Regulation of highly hazardous pesticides in India - implications for suicide prevention

Abstract Background: Pesticide self-poisoning is a common means of suicide in India. Banning highly hazardous pesticides from agricultural use has been successful in reducing total suicide numbers in several South Asian countries without affecting agricultural output. Here, we describe national and state-level regulation of highly hazardous pesticides and relate them to suicide rates across India. Methods: Information on pesticide regulation was collated from agriculture departments of central and state governments. National and state-level data on suicides for 1995 until 2015 was obtained from the National Crime Records Bureau (NCRB). We used joinpoint analysis and negative binomial regression to investigate the possible effects of pesticide bans on trends in suicide rates. Results: As of August 2019, 314 pesticides were registered for use in India, of which 18 were extremely (Class Ia) or highly (Class Ib) hazardous according to World Health Organization toxicity criteria. Despite many highly hazardous pesticides still being available, a number of bans have been implemented during the period studied. In our quantitative analyses we focussed on the permanent bans in Kerala in 2005 (of endosulfan) and 2011 (of 14 other pesticides); and nationally in 2011 (of endosulfan). NCRB data indicate that pesticides were used in 441,918 reported suicides in India from 1995-2015, 90.3% of which occurred in 11 of the 29 states. Time series analysis demonstrated statistical evidence of lower than expected rates of pesticide suicides and total suicides nationally after the 2011 endosulfan ban. In Kerala, there was a lower than expected rate of pesticide suicides but no change to the already decreasing trend in total suicides after both the 2005 ban of endosulfan and the 2011 ban of 14 pesticides. Discussion: Highly hazardous pesticides continue to be used in India, and pesticide suicide remains a serious public health problem. However, some bans of pesticides do appear to have impacted previous trends in the rates of both pesticide suicides and all suicides. Comprehensive national bans of highly hazardous pesticides could lead to a reduction in suicides across India, in addition to reduced occupational poisoning, with minimal effects on agricultural yield.

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Suicide by pesticide poisoning in India: a review of pesticide regulations and their impact on suicide trends

10.21203/rs.2.15477/v2 ◽

2019 ◽

Author(s):

Toby Bonvoisin ◽

Leah Utyasheva ◽

Duleeka Knipe ◽

David Gunnell ◽

Michael Eddleston

Keyword(s):

Negative Binomial ◽

Public Health Problem ◽

State Level ◽

Negative Binomial Regression ◽

World Health ◽

State Governments ◽

Suicide Rates ◽

Level Data ◽

Agricultural Yield ◽

Health Organization

Abstract Background Pesticide self-poisoning is a common means of suicide in India. Banning highly hazardous pesticides (HHPs) from agricultural use has been successful in reducing suicides in several Asian countries without affecting agricultural output. Here, we describe national and state-level regulation of HHPs and explore how they might relate to suicide rates across India.Methods Information on pesticide regulation was collated from agriculture departments of the central and state governments. National and state-level data on suicides from 1995 to 2015 were obtained from the National Crime Records Bureau (NCRB). We used joinpoint analysis and negative binomial regression to investigate any effects on trends in suicide rates nationally and in Kerala.Results As of October 2019, 318 pesticides were registered for use in India, of which 18 were extremely (Class Ia) or highly (Class Ib) hazardous according to World Health Organization criteria. Despite many HHPs still being available, several bans have been implemented during the period studied. In our quantitative analyses we focused on the permanent bans in Kerala in 2005 (of endosulfan) and 2011 (of 14 other pesticides); and nationally in 2011 (of endosulfan). NCRB data indicate that pesticides were used in 441,918 reported suicides in India from 1995-2015, 90.3% of which occurred in 11 of the 29 states. There was statistical evidence of lower than expected rates of pesticide suicides (rate ratio [RR] 0.52, 95% CI 0.49-0.54) and total suicides nationally by 2014 (0.90, 0.87-0.93) after the 2011 endosulfan ban. In Kerala, there was a lower than expected pesticide suicide rate (0.45, 0.42-0.49), but no change to the already decreasing trend in total suicides after the 2011 ban of 14 pesticides. The 2005 ban on endosulfan showed a similar effect. Agricultural outputs continued growing following the bans.Discussion Highly hazardous pesticides continue to be used in India and pesticide suicide remains a serious public health problem. However, some pesticide bans do appear to have impacted previous trends in the rates of both pesticide suicides and all suicides. Comprehensive national bans of HHPs could lead to a reduction in suicides across India, in addition to reduced occupational poisoning, with minimal effects on agricultural yield.

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Retracted: Analysis of the Strength of Legal Firearms Restrictions for Perpetrators of Domestic Violence and Their Associations With Intimate Partner Homicide

American Journal of Epidemiology ◽

10.1093/aje/kwx362 ◽

2017 ◽

Vol 187 (7) ◽

pp. 1449-1455 ◽

Cited By ~ 32

Author(s):

April M Zeoli ◽

Alexander McCourt ◽

Shani Buggs ◽

Shannon Frattaroli ◽

David Lilley ◽

...

Keyword(s):

Domestic Violence ◽

Fixed Effects ◽

Negative Binomial ◽

State Level ◽

Negative Binomial Regression ◽

Intimate Partner ◽

Restraining Order ◽

Level Data ◽

Binomial Regression ◽

Firearms Restrictions

Abstract In this research, we estimate the association of firearm restrictions for domestic violence offenders with intimate partner homicides (IPHs) on the basis of the strength of the policies. We posit that the association of firearm laws with IPHs depends on the following characteristics of the laws: 1) breadth of coverage of high-risk individuals and situations restricted; 2) power to compel firearm surrender or removal from persons prohibited from having firearms; and 3) systems of accountability that prevent those prohibited from doing so from obtaining guns. We conducted a quantitative policy evaluation using annual state-level data from 1980 through 2013 for 45 US states. Based on the results of a series of robust, negative binomial regression models with state fixed effects, domestic violence restraining order firearm-prohibition laws are associated with 10% reductions in IPH. Statistically significant protective associations were evident only when restraining order prohibitions covered dating partners (−11%) and ex parte orders (−12%). Laws prohibiting access to those convicted of nonspecific violent misdemeanors were associated with a 24% reduction in IPH rates; there was no association when prohibitions were limited to domestic violence. Permit-to-purchase laws were associated with 10% reductions in IPHs. These findings should inform policymakers considering laws to maximize protections against IPH.

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Suicide in Developing Countries (1)

Crisis ◽

10.1027/0227-5910.26.3.104 ◽

2005 ◽

Vol 26 (3) ◽

pp. 104-111 ◽

Cited By ~ 65

Author(s):

Lakshmi Vijayakumar ◽

K. Nagaraj ◽

Jane Pirkis ◽

Harvey Whiteford

Keyword(s):

Developing Countries ◽

Public Health Problem ◽

Data Availability ◽

World Health ◽

Global Public Health ◽

Socioeconomic Indicators ◽

Suicide Rates ◽

Country Level ◽

Education Levels ◽

Health Organization

Abstract. Objective. Suicide is a global public health problem, but relatively little epidemiological investigation of the phenomenon has occurred in developing countries. This paper aims to (1) examine the availability of rate data in developing countries, (2) provide a description of the frequency and distribution of suicide in those countries for which data are available, and (3) explore the relationship between country-level socioeconomic factors and suicide rates. It is accompanied by two companion papers that consider risk factors and preventive efforts associated with suicide in developing countries, respectively. Method. Using World Health Organization data, we calculated the average annual male, female, and total suicide rates during the 1990s for individual countries and regions (classified according to the Human Development Index [HDI]), and examined the association between a range of socioeconomic indicators and suicide rates. Results. For reasons of data availability, we concentrated on medium HDI countries. Suicide rates in these countries were variable. They were generally comparable with those in high HDI countries from the same region, with some exceptions. High education levels, high telephone density, and high per capita levels of cigarette consumption were associated with high suicide rates; high levels of inequality were associated with low suicide rates. Conclusion. Epidemiological investigations of this kind have the potential to inform suicide prevention efforts in developing countries, and should be encouraged.

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1960. Lost in Translation: Comparing Rates of Outpatient Antibiotic Use in Three Metrics

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz359.137 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S62-S63

Author(s):

Christopher Prestel ◽

Laura M King ◽

Monina Bartoces ◽

Melinda M Neuhauser ◽

Lauri Hicks ◽

...

Keyword(s):

Negative Binomial ◽

National Level ◽

Negative Binomial Regression ◽

Antibiotic Use ◽

World Health ◽

Oral Antibiotic ◽

Defined Daily Doses ◽

Days Of Therapy ◽

Health Organization ◽

Over Time

Abstract Background The Centers for Disease Control and Prevention (CDC) tracks US outpatient antibiotic use in prescriptions per 1000 persons (Rx/1000), while the World Health Organization uses defined daily doses per 1000 persons (DDD/1000), which are based on average adult dose, for global surveillance. A third metric, days of therapy (DOT)/1,000 persons, has not been previously evaluated at the national level. We aim to compare time trends in outpatient oral antibiotic use as Rx/1000, DDD/1000, and DOT/1,000 in the same data to inform ongoing CDC surveillance and facilitate international comparison. Methods We identified dispensed outpatient oral antibiotics using pharmacy claims in 2011–2016 IBM® MarketScan® Commercial Databases for individuals <65 years old. Using enrollment data, we calculated mean annual membership with drug coverage. Annual rates of outpatient oral antibiotic use were calculated for Rx/1000, DDD/1000, and DOT/1000 persons. Prescriptions written with a ratio of DDD to days supplied >10 were considered biologically implausible and excluded from DDD calculations. We examined trends for each metric from 2011 to 2016 using negative binomial regression. Results Annual numbers of outpatient oral antibiotic prescriptions ranged from 18.6 million to 30.0 million (mean 24.3 million). Overall, Rx/1000 decreased by 7% from 892 in 2011 to 829 in 2016 (Figure 1). From 2011 to 2016, DDD/1000 increased 2% from 23.8 to 24.2 while DOT/1000 decreased 9% from 25.4 to 23.1. Significant per-year decreases were found from 2011 to 2016 for Rx/1000 (−1.1%) and for DOT/1000 (−1.6%), while no significant per-year change was seen with DDD/1000 (table). DDD/1000 underestimate use in pediatrics under the age of 10 (Figure 2). Prolonged duration is seen in adolescents and reflected by DOT/1000. Conclusion Trends in DDD/1000 for population aged <65 years do not mirror trends in Rx/1000 and DOT/1000. These differences may reflect that Rx/1000 and DOT/1000 more accurately capture antibiotic prescriptions in children than DDD/1000. As DDD/1000 underestimate antibiotic use in children, DDD/1000 underestimates reduction in antibiotic use over time and may not accurately reflect changes in use over time. Disclosures All Authors: No reported Disclosures.

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The impact of surveillance and other factors on detection of emergent and circulating vaccine derived polioviruses

Gates Open Research ◽

10.12688/gatesopenres.13272.1 ◽

2021 ◽

Vol 5 ◽

pp. 94

Author(s):

Megan Auzenbergs ◽

Holly Fountain ◽

Grace Macklin ◽

Hil Lyons ◽

Kathleen M O'Reilly

Keyword(s):

Negative Binomial ◽

Oral Polio Vaccine ◽

Negative Binomial Regression ◽

Polio Eradication ◽

Outbreak Detection ◽

World Health ◽

Negative Binomial Regression Model ◽

Uncertainty Interval ◽

Health Organization ◽

The Impact

Background: Circulating vaccine derived poliovirus (cVDPV) outbreaks remain a threat to polio eradication. To reduce cases of polio from cVDPV of serotype 2, the serotype 2 component of the vaccine has been removed from the global vaccine supply, but outbreaks of cVDPV2 have continued. The objective of this work is to understand the factors associated with later detection in order to improve detection of these unwanted events. Methods: The number of nucleotide differences between each cVDPV outbreak and the oral polio vaccine (OPV) strain was used to approximate the time from emergence to detection. Only independent emergences were included in the analysis. Variables such as serotype, surveillance quality, and World Health Organization (WHO) region were tested in a negative binomial regression model to ascertain whether these variables were associated with higher nucleotide differences upon detection. Results: In total, 74 outbreaks were analysed from 24 countries between 2004 and 2019. For serotype 1 (n=10), the median time from seeding until outbreak detection was 284 (95% uncertainty interval (UI) 284-2008) days, for serotype 2 (n=59), 276 (95% UI 172-765) days, and for serotype 3 (n=5), 472 (95% UI 392-603) days. Significant improvement in the time to detection was found with increasing surveillance of non-polio acute flaccid paralysis (AFP) and adequate stool collection. Conclusions: cVDPVs remain a risk globally; all WHO regions have reported at least one VDPV outbreak since the first outbreak in 2001. Maintaining surveillance for poliomyelitis after local elimination is essential to quickly respond to both emergence of VDPVs and potential importations. Considerable variation in the time between emergence and detection of VDPVs were apparent, and other than surveillance quality and inclusion of environmental surveillance, the reasons for this remain unclear.

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Study of the efficacy of Pathadi Ghanavati with Lajamanda in the management of Aamatisara

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.4.3.2 ◽

2019 ◽

Vol 4 (03) ◽

Author(s):

Madhura Jadhav ◽

P. D. Londhe

Keyword(s):

Acute Diarrhoea ◽

Public Health Problem ◽

World Health ◽

Important Public Health Problem ◽

Loose Motion ◽

Economic Class ◽

Watery Stool ◽

Health Organization ◽

Effective Remedy ◽

Trial Drug

Acute Diarrhoea is an important public health problem worldwide. The World Health Organization estimates that there are more than 1000 million cases of Acute Diarrhoea. Loose motion less than 2 weeks that labelled as Acute Diarrhoea. Diarrhoea is described in Ayurvedic classics with the name of ‘Atisara’. It means passing of excessive flow of watery stool through anus. Most important factor in the pathogenesis of Aamatisara is Mandagni. In present study 50 patients of Aamatisara were selected from OPD and IPD of Kayachikitsa department. For the clinical study Pathadi Ghanavati and Lajamanda was selected as the trial drug which was given for the duration of 7 days in the dose of 1gm twice a day. It was observed that 32% patients were from the age group 51-60 years, 70% were females, 62% were from lower-middle socio economic class. Sama Jivha was found in all the patients. Among results loose motion showed 98.75% relief, 97.82% showed improvement in Udarashoola, 97.43% improvement in Agnimandya and Daurbalya each, 100% relief was seen in Aruchi. All the symptoms showed highly significant results. Hence it can be concluded that Pathadi Ghanavati and Lajamanda is very effective remedy in the patients of Aamatisara.

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Possible role of Unani Pharmacology in COVID-19 – a narrative review

Reviews on Environmental Health ◽

10.1515/reveh-2020-0106 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Md Anzar Alam ◽

Mohd Abdul Gani ◽

G. Shama ◽

Ghulamuddin Sofi ◽

Mohd Aleemuddin Quamri

Keyword(s):

Clinical Manifestations ◽

Public Health Problem ◽

World Health ◽

Santalum Album ◽

Boswellia Serrata ◽

Unani Medicine ◽

Significant Public Health Problem ◽

Significant Public Health ◽

Novel Coronavirus ◽

Health Organization

AbstractAccording to the World Health Organization (WHO), viral diseases continue to rise, and pose a significant public health problem. Novel coronavirus disease (COVID-19) is an infectious disease caused by SARS-CoV-2. The pathogenesis and clinical manifestations of COVID-19 is close to Amraz-e-Wabai (epidemic diseases) which was described by Hippocrates, Galen, Aristotle, Razes, Haly Abbas, Avicenna, Jurjani etc. Presently, there is no specific or challenging treatment available for COVID-19. Renowned Unani Scholars recommended during epidemic situation to stay at home, and fumigate the shelters with aromatics herbs like Ood kham (Aquilaria agallocha Roxb.), Kundur (Boswellia serrata Roxb), Kafoor (Cinnamomum camphora L.), Sandal (Santalum album L), Hing (Ferula foetida L.) etc. Use of specific Unani formulations are claimed effective for the management of such epidemic or pandemic situation like antidotes (Tiryaqe Wabai, Tiryaqe Arba, Tiryaqe Azam, Gile Armani), Herbal Decoction (Joshandah), along with Sharbate Khaksi, Habbe Bukhar, Sharbate Zanjabeel, Khamira Marwareed, Jawarish Jalinus, and Sirka (vinegar). Such drugs are claimed for use as antioxidant, immunomodulatory, cardiotonic, and general tonic actions. The study enumerates the literature regarding management of epidemics in Unani medicine and attempts to look the same in the perspective of COVID-19 prevention and management.

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Identification of determinants of healthy ageing in Italy: results from the national survey IDAGIT

Ageing and Society ◽

10.1017/s0144686x20001671 ◽

2020 ◽

pp. 1-21

Author(s):

Erika Guastafierro ◽

Ilaria Rocco ◽

Rui Quintas ◽

Barbara Corso ◽

Nadia Minicuci ◽

...

Keyword(s):

Neurological Diseases ◽

Public Health Problem ◽

The Elderly ◽

Factor Loading ◽

Healthy Ageing ◽

World Health ◽

Italian Population ◽

Social Environments ◽

Ageing Model ◽

Health Organization

Abstract Healthy ageing is a public health problem globally. In Europe, the dependency ratio of the elderly is expected to increase by 21.6 per cent to 51.2 per cent in 2070. The World Health Organization (WHO) study on healthy ageing started in 2002 as a concept whereby all people of all ages should be able to live in a healthy, safe and socially inclusive way. The aim of this study is to present preliminary results of the project Identification of Determinants of Healthy Ageing in Italy (IDAGIT) that aimed to collect data on the active and healthy ageing of the Italian population aged over 18 using the conceptual framework of the WHO's ageing model. To link the determinants of the IDAGIT studies to those of the WHO model, we performed a confirmatory factor analysis which reported these variables as significant (in order of factor loading): smoking, cognition score, comorbidity, outdoor built environment, participation, working expertise and income. Considering comorbidity, 83.8 per cent of the sample declared not having any chronic diseases or to have only one, and regarding neurological diseases, only nine people had received a diagnosis of stroke. Regarding gender, the personal determinants and physical and social environments did not result in statistically significant differences, whereas we found statistical differences between the aged groups in all variables analysed. These results provide a first bio-psycho-social perspective on ageing in the Italian population.

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Lung Cancer in Brazil

American Society of Clinical Oncology Educational Book ◽

10.14694/edbook_am.2012.32.185 ◽

2012 ◽

pp. 426-431

Author(s):

Gilberto Schwartsmann

Keyword(s):

Lung Cancer ◽

Cause Of Death ◽

Public Health Problem ◽

Lung Cancer Mortality ◽

World Health ◽

Cancer Type ◽

Positive Effects ◽

Incident Cancer ◽

Health Organization ◽

Tremendous Challenge

Overview: Cancer is now the second leading cause of death in Brazil (after cardiovascular diseases) and a public health problem, with around 500,000 new cases in 2012. Excluding nonmelanoma skin cancer, lung cancer is the second most incident cancer type in men, with 17,210 expected new cases. In women, it is the fifth most incident cancer, with 10,110 expected new cases. The estimated age-adjusted lung cancer mortality rate is about 13/100,000 for men and 5.4/100,000 for women. Lung cancer rates in men increased until the early 1990s and decreased thereafter, especially in the younger population. In contrast, a steady upward trend was observed for women. The positive effects in men were probably due to the successful anti-tobacco campaign conducted in Brazil over the last decades, which led to a decrease in the adult smoking population, from 32% in the early 1980s to 17% in the 2000s. Although the Brazilian National Cancer Institute is strongly committed to providing excellence in multimodality care to cancer patients, limitations in availability and adequate geographic distribution of specialists and well-equipped cancer centers are evident. Major disparities in patient access to proper staging and state-of-the-art treatment still exist. Considering that World Health Organization (WHO) officials estimate that cancer will become the number one cause of death in most developing countries, including Brazil, in the next decades, it is highly recommended for government authorities to implement firm actions to face this tremendous challenge.

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