Agricultural and horticultural pesticides fatal poisoning; the Jordanian experience 1999-2002

A prospective autopsy study addressing fatal poisoning with agricultural and horticultural pesticides was undertaken in Jordan over a 4 year period. A total number of 140 deaths occurred during 1999-2002. The mean fatality rate was 0.68 case per 100,000 population and the age range was 2-55 years; mean 28.3 years with male to female ratio 1.03. The largest number of cases occurred in those 20-29 years (n=69, 49.3%) followed by the age group 30-39 years (n=34, 24.3%) and 40-49 years (n=17, 12.1%). Less than 3.0% of the total fatal poisoning was noticed in both children younger than 9 years of age and those in the age group 50-59 years, with no fatal poisoning in adults at the age 60 years and above. At least 64.3% of all pesticide fatalities were due to suicide with male: female ratio (1.37:1). Accidental and homicide poisoning resulted in 24.3% and 7.9% of the total fatalities, respectively; however, only five cases 3.6% of fatal poisoning were due to unknown pesticides. The main pesticide used was carbamates with 110 cases 78.6% followed by organophosphorus 23 cases 16.4%. The study showed that the present legislation on pesticides availability in Jordan failed to reduce the number of fatal pesticides poisoning since the number of fatal pesticides poisoning was increased from 25.3 to 35 cases per year over a 20 years period. Enforcement of a new legislation addressing the availability of agricultural and horticultural pesticides for self-harm, especially carbamates and organophosphorus, is the most important strategy in the long term to prevent fatal pesticides poisoning in Jordan.