at risk of repetition and future suicide attempts.”
The research was funded by the American Foundation for Suicide Prevention the Wellcome Trust. The full study is published in Tropical Medicine & International Health.