Longer-term impact of pesticide bans on suicide in South Korea

INTRODUCTION: Pesticide self-poisoning accounts for 14%-20% of global suicides. South Korea banned paraquat and eight insecticides commonly involved in suicide in 2011-2012. We investigated the longer-term (2013-2019) impact of the pesticide bans on reducing suicides in South Korea. METHODS: Suicide data by sex, age, area and method among people aged 15 years or above were extracted from registered death data (1997-2019). Data for suicide by self-poisoning using different categories of pesticides (herbicides and fungicides; insecticides; rodenticides and other pesticides; and unspecified pesticides) were also extracted. Segmented regression analyses were used to estimate step (level) changes in pesticide suicide rate in 2012 (ie, the intervention period) and 2013-2019 (ie, the post-intervention period) as well as the slope (trend) changes in pesticide suicide trends in 2013-2019 (vs the 2003-2011 pre-intervention period). RESULTS: The bans on paraquat and eight insecticides (2011-2012) were followed by a 15% reduction in pesticide suicide rates in 2012 and a further 36% reduction in 2013, accompanied by an additional 6% annual decline in trend in 2013-2019 versus 2003-2011, with an estimated 8353 pesticide suicides averted (2012-2019). The reduction was mainly found in males, older people aged 70+ and rural populations. The greatest impact was found in suicides involving herbicides and fungicides (including paraquat) and insecticides across the categories of pesticides. No evidence was found for a shift to other poisoning suicides or an impact on agricultural yields of the pesticide bans. CONCLUSION: South Korea's pesticide bans in 2011-2012 were followed by a sustained decrease in pesticide suicides in the 7-year period (2013-2019) after their implementation. National policies restricting or banning highly hazardous pesticides commonly involved in self-poisoning can prevent many suicide deaths over a sustained period. Additional regulatory efforts could further reduce these unnecessary premature deaths.