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.