Format

Send to

Choose Destination
Yonsei Med J. 2017 Jul;58(4):859-866. doi: 10.3349/ymj.2017.58.4.859.

Effects of Paraquat Ban on Herbicide Poisoning-Related Mortality.

Author information

1
Department of Emergency Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea.
2
Department of Emergency Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea. emstar@yuhs.ac.
3
Department of Emergency Medicine, College of Medicine, Chosun University, Gwangju, Korea.
4
Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Korea.
5
Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
6
Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
7
Department of Emergency Medicine, Konyang University College of Medicine, Daejeon, Korea.
8
Department of Emergency Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
9
Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea.
10
Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Ilsan, Korea.
11
Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju, Korea.
12
Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon, Korea.
13
Department of Emergency Medicine, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon, Korea.
14
Department of Emergency Medicine, Inje University Haeundae Paik Hospital, Busan, Korea.
15
Department of Emergency Medicine, College of Medicine, Korea University Hospital, Seoul, Korea.
16
Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea.
17
Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Korea.
18
Department of Research Affairs, Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea.

Abstract

PURPOSE:

In Korea, registration of paraquat-containing herbicides was canceled in November 2011, and sales thereof were completely banned in November 2012. We evaluated the effect of the paraquat ban on the epidemiology and mortality of herbicide-induced poisoning.

MATERIALS AND METHODS:

This retrospective study analyzed patients treated for herbicide poisoning at 17 emergency departments in South Korea between January 2010 and December 2014. The overall and paraquat mortality rates were compared pre- and post-ban. Factors associated with herbicide mortality were evaluated using logistic analysis. To determine if there were any changes in the mortality rates before and after the paraquat sales ban and the time point of any such significant changes in mortality, R software, version 3.0.3 (package, bcp) was used to perform a Bayesian change point analysis.

RESULTS:

We enrolled 2257 patients treated for herbicide poisoning (paraquat=46.8%). The overall and paraquat poisoning mortality rates were 40.6% and 73.0%, respectively. The decreased paraquat poisoning mortality rate (before, 75% vs. after, 67%, p=0.014) might be associated with increased intentionality. The multivariable logistic analysis revealed the paraquat ban as an independent predictor that decreased herbicide poisoning mortality (p=0.035). There were two major change points in herbicide mortality rates, approximately 3 months after the initial paraquat ban and 1 year after complete sales ban.

CONCLUSION:

This study suggests that the paraquat ban decreased intentional herbicide ingestion and contributed to lowering herbicide poisoning-associated mortality. The change point analysis suggests a certain timeframe was required for the manifestation of regulatory measures outcomes.

KEYWORDS:

Poisoning; herbicides; mortality; paraquat

PMID:
28541002
PMCID:
PMC5447120
DOI:
10.3349/ymj.2017.58.4.859
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Yonsei University College of Medicine Icon for PubMed Central
Loading ...
Support Center