2011—2020年农药中毒咨询病例特征分析及控制策略探讨

Characteristics of counseling cases related to pesticide poisoning from 2011 to 2020 and discussion on control strategies

目的 了解我国农药中毒咨询病例特征、农药中毒的毒物谱,探讨农药管理规定对农药中毒控制的影响,为农药中毒预防控制策略提供参考。方法 筛选2011—2020年全国农药中毒咨询病例数据,对时间、地区、农药中毒种类、性别和年龄情况等进行描述性分析,并分析政策对农药中毒的影响。结果 2011—2020年全国中毒咨询热线共收集农药中毒咨询病例16 683例,男女性别比1.28∶1,居于前5位的省份是河南(2 428例,占14.55%)、河北(1 635例,占9.80%)、山东(1 435例,占8.60%)、安徽(1 304例,占7.82%)、江苏(926例,占5.55%),农药中毒病例逐年下降,每年病例最多集中在5月份。杀虫剂引起的中毒为最多,有9 469例,占总病例数的56.76%;其次为除草剂中毒,中毒病例4 371例,占26.20%;杀菌剂中毒1 609例,占9.64%。因自服、误服、意外事件和职业接触4类主要原因而中毒的病例数为15 786例。自服中毒占比最高,有7 763例,占46.53%;其次为误服,有4 438例,占26.60%;职业接触2 850例,占17.08%。不同原因中毒病例男女性别分布差异有统计学意义(P <0.01),男性更多为职业接触,女性更多为自服。误服是6岁及以下婴幼儿最主要的中毒原因,男女性别比2.56∶1;自服中毒和职业接触中毒则是18岁以上成人主要的中毒原因。结论 农药中毒流行病学特征明显,剧毒高毒农药禁限用后,病例明显减少。政策干预对农药中毒控制效果显著,针对不同人群不同地区开展针对性预防控制措施以减少农药中毒的发生。

Objective To understand the characteristics of counseling cases related to pesticide poisoning, and the pesticide spectrum that caused poisoning, to explore the impact of pesticide management regulations on pesticide poisoning control,and to provide a reference for the prevention and control strategy of pesticide poisoning. Methods The data of national consultation cases of pesticide poisoning from 2011 to 2020 were collected, the counseling time, region, type of pesticide poisoning, gender and age distribution were analyzed, and the effects of policies on pesticide poisoning were discussed.Results There were a total of 16 683 counseling cases of pesticide poisoning from 2011 to 2020, with a gender ratio of1.28∶1, and the most cases were concentrated in May. The top five provinces for counseling cases were Henan(2 428, 14.55%),Hebei(1 635, 9.80%), Shandong(1 435, 8.60%), Anhui(1 304, 7.82%) and Jiangsu(926, 5.55%). The number of pesticide poisoning counseling cases decreased year over year. 9 469 poisoning cases were caused by insecticides(accounting for 56.76%), 4 371 cases were caused by herbicides(accounting for 26.20%), and 1 609 poisoning cases were caused by fungicides with low toxicity(accounting for 9.64%). Totally, 15 786 counseling cases were due to self-medication, misuse, accidents, and occupational exposure. The highest proportion of self-medication was in 7 763 cases,accounting for 46.53%, followed by misuse(4 438 cases, accounting for 26.60%) and occupational exposure(2 850 cases accounting for 17.08%). There was a statistical difference of poisoning causes between men and women( P < 0.01), men were more affected by occupational exposure and women were more affected by self-medication. Misuse was the most common cause for the infants aged 6 years and below, with a sex ratio of 2.56 ∶1, while self-medication and occupational exposure were the main causes for adults over 18 years old. Conclusions The characteristics of counseling cases related to pesticide poisoning were obvious. The number of counseling cases has been significantly reduced since the use of(extremely) toxic pesticides has been banned or restricted. Policy intervention has a significant effect on the control of pesticide poisoning, and targeted prevention and control measures should be continuously taken in different populations and regions to reduce the occurrence of pesticide poisoning.