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Effects of Paraquat Ban on Herbicide Poisoning-Related Mortality

Authors
Ko, Dong RyulChung, Sung PhilYou, Je SungCho, SoohyungPark, YongjinChun, ByeongjoMoon, JeongmiKim, HyunKim, Yong HwanKim, Hyun JinLee, Kyung-WooChoi, SangChunPark, JunseokPark, Jung SooKim, Seung WhanSeo, Jeong YeolPark, Ha YoungKim, Su JinKang, HyunggooHong, Dae YoungHong, Jung Hwa
Issue Date
7월-2017
Publisher
YONSEI UNIV COLL MEDICINE
Keywords
Poisoning; herbicides; paraquat; mortality
Citation
YONSEI MEDICAL JOURNAL, v.58, no.4, pp.859 - 866
Indexed
SCIE
SCOPUS
KCI
Journal Title
YONSEI MEDICAL JOURNAL
Volume
58
Number
4
Start Page
859
End Page
866
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/82993
DOI
10.3349/ymj.2017.58.4.859
ISSN
0513-5796
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.
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