The impact of pesticide suicide on the geographic distribution of suicide in Taiwan: a spatial analysis

• Main Authors: Chang Shu-Sen, Lu Tsung-Hsueh, Sterne Jonathan AC, Eddleston Michael, Lin Jin-Jia, Gunnell David
• Format: Article
• Language: English
• Published: BMC 2012-04-01
• Series: BMC Public Health
• Subjects: Suicide; Pesticide; Mapping; Ecological studies; Taiwan
• Online Access: http://www.biomedcentral.com/1471-2458/12/260

<p>Abstract</p> <p>Background</p> <p>Pesticide self-poisoning is the most commonly used suicide method worldwide, but few studies have investigated the national epidemiology of pesticide suicide in countries where it is a major public health problem. This study aims to investigate geographic variations in pesticide suicide and their impact on the spatial distribution of suicide in Taiwan.</p> <p>Methods</p> <p>Smoothed standardized mortality ratios for pesticide suicide (2002-2009) were mapped across Taiwan's 358 districts (median population aged 15 or above = 27 000), and their associations with the size of agricultural workforce were investigated using Bayesian hierarchical models.</p> <p>Results</p> <p>In 2002-2009 pesticide poisoning was the third most common suicide method in Taiwan, accounting for 13.6% (4913/36 110) of all suicides. Rates were higher in agricultural East and Central Taiwan and lower in major cities. Almost half (47%) of all pesticide suicides occurred in areas where only 13% of Taiwan's population lived. The geographic distribution of overall suicides was more similar to that of pesticide suicides than non-pesticide suicides. Rural-urban differences in suicide were mostly due to pesticide suicide. Areas where a higher proportion of people worked in agriculture showed higher pesticide suicide rates (adjusted rate ratio [ARR] per standard deviation increase in the proportion of agricultural workers = 1.58, 95% Credible Interval [CrI] 1.44-1.74) and overall suicide rates (ARR = 1.06, 95% CrI 1.03-1.10) but lower non-pesticide suicide rates (ARR = 0.91, 95% CrI 0.87-0.95).</p> <p>Conclusion</p> <p>Easy access to pesticides appears to influence the geographic distribution of suicide in Taiwan, highlighting the potential benefits of targeted prevention strategies such as restricting access to highly toxic pesticides.</p>