Pesticide Poisoning
Conditions
Keywords
Pesticide poisoning, Suicide, Unintentional poisoning, Prevention, Cluster randomised controlled trial
Brief summary
A major global public health priority is to identify effective methods for preventing deaths from pesticide self-poisoning. The aim of this work is to determine whether the provision of lockable storage containers to poor households in rural Asia can reduce the incidence of intentional pesticide self-poisoning. Secondary questions include the effect of these containers on unintentional pesticide poisoning in children and overall self-harm.
Detailed description
We will set up a large community-based, cluster randomised controlled trial of 162 villages (mean adult population 900) in rural Sri Lanka to determine the effectiveness and cost of the provision of safe storage containers to prevent pesticide poisoning. The study will be based in Anuradhapura District where we have carried out public health studies of pesticide poisoning since 2002. 81 intervention and 81 control villages will be recruited. Randomisation will be clustered, with villages rather than households randomised. A census will be performed at baseline and after 3 years to establish the population demographics and number of person-years exposed. The primary outcome will be the incidence of pesticide self-poisoning; secondary outcomes will be the incidence of all self-poisoning, all self-harm, fatal self-harm, pesticide poisoning and unintentional paediatric pesticide poisoning. We will use Poisson regression models, taking account of clustering and stratification, for the analysis. The study will provide definitive evidence concerning the cost-effectiveness of this approach that will determine whether it should be promoted across Asia.
Interventions
DEVICEUltraviolet light-resistant plastic in-ground pesticide storage container
In-ground pesticide storage container to be supplied to every household that uses pesticides in intervention villages
Sponsors
University of Bristol
University of Oxford
University of Peradeniya
University of Kelaniya
University of Copenhagen
University of Edinburgh
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Any village in the study area that gives consent to the study
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Pesticide Self-poisoning | For three years after intervention | Cases identified by survey of local and referral hospitals and by regular interview of primary informants in each village |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of All Self-poisoning | For three years post-intervention | Cases of self-poisoning identified |
| Incidence of All Self-harm | For three years after intervention | — |
| Incidence of Fatal Self-harm | For three years post intervention | — |
| Incidence of Pesticide Poisoning | For three years post intervention | — |
| Incidence of Unintentional Paediatric Pesticide Poisoning | For three years post intervention | — |
Countries
Sri Lanka
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Storage Container Ultraviolet light resistant plastic in-ground pesticide storage container
Ultraviolet light-resistant plastic in-ground pesticide storage container: In-ground pesticide storage container to be supplied to every household that uses pesticides in intervention villages | 114,168 |
| Control | 109,693 |
| Total | 223,861 |
Baseline characteristics
| Characteristic | Storage Container | Control | Total |
|---|---|---|---|
| Age, Customized Number >14 years | 87751 Participants | 84469 Participants | 172220 Participants |
| Race/Ethnicity, Customized Sri Lankan | 114168 Participants | 109693 Participants | 223861 Participants |
| Region of Enrollment Sri Lanka | 114168 participants | 109693 participants | 223861 participants |
| Sex/Gender, Customized Females >14 yrs | 44693 Participants | 43105 Participants | 87798 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 114,168 | 0 / 109,693 |
| serious Total, serious adverse events | 0 / 114,168 | 0 / 109,693 |
Outcome results
Primary
Incidence of Pesticide Self-poisoning
Cases identified by survey of local and referral hospitals and by regular interview of primary informants in each village
Time frame: For three years after intervention
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Storage Container | Incidence of Pesticide Self-poisoning | 611 Participants |
| Control | Incidence of Pesticide Self-poisoning | 641 Participants |
Secondary
Incidence of All Self-harm
Time frame: For three years after intervention
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Storage Container | Incidence of All Self-harm | 1217 Participants |
| Control | Incidence of All Self-harm | 1220 Participants |
Secondary
Incidence of All Self-poisoning
Cases of self-poisoning identified
Time frame: For three years post-intervention
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Storage Container | Incidence of All Self-poisoning | 1155 Participants |
| Control | Incidence of All Self-poisoning | 1173 Participants |
Secondary
Incidence of Fatal Self-harm
Time frame: For three years post intervention
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Storage Container | Incidence of Fatal Self-harm | 82 Participants |
| Control | Incidence of Fatal Self-harm | 67 Participants |
Secondary
Incidence of Pesticide Poisoning
Time frame: For three years post intervention
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Storage Container | Incidence of Pesticide Poisoning | 633 Participants |
| Control | Incidence of Pesticide Poisoning | 662 Participants |
Secondary
Incidence of Unintentional Paediatric Pesticide Poisoning
Time frame: For three years post intervention
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Storage Container | Incidence of Unintentional Paediatric Pesticide Poisoning | 18 Participants |
| Control | Incidence of Unintentional Paediatric Pesticide Poisoning | 15 Participants |