Potential underestimation of pesticide suicide and its impact on secular trends in South Korea, 1991–2012

Eun Shil Cha, Shu Sen Chang, Won Jin Lee

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background Pesticide ingestion is among the most commonly used suicide methods globally. Underestimation of deaths by pesticide self-poisoning is thought to be common but under-researched. We investigated potential misclassification and underestimation of suicide by pesticide poisoning and their impact on trends in pesticide suicide in South Korea. Methods we compared sociodemographic profiles between deaths certified as suicide, undetermined deaths and injuries by poisoning using pesticides, unspecified chemicals and medicines/alcohol in South Korea (1991–2012), and calculated similarity scores. Joinpoint regression analysis was used to examine time trends. Results The profiles of deaths classified as pesticide suicides showed generally similar patterns to those for undetermined deaths/injuries by poisoning using pesticides and suicides/undetermined deaths/injuries by poisoning using unspecified chemicals. Over the study period, the number of pesticide suicides (on average 2033 per year; range 623–3530) would increase by 15%, 23% and 31%, when assuming that 20%, 30% and 40% of deaths in alternative cause-of-death categories were misclassified pesticide suicides respectively. Age-standardised rates of pesticide suicide increased more than four times in 1991–2003 but fell by around 50% in 2003–2012. This trend did not change when the assumed proportion of misclassification was 20%, whereas the rapid increase in 2000–2003 would be lessened if misclassification occurred by 30% or more. Conclusions Pesticide suicides may be underestimated in South Korea as some are possibly misclassified as deaths due to other causes; however, such underestimation would not substantially affect estimated secular trends.

Original languageEnglish
Pages (from-to)189-194
Number of pages6
JournalInjury Prevention
Volume22
Issue number3
DOIs
Publication statusPublished - 2016 Jun 1

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Republic of Korea
Pesticides
Suicide
Poisoning
Wounds and Injuries
Cause of Death
Eating
Regression Analysis
Alcohols
Medicine

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Potential underestimation of pesticide suicide and its impact on secular trends in South Korea, 1991–2012. / Cha, Eun Shil; Chang, Shu Sen; Lee, Won Jin.

In: Injury Prevention, Vol. 22, No. 3, 01.06.2016, p. 189-194.

Research output: Contribution to journalArticle

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abstract = "Background Pesticide ingestion is among the most commonly used suicide methods globally. Underestimation of deaths by pesticide self-poisoning is thought to be common but under-researched. We investigated potential misclassification and underestimation of suicide by pesticide poisoning and their impact on trends in pesticide suicide in South Korea. Methods we compared sociodemographic profiles between deaths certified as suicide, undetermined deaths and injuries by poisoning using pesticides, unspecified chemicals and medicines/alcohol in South Korea (1991–2012), and calculated similarity scores. Joinpoint regression analysis was used to examine time trends. Results The profiles of deaths classified as pesticide suicides showed generally similar patterns to those for undetermined deaths/injuries by poisoning using pesticides and suicides/undetermined deaths/injuries by poisoning using unspecified chemicals. Over the study period, the number of pesticide suicides (on average 2033 per year; range 623–3530) would increase by 15{\%}, 23{\%} and 31{\%}, when assuming that 20{\%}, 30{\%} and 40{\%} of deaths in alternative cause-of-death categories were misclassified pesticide suicides respectively. Age-standardised rates of pesticide suicide increased more than four times in 1991–2003 but fell by around 50{\%} in 2003–2012. This trend did not change when the assumed proportion of misclassification was 20{\%}, whereas the rapid increase in 2000–2003 would be lessened if misclassification occurred by 30{\%} or more. Conclusions Pesticide suicides may be underestimated in South Korea as some are possibly misclassified as deaths due to other causes; however, such underestimation would not substantially affect estimated secular trends.",
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N2 - Background Pesticide ingestion is among the most commonly used suicide methods globally. Underestimation of deaths by pesticide self-poisoning is thought to be common but under-researched. We investigated potential misclassification and underestimation of suicide by pesticide poisoning and their impact on trends in pesticide suicide in South Korea. Methods we compared sociodemographic profiles between deaths certified as suicide, undetermined deaths and injuries by poisoning using pesticides, unspecified chemicals and medicines/alcohol in South Korea (1991–2012), and calculated similarity scores. Joinpoint regression analysis was used to examine time trends. Results The profiles of deaths classified as pesticide suicides showed generally similar patterns to those for undetermined deaths/injuries by poisoning using pesticides and suicides/undetermined deaths/injuries by poisoning using unspecified chemicals. Over the study period, the number of pesticide suicides (on average 2033 per year; range 623–3530) would increase by 15%, 23% and 31%, when assuming that 20%, 30% and 40% of deaths in alternative cause-of-death categories were misclassified pesticide suicides respectively. Age-standardised rates of pesticide suicide increased more than four times in 1991–2003 but fell by around 50% in 2003–2012. This trend did not change when the assumed proportion of misclassification was 20%, whereas the rapid increase in 2000–2003 would be lessened if misclassification occurred by 30% or more. Conclusions Pesticide suicides may be underestimated in South Korea as some are possibly misclassified as deaths due to other causes; however, such underestimation would not substantially affect estimated secular trends.

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