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

Effects of Paraquat Ban on Herbicide Poisoning-Related Mortality

• Ko DR
• Chung SP
• You JS
• Cho S
• Park Y
• Chun B
• Moon J
• Kim H
• Kim YH
• Kim HJ
• Lee KW
• Choi S
• Park J
• Park JS
• Kim SW
• Seo JY
• Park HY
• Kim SJ
• Kang H
• Hong DY
• Hong JH

• KMID: 2419095
• DOI: http://doi.org/10.3349/ymj.2017.58.4.859

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.

Keyword

Poisoning; herbicides; paraquat; mortality

MeSH Terms

Bayes Theorem
Demography
Female
Geography
Herbicides/*poisoning
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Paraquat/*poisoning
Poisoning/*mortality
Republic of Korea
Herbicides
Paraquat

Figure

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  Fig. 1 Regions of participating hospitals and number of enrolled patients.

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  Fig. 2 Changes in number of deaths due to herbicide poisoning.

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  Fig. 3 Bayesian change point analysis of herbicide mortality. Posterior mean is trend line of herbicide mortality, posterior probability of change reflects change in herbicide mortality. (A) Production ban and (B) distribution ban.

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