Suicide in Sri Lanka 1975-2012: age, period and cohort analysis of police and hospital data
Duleeka Knipe,Duleeka Knipe,Chris Metcalfe,Ravindra Fernando,Ravindra Fernando,Melissa Pearson,Melissa Pearson,Flemming Konradsen,Flemming Konradsen,Michael Eddleston,Michael Eddleston,David Gunnell,David Gunnell +12 more
TLDR
The introduction of pesticide regulations in Sri Lanka coincides with a reduction in suicide rates, with evidence of limited method substitution.Abstract:
Sri Lanka has experienced major changes in its suicide rates since the 1970s, and in 1995 it had one of the highest rates in the world. Subsequent reductions in Sri Lanka’s suicide rates have been attributed to the introduction of restrictions on the availability of highly toxic pesticides. We investigate these changes in suicide rates in relation to age, gender, method specific trends and birth-cohort and period effects, with the aim of informing preventative strategies. Secular trends of suicide in relation to age, sex, method, birth-cohort and period effects were investigated graphically using police data (1975–2012). Poisoning case-fatality was investigated using national hospital admission data (2004–2010). There were marked changes to the age-, gender- and method-specific incidence of suicide over the study period. Year on year declines in rates began in 17–25 year olds in the early 1980s. Reduction in older age groups followed and falls in all age groups occurred after all class I (the most toxic) pesticides were banned. Distinct changes in the age/gender pattern of suicide are observed: in the 1980s suicide rates were highest in 21–35 year old men; by the 2000s, this pattern had reversed with a stepwise increase in male rates with increasing age. Throughout the study period female rates were highest in 17–25 year olds. There has been a rise in suicide by hanging, though this rise is relatively small in relation to the marked decline in self-poisoning deaths. The patterns of suicides are more consistent with a period rather than birth-cohort effect. The epidemiology of suicide in Sri Lanka has changed noticeably in the last 30 years. The introduction of pesticide regulations in Sri Lanka coincides with a reduction in suicide rates, with evidence of limited method substitution.read more
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Preventing disease through healthy environments: a global assessment of the burden of disease from environmental risks
TL;DR: The main message emerging from this new comprehensive global assessment is that premature death and disease can be prevented through healthier environments – and to a significant degree.
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Prevention of suicide with regulations aimed at restricting access to highly hazardous pesticides: a systematic review of the international evidence.
David Gunnell,David Gunnell,David Gunnell,Duleeka Knipe,Duleeka Knipe,Shu-Sen Chang,Melissa Pearson,Melissa Pearson,Flemming Konradsen,Flemming Konradsen,Won Jin Lee,Michael Eddleston,Michael Eddleston +12 more
TL;DR: A systematic review of the evidence of the effectiveness of pesticide regulation in reducing the incidence of pesticide suicides and overall suicides was carried out by as discussed by the authors, where the authors searched MEDLINE, PsycINFO, and Embase for studies published between Jan 1, 1960, and Dec 31, 2016, which investigated the effect of national or regional bans, and sales or import restrictions, on the availability of one or more pesticides and incidence of suicide in different countries.
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Suicide prevention through means restriction: Impact of the 2008-2011 pesticide restrictions on suicide in Sri Lanka.
Duleeka Knipe,Shu-Sen Chang,Andrew H. Dawson,Michael Eddleston,Fleming Konradsen,Chris Metcalfe,David Gunnell +6 more
TL;DR: Bans of paraquat, dimethoate and fenthion in Sri Lanka were associated with a reduction in pesticide suicide mortality and in overall suicide mortality despite a small rise in other methods, providing further evidence for the effectiveness of pesticide regulation in limiting the availability of highly hazardous pesticides and thereby reducing the number of global suicides.
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Conflict, forced displacement and health in Sri Lanka: a review of the research landscape
TL;DR: It is contended that Sri Lanka’s post-conflict research landscape requires exploration of individual, community and health system resilience, to provide better evidence for health programs and interventions after 26 years of conflict.
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Toxicology of organophosphorus compounds in view of an increasing terrorist threat
TL;DR: The authors' societies may face new, up to now disregarded, threats by toxic OP which calls for increased awareness and appropriate preparedness of military and civilian CBRN defense, a broader approach for new physical and medical countermeasures and an integrated system of effective detection, decontamination, physical protection and treatment.
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