Effects of a provincial ban of two toxic organophosphorus insecticides on pesticide poisoning hospital admissions

Figures & data

Fig. 1. (A) Map showing study districts (Anu: Anuradhapura, Polo: Polonnaruwa; source: Wikimedia Commons, http://en.wikipedia.org/wiki/File:Sri_Lanka_North_Central_ Province_locator_map.svg); (B) One of the public meetings with pesticide sellers showing staff from both Provincial Department of Agriculture and Provincial Ministry of Health; (C) Study doctor and agriculture instructor visiting a pesticide shop; (D) Schema of study design. (See colour version of this figure online).

Fig. 2. Polonnaruwa District showing the seven administrative divisions, district health care facilities, and pesticide shops in January 2005. Shops are marked in black where neither dimethoate nor fenthion was stocked, green or red where fenthion or dimethoate were stocked, respectively, and grey where access to the shop could not be obtained. Agriculture in the poorly populated Mahaweli B area (Welikanda and Dimbulagala divisions) was not under the jurisdiction of the Dept of Agriculture and continued to use the insecticides. The Mahaweli river national park, where agriculture is banned, is marked in dark green. Abbreviations: DH, district hospital; GH, general hospital; PU, peripheral unit; RH rural hospital. (See colour version of this figure online).

Table 1. Number of pesticides shops in Polonnaruwa District visited, with details of their dimethoate and fenthion stockings. Abbreviation: N/A, not available.

				Dimethoate		Fenthion
Period	Total number of shops	Number visited	Number of first visits	Number of shops	Total number of bottles	Number of shops	Total number of bottles
May 2004	160	115	115	19	N/A	13	N/A
Dec 2004	206	188	49	4	52	8	84
Aug 2005	218	158	11	1	1	6	116
Dec 2005	223	111	7	1	4	3	4
Jun 2006	227	179	4	0	0	1	5

Fig. 3. Admissions to hospital with dimethoate or fenthion poisoning (A) or case fatality for pesticide poisoning (B) by quarter in Anuradhapura (red circles) and Polonnaruwa (blue squares) district general hospitals. (See colour version of this figure online).

Table 2. Case fatality for pesticide poisoning in Anuradhapura and Polonnaruwa district general hospitals before the ban and after the one year wash-out period.

	Jul 02–Jun 03	Jul 04–Jun 06	Odds Ratio
Anuradhapura (control)	66/583 (11.3%)	213/2003 (10.6%)	0.93 (95% CI 0.70–1.25)
Polonnaruwa (intervention)	50/348 (14.4%)	106/1182 (9.0%)	0.59 (95% CI 0.41–0.84)

Fig. 4. Admissions to hospital (A, B) and case fatality for poisoning (C, D) with insecticide (green), herbicide (blue), unknown pesticide (purple), and any pesticide (red squares) in Polonnaruwa (A, C) and Anuradhapura (B, D) district general hospitals from June 2002 until June 2008. (See colour version of this figure online).