Summary: | 碩士 === 國立成功大學 === 公共衛生研究所 === 97 === Background: Poisoning by pesticides is cause of death with the highest standardized mortality ratio in aboriginal areas in Taiwan. The new injury prevention concept suggests that an effective injury prevention measure could prevent injuries of all kinds of intents, such as unintentional (accident), intentional (suicide and homicide) and intent undetermined. Therefore, a category
of all-intents-combined should be included in the mortality tabulation list. However, there is no category of “pesticides” in intentional and intent unknown poisoning deaths in ICD-8 and ICD-9, which render the exact estimation of all-intents-combined pesticides deaths.
Objective: To compare the accidental and all-intents-combined pesticides mortality trends by different versions of ICD in Taiwan, aboriginal areas as a whole and individual aboriginal area.
Materials and methods: Cause of deaths mortality data from 1971 through 2007 extracted from Department of Health of Taiwan were used in this study. ICD-8 was used for 1971-1980, ICD-9 was used for 1981-2007 and ICD-10 was used for 1987, 1992, 1997, 2002-2007. I calculated pesticides poisoning standardized death rates (SDR) of Taiwan and the standardized mortality rate ratios (SMR) of aboriginal areas.
Results: The accidental pesticide poisoning SDR in 1991-1995 in Taiwan was 1.85 per 100,000 and decreased to 0.24 in 2001-2005, a 90.1% decrease. However, the all-intents-combined pesticide poisoning SDR was 4.88 and 4.12 in 1991-1995 and 2001-2005, which showed a 48.6% of decrease. The outcome had inferred that these two classification tabulation lists would offer different death trends. The accidental pesticide poisoning SMR in 1991-1995 in aboriginal areas was 7.30 and increased to 9.85 in 2001-2005, which showed an increasing trend. However, the combined-intent pesticide poisoning SMR presented a decreasing trend from 6.01 in 1991-1995 decreased to 4.08 2001-2005. The pattern of mortality trends calculated according to ICD-8 and ICD-9 did not differ very much from those according to ICD-10.
Conclusions: The pattern of mortality trends of accidental pesticides poisoning differed from those of all-intent-combined. The main reason resulted in the difference was the increase of suicide rates using pesticides. To have a better estimation the trends of mortality burden of pesticides poisoning it is needed to calculate the mortality of all-intent-combined.
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