METHODS: Data were collected from an East (Bintulu) and a West (Ipoh) Malaysian hospital medical records in 2015-2021 and 2018-2021, respectively. Logistic regression analyses were conducted to investigate the association of aspects such as socio-demographic and clinical characteristics, paraquat ban with the types of pesticides involved (paraquat versus non-paraquat versus unknown) ,and the outcomes (fatal versus non-fatal).

RESULTS: From the study sample of 212 pesticide poisoning patients aged 15 years or above, the majority were self-poisoning cases (75.5%) with a disproportionate over-representation of Indian ethnic minority (44.8%). Most pesticide poisoning cases had socio-environmental stressors (62.30%). The commonest stressors were domestic interpersonal conflicts (61.36%). 42.15% of pesticide poisoning survivors had a psychiatric diagnosis. Paraquat poisoning accounted for 31.6% of all patients and 66.7% of fatalities. Case fatality was positively associated with male gender, current suicidal intent, and paraquat poisoning. After the paraquat ban, the proportion of pesticide poisoning cases using paraquat decreased from 35.8 to 24.0%, and the overall case-fatality dropped slightly from 21.2 to 17.3%.

SETTING: Pesticide poisoning database of Malaysia National Poison Centre (NPC) from 2006 to 2015.

PARTICIPANTS: Telephone enquiries regarding pesticide poisoning were made by healthcare professionals. Information received by the NPC was entered into a retrievable database of standardised Poison Case Report Form, as adapted from the World Health Organization (WHO).

OUTCOMES: The outcome of the study is to provide an overview of national epidemiological profile of pesticide poisoning. High-risk groups of people and their circumstances were also identified to ensure that appropriate measures are strategised.

RESULTS: Within the study period, a total of 11 087 pesticide poisoning cases were recorded. Sixty per cent of these cases were intentional in nature and most were found among male individuals (57%) of the Indian race (36.4%) aged between 20 and 29 years (25.5%), which occurred at home (90%) through the route of ingestion (94%). The highest number of poisoning was due to herbicides (44%) followed by agricultural insecticides (34%), rodenticides (9.9%), household insecticides (9.5%) and fungicides (0.5%). In addition, 93.6% of intentional pesticide poisoning cases were caused by suicide attempts. The results of this study show that there was an increasing trend in pesticide poisoning incidents over the 10-year duration. This indicates that pesticide poisoning is a prevalent public health problem in Malaysia, resulting in an average incidence rate of 3.8 per 100 000 population.

OBJECTIVES: This study aims to assess workers' lifetime occupational pesticide exposure and examine the relationship with neurobehavioral health.

METHODS: A cross-sectional study was conducted on 158 pesticide-exposed and 176 non-exposed workers. To collect historical exposure and job tasks, a questionnaire and an occupational history interview were used. Pesticide exposure was measured in a subgroup of workers via inhalation and skin contact. The total pesticide intake of each worker was assessed using inhalation and dermal exposure models. CANTAB® computerised neurobehavioral performance assessments were used.

RESULTS: The participants' mean age was 31 (8) years. Pirimiphos-methyl (median = 0.569 mg/m3, Interquartile range [IQR] = 0.151, 0.574) and permethrin (median = 0.136 mg/m3, IQR = 0.116, 0.157) had the highest measured personal inhalation concentrations during thermal spraying. The estimated total lifetime pesticide intake for exposed workers ranged from 0.006 g to 12800 g (median = 379 g and IQR = 131, 794 g). Dermal exposure was the predominant route of pesticide intake for all workers. Compared to controls, workers with high lifetime pesticide intake had lower Match to Sample Visual (adjusted B = -1.4, 95% Confidence Interval (CI) = -2.6, 0.1), Spatial Recognition Memory (adjusted B = -3.3, 95% CI = -5.8, 0.8), Spatial Span (SSP) (adjusted B = -0.6, 95% CI = -0.9, 0.3) scores. Workers with low pesticide intake performed worse than controls (adjusted B = -0.5, 95% CI = -0.8, -0.2) in the SSP test, but scored higher in the Motor Screening test (adjusted B = 0.9, 95% CI = 0.1, 1.6). Higher Paired Associates Learning test scores were observed among higher (adjusted B = 7.4, 95% CI = 2.3, 12.4) and lower (adjusted B = 8.1, 95% CI = 3, 13.2) pesticide intake groups. There was no significant difference between the Reaction Time and Pattern Recognition Memory tests with lifetime pesticide intake after adjusting for confounders.

METHODS: We searched 13 electronic databases and Google scholar, conducted citation searching and a review of reference lists to find studies which investigated the relationship of alcohol with clinical outcome of pesticide self-poisoning in different countries. Thirteen studies, including 11 case series/reports and two cohort studies were considered for inclusion.

RESULTS: Meta-analysis showed that alcohol co-ingestion in pesticide self-poisoning was associated with increased risk of death [odds ratio (OR) 4.9, 95% confidence interval (CI) 2.9-8.2 P<0.0001] and that alcohol co-ingested group required intubation eight times more often than non-co-ingested group in organophosphorus insecticide self-poisoning (OR 8.0, 95% CI 4.9-13.0 P<0.0001). Cases who co-ingested alcohol were older than non-alcohol group in two studies. One cohort study demonstrated that alcohol co-ingestion was associated with larger pesticide ingestions but did not itself affect the outcome.