title: Community uptake of safe storage boxes to reduce self-poisoning from pesticides in rural Sri Lanka.
abstract: BACKGROUND
  Acute poisoning by agricultural pesticides is a well established global public health problem. Keeping pesticides under safe storage is now promoted as a potential way to reduce the number of severe poisoning cases. However, there have been no published studies documenting the feasibility of such an approach. Therefore, the objective of the study presented here was to determine community perceptions and use of in-house safe storage boxes for pesticides in rural Sri Lanka.
  
  
  METHODS
  Boxes with a lock, to be used for the in-house safe storage of pesticides, were distributed to 200 randomly selected farming households in two agricultural communities. A baseline survey determined pesticide storage practices and household characteristics prior to distribution. The selected households were encouraged to make use of the box at community meetings and during a single visit to each household one month after distribution. No further encouragement was offered. A follow-up survey assessed storage practices seven months into the project.
  
  
  RESULTS
  Following the distribution of the boxes the community identified a number of benefits including the protection of pesticide containers against exposure from the rain and sun and a reduced risk of theft. Data were analysed for 172 households that reported agricultural use of pesticides at follow-up. Of these, 141 (82%) kept pesticides in the house under lock against 3 (2%) at baseline. As expected, the distribution of boxes significantly reduced the number of households storing pesticides in the field, from 79 (46%) at baseline to 4 (2%) at follow-up. There was a significant increase in the number of households keeping pesticides safe from children between baseline (64%) and seven months after the distribution of boxes (89%). The same was true for adults although less pronounced with 51% at baseline and 66% at follow-up.
  
  
  CONCLUSIONS
  The farming community appreciated the storage boxes and made storage of pesticides safer, especially for children. It seems that additional, intensive promotion is needed to ensure that pesticide boxes are locked. The introduction of in-house safe storage boxes resulted in a shift of storage into the farmer's home and away from the field and this may increase the domestic risk of impulsive self-poisoning episodes. This increased risk needs attention in future safe storage promotion projects.
authors.affiliation: Department of International Health, University of Copenhagen, Øster Farimagsgade 5, Denmark. f.konradsen@pubhealth.ku.dk
authors.forename: Flemming
authors.initials: F
authors.lastname: Konradsen
authors.forename: Ravi
authors.initials: R
authors.lastname: Pieris
authors.forename: Manjula
authors.initials: M
authors.lastname: Weerasinghe
authors.forename: Wim
authors.initials: W
authors.lastname: van der Hoek
authors.forename: Michael
authors.initials: M
authors.lastname: Eddleston
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Dawson
mesh_terms: D000061:Accidents, Home / Q000517:prevention & control; D000328:Adult; D000383:Agriculture / Q000295:instrumentation*; D001294:Attitude to Health; D002648:Child; D003256:Community Participation; D004356:Drug Storage / Q000379:methods* / Q000706:statistics & numerical data; D006798:Housing / Q000592:standards*; D006801:Humans; D010575:Pesticides / Q000506:poisoning / Q000600:supply & distribution*; D011041:Poisoning / Q000453:epidemiology / Q000517:prevention & control; D012423:Rural Health; D012449:Safety; D012637:Security Measures / Q000706:statistics & numerical data*; D012938:Social Perception; D013188:Sri Lanka / Q000453:epidemiology; D013405:Suicide / Q000706:statistics & numerical data; D000092864:Suicide Prevention
chemical_list: D010575:Pesticides