The early impact of paraquat ban on suicide in Taiwan

This paper explores the impact of the first-stage ban of paraquat, a highly lethal herbicide when ingested, on suicide in Taiwan. The study found that the ban on the import and production of paraquat was followed by a fall in pesticide and paraquat suicides.

Authors: Shu-Sen Chang, Chien-Yu Lin, Ming-Been Lee, Lih-Jong Shen, David Gunnell & Michael Eddleston
Published in: Clinical Toxicology, 60:1, 131-135

Abstract

Introduction

Pesticide ingestion is a leading method for suicide worldwide. Paraquat is a highly lethal herbicide when ingested. We assessed the impact of the first-stage ban on the import and production of paraquat (from February 2018) on suicides by pesticide poisoning in Taiwan.

Methods

Suicide data by method (pesticide vs. non-pesticide), pesticide (paraquat vs. non-paraquat), and area/sex/age were extracted from the national cause-of-death data files (2011–2019). Negative binomial regression was used to estimate changes in suicide rates in 2019, compared to the expected rates based on pre-ban linear trends (2011–2017).

Results

The paraquat ban was followed by an estimated 37% (rate ratio [RR]¼0.63, 95% confidence interval [CI] 0.54–0.74) reduction in pesticide suicide rate (190 [95% CI 116–277] fewer suicides) in 2019, mainly due to a 58% (RR ¼ 0.42, 95% CI 0.33–0.54) reduction in paraquat suicides (145 [95% CI 92–213] fewer suicides). Larger absolute reductions in pesticide suicides were found in rural areas, males, and the elderly (aged 65þ years) than their counterparts. Except for a 10% (95% CI 3–18%) reduction in overall suicide rates in the elderly, there was no statistical evidence for a change in nonpesticide and overall (all-method) suicides.

Conclusion

The ban on the import and production of paraquat was followed by a fall in whole-population pesticide and paraquat suicides and elderly suicides in Taiwan.