Proceedings of the Asia regional workshop on the

Poisonings in occupationally exposed persons are usually associated with contract spray
operator groups or farmers carrying out prolonged spray operations under hot humid conditions,
without adequate personal protection. Recent poisoning data revealed >80 percent <strong>of</strong> poisonings
caused by pesticides to be due to willful ingestion <strong>of</strong> pesticides for self-harm (Ref. Police Data on
Suicides, 1998; Annual Poisoning Reports 1990-1996, National Poison Information Center). In
1979, out <strong>of</strong> all pesticide poisonings recorded, 73 percent were suicidal attempts with unintentional
poisonings accounted for occupational exposure and accidental exposure incidences reported to be
16 percent and 7 percent, respectively (Jeyaratnam, et al., 1982). Though <strong>the</strong> use <strong>of</strong> highly hazardous
pesticide formulations (WHO hazard class Ib), such as monocrotophos 60 percent SL,
methamidophos 60 percent SL, endosulfan 35 percent EC, carbosulfan 20 percent EC, etc., have
been restricted or banned, poisoning was considered severe based on percentage <strong>of</strong> persons affected
and recurrent <strong>of</strong> episodes.
Many examples worldwide have shown that restricting <strong>the</strong> availability <strong>of</strong> toxic pesticides can
reduce death rates from self-harm. WHO has suggested that death rates could be reduced by
restricting <strong>the</strong> availability <strong>of</strong> poisons commonly used for self-harm (WHO, 2001). For example,
a national ban on <strong>the</strong> organophosphate parathion reduced <strong>the</strong> total number <strong>of</strong> deaths reported to
a poison center in Rosario, Argentina during <strong>the</strong> 1990s. (Piola et al., 2001) As shown in <strong>the</strong> Table 3,
it is possible to speculate that while <strong>the</strong> total deaths due to pesticides from 1983 through 1990
remains more or less stable, <strong>the</strong> death caused by organochlorines became gradually decreased,
basically due to <strong>the</strong> restrictions and banning <strong>of</strong> some <strong>of</strong> <strong>the</strong> organochlorine candidates during that
specified period.
A case study conducted at <strong>the</strong> Anuradhapura hospital showed that due to recent ban <strong>of</strong>
endosulfan products (35 percent EC formulations <strong>of</strong> WHO hazard class Ib) in Sri Lanka (<strong>the</strong> last
member <strong>of</strong> organochlorine pesticide) in 1998, <strong>the</strong> number <strong>of</strong> deaths <strong>of</strong> endosulfan poisoning fell
quickly from 50 in 1998 to 3 in 2001 along with a fall in <strong>the</strong> total number <strong>of</strong> pesticide deaths
(Roberts et al., 2003). The overall reduction on total death rates amidst <strong>the</strong> rising incidence <strong>of</strong>
self-poisoning due to pesticides from 1998 through 2001 (Table 4) would have been due to
displacement <strong>of</strong> a poisoning candidate (viz. endosulfan) which has a higher Case Fatality Rate (CFR)
(42 percent) than that <strong>of</strong> common organophosphates (29 percent) concluded <strong>the</strong> beneficial impacts <strong>of</strong>
pesticide regulation on deaths from poisoning in Sri Lanka (Roberts et al., 2003).
Table 3. Total pesticide poisoning episodes during 1983-1990
Pesticide Category 1983 1984 1985 1986 1988 1989 1990
Organochlorines 269 319 105 170 95 88 94
Organophosphates/Carbamates 900 931 1 052 1 022 1 190 987 1 069
O<strong>the</strong>r Pesticides 352 209 282 260 239 – –
Total 1 521 1 459 1 439 1 452 1 524 – –
Source: Ministry <strong>of</strong> Health Statistics Division Personal Communication, Pr<strong>of</strong>. Ravindra Fernando, University <strong>of</strong>
Colombo, Department <strong>of</strong> Forensic Medicine, Colombo.
Table 4. Total pesticide poisoning episodes during 1996-2002
Category 1996 1997 1998 1999 2000 2001 2002
Admissions 21 129 19 286 21 429 19 996 20 326 19 081 17 364
Deaths 1 852 2 121 2 250 1 847 1 843 1 717 1 437
Source: Annual Poisoning Data, National Poison Information Center, Colombo.
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