Effects of paraquat ban on herbicide poisoning-related mortality

Dong Ryul Ko, Sung Phil Chung, Je Sung You, Soohyung Cho, Yongjin Park, Byeongjo Chun, Jeongmi Moon, Hyun Kim, Yong Hwan Kim, Hyun Jin Kim, Kyung Woo Lee, Sang Chun Choi, Junseok Park, Jung Soo Park, Seung Whan Kim, Jeong Yeol Seo, Ha Young Park, Su Jin Kim, Hyunggoo Kang, Dae Young HongJung Hwa Hong

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13 Citations (Scopus)

Abstract

Purpose: In Korea, registration of paraquat-containing herbicides was canceled in November 2011, and sales thereof were completely banned in November 2012. We evaluated the effect of the paraquat ban on the epidemiology and mortality of herbicide-in-duced poisoning. 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 mortality rates 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 independent predictor 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 manifestation of regulatory measures outcomes.

Original languageEnglish
Pages (from-to)859-866
Number of pages8
JournalYonsei medical journal
Volume58
Issue number4
DOIs
Publication statusPublished - 2017 Jul

Keywords

  • Herbicides
  • Mortality
  • Paraquat
  • Poisoning

ASJC Scopus subject areas

  • Medicine(all)

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    Ko, D. R., Chung, S. P., You, J. S., Cho, S., Park, Y., Chun, B., Moon, J., Kim, H., Kim, Y. H., Kim, H. J., Lee, K. W., Choi, S. C., Park, J., Park, J. S., Kim, S. W., Seo, J. Y., Park, H. Y., Kim, S. J., Kang, H., ... Hong, J. H. (2017). Effects of paraquat ban on herbicide poisoning-related mortality. Yonsei medical journal, 58(4), 859-866. https://doi.org/10.3349/ymj.2017.58.4.859