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Trends in pesticide suicide in South Korea, 1983–2014

  • Eun Shil Cha (a1), Shu-Sen Chang (a2), Yeongchull Choi (a3) and Won Jin Lee (a1)

Abstract

Aims

Self-poisoning using pesticides is among the major methods of suicide worldwide, and accounts for one-fifth of suicides in 2006–2010 in South Korea. We investigated long-term trends in pesticide suicide rates in South Korea and factors related to these trends.

Methods

We calculated age-standardised rates of pesticide suicide in South Korea (1983–2014) using registered death data. We used graphical approach and joinpoint regression analysis to examine secular trends in pesticide suicide by sex, age and area, and a time-series analysis to investigate association of pesticide suicide rate with socioeconomic and agriculture-related factors. Age, period and cohort effects were examined using the intrinsic estimator method.

Results

Age-standardised rate of pesticide suicide fluctuated between 1983 and 2000 before it markedly increased in 2000–2003 (annual percent change 29.7%), followed by a gradual fall (annual percent change −6.3%) in 2003–2011. Following the paraquat ban (2011–2012), there was a marked reduction (annual percent change −28.2%) in 2011–2014. Trend in pesticide suicide was associated with divorce rate but not with other factors studied. Declines in pesticide suicide in 2003–2011 were most noticeable in younger groups and metropolises; by contrast, elderly adults aged 70+ living in rural areas showed an upward trend until after the 2011–2012 paraquat ban, when it turned downward. In the age–period–cohort modelling, having been born between 1938 and 1947 was associated with higher pesticide suicide rates.

Conclusions

Pesticide suicide trend changed substantially in South Korea over the last three decades. Effective prevention should include close monitoring of trends and strong regulations of toxic pesticides.

Copyright

Corresponding author

Author for correspondence: Shu-Sen Chang, E-mail: shusenchang@ntu.edu.tw and Won Jin Lee, E-mail: leewj@korea.ac.kr

References

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Ahmad, OB, Boschi-Pinto, C, Lopez, AD, Murray, CJL, Lozano, R and Inoue, M (2001) Age standardization of rates: a new WHO standard. Available at http://www.who.int/healthinfo/paper31.pdf (Accessed 29 January 2019).
Ajdacic-Gross, V, Weiss, MG, Ring, M, Hepp, U, Bopp, M, Gutzwiller, F and Rossler, W (2008) Methods of suicide: international suicide patterns derived from the WHO mortality database. Bulletin of the World Health Organization 86, 726732.
Ben Park, BC and Lester, D (2006) Social integration and suicide in South Korea. Crisis 27, 4850.
Cha, ES, Khang, YH and Lee, WJ (2014 a) Mortality from and incidence of pesticide poisoning in South Korea: findings from National Death and Health Utilization Data between 2006 and 2010. PLoS ONE 9, e95299.
Cha, ES, Jeong, M and Lee, WJ (2014 b) Agricultural pesticide usage and prioritization in South Korea. Journal of Agromedicine 19, 281293.
Cha, ES, Chang, SS and Lee, WJ (2016 a) Potential underestimation of pesticide suicide and its impact on secular trends in South Korea, 1991–2012. Injury Prevention 22, 189194.
Cha, ES, Chang, SS, Gunnell, D, Eddleston, M, Khang, YH and Lee, WJ (2016 b) Impact of paraquat regulation on suicide in South Korea. International Journal of Epidemiology 45, 470479.
Chan, CH, Caine, ED, You, S, Fu, KW, Chang, SS and Yip, PS (2014) Suicide rates among working-age adults in South Korea before and after the 2008 economic crisis. Journal of Epidemiology and Community Health 68, 246252.
Chan, CH, Caine, ED, Chang, SS, Lee, WJ, Cha, ES and Yip, PS (2015) The impact of improving suicide death classification in South Korea: a comparison with Japan and Hong Kong. PLoS ONE 10, e0125730.
Chang, SS, Gunnell, D, Sterne, JA, Lu, TH and Cheng, AT (2009) Was the economic crisis 1997–1998 responsible for rising suicide rates in East/Southeast Asia? A time-trend analysis for Japan, Hong Kong, South Korea, Taiwan, Singapore and Thailand. Social Science & Medicine 68, 13221331.
Chang, SS, Sterne, JA, Lu, TH and Gunnell, D (2010) ‘Hidden’ suicides amongst deaths certified as undetermined intent, accident by pesticide poisoning and accident by suffocation in Taiwan. Social Psychiatry and Psychiatric Epidemiology 45, 143152.
Chang, SS, Lu, TH, Eddleston, M, Konradsen, F, Sterne, JA, Lin, JJ and Gunnell, D (2012 a) Factors associated with the decline in suicide by pesticide poisoning in Taiwan: a time trend analysis, 1987–2010. Clinical Toxicology 50, 471480.
Chang, SS, Lu, TH, Sterne, JA, Eddleston, M, Lin, JJ and Gunnell, D (2012 b) The impact of pesticide suicide on the geographic distribution of suicide in Taiwan: a spatial analysis. BMC Public Health 12, 260.
Choi, YR, Cha, ES, Chang, SS, Khang, YH and Lee, WJ (2014) Suicide from carbon monoxide poisoning in South Korea: 2006–2012. Journal of Affective Disorders 167, 322325.
Conner, KR, Phillips, MR, Meldrum, S, Knox, KL, Zhang, Y and Yang, G (2005) Low-planned suicides in China. Psychological Medicine 35, 11971204.
Eddleston, M, Karunaratne, A, Weerakoon, M, Kumarasinghe, S, Rajapakshe, M, Sheriff, MH, Buckley, NA and Gunnell, D (2006) Choice of poison for intentional self-poisoning in rural Sri Lanka. Clinical Toxicology 44, 283286.
Fu, KW and Chan, CH (2013) A study of the impact of thirteen celebrity suicides on subsequent suicide rates in South Korea from 2005 to 2009. PLoS ONE 8, e53870.
Girard, C (1993) Age, gender, and suicide: a cross-national analysis. American Sociological Review 58, 553574.
Gunnell, D, Eddleston, M, Phillips, MR and Konradsen, F (2007) The global distribution of fatal pesticide self-poisoning: systematic review. BMC Public Health 7, 357.
Gunnell, D, Knipe, D, Chang, SS, Pearson, M, Konradsen, F, Lee, WJ and Eddleston, M (2017) Prevention of suicide with regulations aimed at restricting access to highly hazardous pesticides: a systematic review of the international evidence. The Lancet Global Health 5, e1026e1037.
Hee Ahn, M, Park, S, Ha, K, Choi, SH and Hong, JP (2012) Gender ratio comparisons of the suicide rates and methods in Korea, Japan, Australia, and the United States. Journal of Affective Disorders 142, 161165.
Hong, J and Knapp, M (2014) Impact of macro-level socio-economic factors on rising suicide rates in South Korea: panel-data analysis in East Asia. The Journal of Mental Health Policy and Economics 17, 151162.
Jee, YH and Jo, H (2014) Trends of suicide rate over last 10-years in Korea, 2003–2012 [in Korean]. Journal of Health Informatics and Statistics 39, 132142.
Jeon, SY, Reither, EN and Masters, RK (2016) A population-based analysis of increasing rates of suicide mortality in Japan and South Korea, 1985–2010. BMC Public Health 16, 356.
Ji, NJ, Lee, WY, Noh, MS and Yip, PS (2014) The impact of indiscriminate media coverage of a celebrity suicide on a society with a high suicide rate: epidemiological findings on copycat suicides from South Korea. Journal of Affective Disorders 156, 5661.
Kim, HJ, Fay, MP, Feuer, EJ and Midthune, DN (2000) Permutation tests for joinpoint regression with applications to cancer rates. Statistics in Medicine 19, 335351.
Kim, MH, Jung-Choi, K, Jun, HJ and Kawachi, I (2010) Socioeconomic inequalities in suicidal ideation, parasuicides, and completed sucides in South Korea. Social Science & Medicine 70, 12541261.
Kim, SY, Kim, MH, Kawachi, I and Cho, Y (2011) Comparative epidemiology of suicide in South Korea and Japan: effects of age, gender and suicide methods. Crisis 32, 514.
Kim, B, Ahn, JH, Cha, B, Chung, YC, Ha, TH, Hong Jeong, S, Jung, HY, Ju, G, Kim, EY, Kim, JM, Kim, MD, Kim, MH, Kim, SI, Lee, KU, Lee, SH, Lee, SJ, Lee, YJ, Moon, E and Ahn, YM (2015) Characteristics of methods of suicide attempts in Korea: Korea National Suicide Survey (KNSS). Journal of Affective Disorders 188, 218225.
Knipe, DW, Metcalfe, C, Fernando, R, Pearson, M, Konradsen, F, Eddleston, M and Gunnell, D (2014) Suicide in Sri Lanka 1975–2012: age, period and cohort analysis of police and hospital data. BMC Public Health 14, 839.
Kong, Y and Zhang, J (2010) Access to farming pesticides and risk for suicide in Chinese rural young people. Psychiatry Research 179, 217221.
Korea Crop Protection Association (1993) History of 20 Years of Korea Crop Protection Association [in Korean]. Seoul: Korea Crop Protection Association.
Korea Crop Protection Association (2014) Agrochemical Year Book. Seoul: Korea Crop Protection Association.
Lee, JY (2008) Suicide in Korea: age, period, cohort analysis, 1983–2003 [in Korean]. Korean Journal of Sociology, 345368.
Lee, WJ, Cha, ES, Park, ES, Kong, KA, Yi, JH and Son, M (2009) Deaths from pesticide poisoning in South Korea: trends over 10 years. International Archives of Occupational and Environmental Health 82, 365371.
Lee, JW, Hwang, IW, Kim, JW, Moon, HJ, Kim, KH, Park, S, Gil, HW and Hong, SY (2015) Common pesticides used in suicide attempts following the 2012 paraquat ban in Korea. Journal of Korean Medical Science 30, 15171521.
Lim, D, Ha, M and Song, I (2014) Trends in the leading causes of death in Korea, 1983–2012. Journal of Korean Medical Science 29, 15971603.
Mew, EJ, Padmanathan, P, Konradsen, F, Eddleston, M, Chang, SS, Phillips, MR and Gunnell, D (2017) The global burden of fatal self-poisoning with pesticides 2006–15: systematic review. Journal of Affective Disorders 219, 93104.
Mishara, BL (2007) Prevention of deaths from intentional pesticide poisoning. Crisis 28, 1020.
Moon, JM, Chun, BJ and Cho, YS (2016) The characteristics of emergency department presentations related to acute herbicide or insecticide poisoning in South Korea between 2011 and 2014. Journal of Toxicology and Environmental Health. Part A 79, 466476.
Myung, W, Lee, GH, Won, HH, Fava, M, Mischoulon, D, Nyer, M, Kim, DK, Heo, JY and Jeon, HJ (2015) Paraquat prohibition and change in the suicide rate and methods in South Korea. PLoS ONE 10, e0128980.
OECD (2011) A Framework for Growth and Social Cohesion in Korea. Available at https://www.oecd.org/korea/48225033.pdf (Accessed 29 January 2019).
Park, C, Jee, YH and Jung, KJ (2016) Age-period-cohort analysis of the suicide rate in Korea. Journal of Affective Disorders 194, 1620.
Prais, SJ and Winsten, CB (1954) Trend estimators and serial correlation. Working paper 383, Cowles Commission. Available at http://cowles.econ.yale.edu/P/ccdp/st/s-0383.pdf (Accessed 29 January 2019).
Roh, BR (2013) Threatened self-concept and changes in the demographic structures of suicide in South Korea: a social psychological approach [in Korean]. Health and Social Welfare Review 33, 218244.
Rural Development Administration (2008) A Study on Establishment of Management System of Pesticide Poisoning [in Korean]. Suwon: Rural Development Administration.
Rural Development Administration (2013) The Management of Pesticide Use and Purchase for Non-Business Purpose [in Korean]. Suwon: Rural Development Administration.
Seok, SJ, Gil, HW, Jeong, DS, Yang, JO, Lee, EY and Hong, SY (2009) Paraquat intoxication in subjects who attempt suicide: why they chose paraquat. The Korean Journal of Internal Medicine 24, 247251.
Statistics Korea (2016) Causes of Death Statistics. Report on Statistical Information [in Korean]. Available at http://kostat.go.kr/portal/korea/kor_pi/11/1/index.action (Accessed 29 January 2019).
World Health Organization (2014) Preventing Suicide: A Global Imperative. Available at http://www.who.int/mental_health/suicide-prevention/world_report_2014/en (Accessed 29 January 2019).
Wu, KC, Chen, YY and Yip, PS (2012) Suicide methods in Asia: implications in suicide prevention. International Journal of Environmental Research and Public Health 9, 11351158.
Yang, Y, Wenjiang, JF and Kenneth, CL (2004) A methodological comparison of age- period- cohort models: the intrinsic estimator and conventional generalized linear models. Sociological Methodology 34, 75110.

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