Dr. Manjula Weerasinghe

Thesis summary

Ingestion of pesticides is one of the three most common means of suicide globally. In South Asia, up to every 1 in 5 individuals who ingest pesticides for self-poisoning purchased them from a shop immediately prior to the event. The study was aimed to examine risk factors associated with purchases and to develop an intervention that has the potential to be effective in reducing access to pesticide from shops for self-poisoning.

Two distinguishing risk factors of patients buying pesticides for self-poisoning were identified; alcohol intoxicated males were over 36 times and non-farmers over 13 times more likely to intentionally ingest pesticides than legitimate customers. Individuals who are intoxicated with alcohol and/or non-farmers represent three fourth of high-risk individuals. We discussed with local stakeholders four potential interventions to reduce the risk of self-poisoning directly from shops: 1) farmer identification (ID) cards; 2) prescriptions; 3) cooling-off periods; and 4) ‘gatekeeper’ training of pesticide vendors to prevent sale to customers at high-risk of self-poisoning. Nearly all local stakeholders supported focused training of pesticide vendors. A pilot training program was developed, and vendors were trained to check for intoxication, and to ask questions to which only farmers would know the responses to. Results suggested that this program was widely supported by the vendors and had an important effect on the knowledge and behavior of the vendors.

This study suggests that restricting pesticide sales to non-farmers and alcohol intoxicated persons in regions with high rates of self-poisoning via ‘gatekeeper’ training has the potential to reduce the self-poisoning attempts with pesticides. A large-scale study of the effectiveness and sustainability of this approach is needed. If effective, it could contribute to saving many lives each year. 

List of Publications from the PhD

Weerasinghe, M., Konradsen, F., Eddleston, M., Pearson, M., Jayamanne, S., Gunnell, D., Hawton, K. and Agampodi, S., 2018. Potential interventions for preventing pesticide self-poisoning by restricting access through vendors in Sri Lanka: A study of stakeholders’ views. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 39(6), p.479.

Weerasinghe, M., Konradsen, F., Eddleston, M., Pearson, M., Jayamanne, S., Gunnell, D., Hawton, K. and Agampodi, S., 2018. Vendor-based restrictions on pesticide sales to prevent pesticide self-poisoning-a pilot study. BMC public health, 18(1), p.272.

Weerasinghe, M., Konradsen, F., Eddleston, M., Pearson, M., Gunnell, D., Hawton, K., Jayamanne, S., Pabasara, C., Jayathilaka, T., Dissanayaka, K. and Rajapaksha, S., 2015. Risk factors associated with purchasing pesticide from shops for self-poisoning: a protocol for a population-based case–control study. BMJ open, 5(5), p.e007822.

Weerasinghe, M., Pearson, M., Peiris, R., Dawson, A.H., Eddleston, M., Jayamanne, S., Agampodi, S. and Konradsen, F., 2014. The role of private pesticide vendors in preventing access to pesticides for self-poisoning in rural Sri Lanka. Injury prevention, 20(2), pp.134-137.