We investigated the association between suicide and pesticide exposure in a community-based cohort study.
We performed a longitudinal analysis of 6333 who participated in the initial survey of the Korean Genome and Epidemiology Study. Data were collected using a questionnaire to assess the prevalence of suicide. We calculated the hazard ratios (HRs) for suicide by pesticide exposure using the Cox proportional hazard model.
After adjusting for variables, participants exposed to pesticides had a 1.88-fold increased risk of suicide (HR, 1.88; 95% confidence interval [CI], 1.11 to 3.16) than those who were not exposed. Study populations with greater pesticide use (HR, 2.42; 95% CI, 1.27 to 4.60) and pesticide addiction had the highest suicide rates (HR, 1.91; 95% CI, 1.03 to 3.56).
Pesticide exposure for suicide should be considered during the development and implementation of suicide prevention in rural area.
Department of Preventive Medicine (Ms Jung, Dr Chang, Dr Kim, Dr Koh); Department of Psychiatry (Dr Min); National Academy of Agricultural Science, Rural Development Administration, Jeonju (Dr Lee); and Institute of Genomic Cohort (Dr Koh, Dr Choi), Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
Address correspondence to: Sang Baek Koh, MD, PhD, Department of Preventive Medicine, Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwon-do, 26426, Republic of Korea (firstname.lastname@example.org); Jung Ran Choi, PhD, Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwon-do, 26426, Republic of Korea (email@example.com).
J.R.C. is co-corresponding author.
Clinical Significance: Several pesticides, especially organophosphates, are neurotoxic and have been associated with increased psychiatric problems, particularly depression. These problems could contribute to the occurrence of suicide among exposed workers. In a community-based cohort study, the frequency of pesticide use and addiction status were associated with a higher risk of suicide. The association with suicide was stronger among individuals with previous pesticide exposures than those with no such reported experiences. Furthermore, positive associations between suicide and addiction of pesticide use were noted among individuals exposed to pesticides after adjusting for socioeconomic status in the Korean elderly. Pesticide exposure for suicide should be considered during the development and implementation of suicide prevention program in rural area. This study provides further evidence to support that the restricting access to highly toxic pesticides decreases suicide rates.
This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) and funded by the Ministry of Education (2017R1D1A3B03034119). This work was carried out with the support of “Cooperative Research Program for Agriculture Science & Technology Development (project no. PJ01250901)” Rural Development Administration, Republic of Korea. This research was supported by the Medical Research Center Program 2017R1A5A2015369. This work was supported (in part) by the Yonsei University Research Fund of 2017.
Conflict of Interest: None declared.