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.