title: Suicide and exposure to organophosphate insecticides: cause or effect?
abstract: BACKGROUND
  Suicide using pesticides as agent is recognized as a major cause of pesticide poisoning.
  
  
  METHODS
  A literature review of mortality and morbidity studies related to suicide among pesticide-exposed populations, and of human and animal studies of central nervous system toxicity related to organophosphate (OP) pesticides was performed.
  
  
  RESULTS
  Suicide rates are high in farming populations. Animal studies link OP exposure to serotonin disturbances in the central nervous system, which are implicated in depression and suicide in humans. Epidemiological studies conclude that acute and chronic OP exposure is associated with affective disorders. Case series and ecological studies also support a causal association between OP use and suicide.
  
  
  CONCLUSIONS
  OPs are not only agents for suicide. They may be part of the causal pathway. Emphasizing OPs solely as agents for suicide shifts responsibility for prevention to the individual, reducing corporate responsibility and limiting policy options available for control.
authors.affiliation: Occupational and Environmental Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. ll@cormack.uct.ac.za
authors.forename: L
authors.initials: L
authors.lastname: London
authors.forename: A J
authors.initials: AJ
authors.lastname: Flisher
authors.forename: C
authors.initials: C
authors.lastname: Wesseling
authors.forename: D
authors.initials: D
authors.lastname: Mergler
authors.forename: H
authors.initials: H
authors.lastname: Kromhout
mesh_terms: D000382:Agricultural Workers' Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control; D015984:Causality; D003866:Depressive Disorder / Q000139:chemically induced* / Q000453:epidemiology; D014943:Global Health; D006801:Humans; D007306:Insecticides / Q000009:adverse effects* / Q000506:poisoning; D062025:Organophosphate Poisoning; D010755:Organophosphates / Q000009:adverse effects*; D011640:Public Policy; D013405:Suicide / Q000706:statistics & numerical data*; D000092864:Suicide Prevention
chemical_list: D007306:Insecticides; D010755:Organophosphates