{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:52:58Z","timestamp":1782924778420,"version":"3.54.5"},"reference-count":68,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Fatal self-poisoning with the herbicide paraquat has been reported for decades as an important toxicological and public health concern in several countries, including China and Sri Lanka, and regulatory bans have been associated with subsequent reductions in cases. It is now becoming an emerging toxicological problem in India and Bangladesh. Data were collected in 10 tertiary hospitals in Bangladesh, which serve more than 65% of the population. Data were collected both prospectively from patient files and retrospectively from hospital records. Annual paraquat import (use) data were obtained from the National Board of Revenue of Bangladesh. A total of 1,420 patients were reported across sites between 2013 and 2024, and 257 patients\u2019 data were available for analysis. A consistent upward trend was observed in the number of cases, increasing from a single case in 2013 to 493 cases reported across the 10 study sites in 2024. Common presentations included leg swelling from acute kidney failure (183\/257; 71.2%), vomiting (169\/257; 65.8%), and abdominal pain (149\/257; 58.0%). The case fatality rate was 43.2%, with a 95% CI (23.6\u201327.7). Markers of poor prognosis included male sex, large ingestion, fever, \u201cparaquat tongue,\u201d acute kidney failure, and a low Glasgow Coma Scale score. The case fatality rate of paraquat poisoning is far higher than that of poisoning with other pesticides in Bangladesh. Banning its use in agriculture and replacing it with less toxic substitutes is urgently needed to reduce mortality and morbidity.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0719","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T14:28:13Z","timestamp":1779200893000},"page":"176-182","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and Laboratory Profile of Paraquat Poisoning: A Toxicological Crisis in Bangladesh"],"prefix":"10.4269","volume":"115","author":[{"given":"Fazle Rabbi","family":"Chowdhury","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Bangladesh Medical University, Dhaka, Bangladesh;"},{"name":"Institute for Neuroscience and Cardiovascular Research, University of Edinburgh, Edinburgh, United Kingdom;"},{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tabiha Binte","family":"Hannan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Bangladesh Medical University, Dhaka, Bangladesh;"},{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abu Shahin Mohammed Mahbubur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Rajshahi Medical College Hospital, Rajshahi, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gourab","family":"Dewan","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Rangamati Medical College Hospital, Rangamati, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Mahfuzul","family":"Hoque","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Jahangir","family":"Kabir","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Rangpur Medical College Hospital, Rangpur, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. U. M. Wahid","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Manikganj Medical College Hospital, Manikganj, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah Abu","family":"Sayeed","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Chittagong Medical College Hospital, Chattogram, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pritish","family":"Tarafder","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Khulna Medical College Hospital, Khulna, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goutam Kumar","family":"Acherjya","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Jashore Medical College Hospital, Jashore, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujit Kumar","family":"Sarker","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Therapeutics, Dhaka Medical College, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah Al","family":"Marzan","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toma","family":"Mehedi","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Rajshahi Medical College Hospital, Rajshahi, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabila","family":"Zaman","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Rangpur Medical College Hospital, Rangpur, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syeda Sumaiya Ahmed","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Chittagong Medical College Hospital, Chattogram, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miah Mohammed","family":"Sakib","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Khulna Medical College Hospital, Khulna, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Al","family":"Amin","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah Rawha","family":"Abir","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Shaheed Ziaur Rahman Medical College Hospital, Bogra, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul Mahib","family":"Tanvir","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zakir","family":"Hassan","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suvodip","family":"Shaw","sequence":"additional","affiliation":[{"name":"Institute for Neuroscience and Cardiovascular Research, University of Edinburgh, Edinburgh, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Hezbullah","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Mahfuzer","family":"Rahman","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Rangpur Medical College Hospital, Rangpur, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Halimur","family":"Rashid","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Shaheed Ziaur Rahman Medical College Hospital, Bogra, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Shafiqul","family":"Bari","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shishir Ranjan","family":"Chakrabarty","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aniruddha","family":"Ghose","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Department of Medicine, Chittagong Medical College Hospital, Chattogram, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Robed","family":"Amin","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Non-communicable Disease Control Program, Directorate General of Health Services, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Eddleston","sequence":"additional","affiliation":[{"name":"Institute for Neuroscience and Cardiovascular Research, University of Edinburgh, Edinburgh, United Kingdom;"},{"name":"Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Abul","family":"Faiz","sequence":"additional","affiliation":[{"name":"Toxicology Society of Bangladesh, Chattogram, Bangladesh;"},{"name":"Dev Care Foundation, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"issue":"7","key":"b1","series-title":"Environ Sci Pollut Res 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Med","first-page":"e49","article-title":"Improvement in survival after paraquat ingestion following introduction of a new formulation in Sri Lanka","volume":"5","author":"Wilks","year":"2008"},{"issue":"6","key":"b6","series-title":"Lancet Glob Health","first-page":"e854","article-title":"Case fatality of agricultural pesticides after self-poisoning in Sri Lanka: A prospective cohort study","volume":"9","author":"Buckley","year":"2021"},{"issue":"1","key":"b7","series-title":"Clin Toxicol (Phila)","first-page":"29","article-title":"Dose ingested, vomiting, and outcome in patients ingesting a standard paraquat 20SL formulation","volume":"61","author":"Deuster","year":"2023"},{"key":"b8","series-title":"Hayes\u2019 Handbook of Pesticide Toxicology, 3rd Edition","first-page":"1771","author":"Lock","year":"2010"},{"issue":"11","key":"b9","series-title":"QJM","first-page":"809","article-title":"Prospects for treatment of paraquat-induced lung fibrosis with immunosuppressive drugs and the need for better prediction of outcome: A systematic review","volume":"96","author":"Eddleston","year":"2003"},{"issue":"1","key":"b10","series-title":"J Acute Med","first-page":"6","article-title":"Prediction of early mortality in patients with paraquat intoxication","volume":"3","author":"Liu","year":"2013"},{"issue":"2","key":"b11","series-title":"TAJ: J Teachers Assoc","first-page":"35","article-title":"Outcome of paraquat poisoning patients admitted in a tertiary hospital in Bangladesh","volume":"36","author":"Khan","year":"2023"},{"issue":"1","key":"b12","series-title":"BMC Public Health","first-page":"1441","article-title":"Importance of pesticides for lethal poisoning in India during 1999 to 2018: A systematic review","volume":"21","author":"Karunarathne","year":"2021"},{"issue":"1","key":"b13","series-title":"Toxicol Commun","first-page":"2272073","article-title":"Effectiveness of calcium channel blockade for organophosphorus and carbamate pesticide poisoning \u2013 Study protocol for an open label, pragmatic, 3-arm RCT repurposing two widely available medicines","volume":"7","author":"Chowdhury","year":"2023"},{"issue":"11","key":"b14","series-title":"J Korean Med Sci","first-page":"1441","article-title":"Diagnostic and therapeutic approach for acute paraquat intoxication","volume":"29","author":"Gil","year":"2014"},{"key":"b15","series-title":"Asia Pac J Med Toxicol","first-page":"74","article-title":"Medical management and outcome of paraquat poisoning in Ahvaz, Iran: A hospital-based study","volume":"4","author":"Rahmani","year":"2015"},{"key":"b16","series-title":"BMJ Case Rep","first-page":"bcr2014206581","article-title":"Paraquat tongue","volume":"2014","author":"Madhan","year":"2014"},{"issue":"9","key":"b17","series-title":"J Int Med Res","first-page":"4194","article-title":"Clinical features and risk factors of acute kidney injury in children with acute paraquat intoxication","volume":"47","author":"Song","year":"2019"},{"issue":"1","key":"b18","series-title":"PLoS One","first-page":"e0245363","article-title":"Association between liberal oxygen therapy and mortality in patients with paraquat poisoning: A multi-center retrospective cohort study","volume":"16","author":"Lin","year":"2021"},{"key":"b19","series-title":"J Pharm Policy Pract","first-page":"123","article-title":"Predicting mortality in paraquat poisoning through clinical findings, with a focus on pulmonary and cardiovascular system disorders","volume":"16","author":"Tajai","year":"2024"},{"issue":"4","key":"b20","series-title":"QJM","first-page":"251","article-title":"Prediction of outcome after paraquat poisoning by measurement of the plasma paraquat concentration","volume":"102","author":"Senarathna","year":"2009"},{"issue":"1","key":"b21","series-title":"PLoS One","first-page":"e87568","article-title":"Addition of immunosuppressive treatment to hemoperfusion is associated with improved survival after paraquat poisoning: A nationwide study","volume":"9","author":"Wu","year":"2014"},{"issue":"1","key":"b22","series-title":"Sci Rep","first-page":"2239","article-title":"Time-dependent haemoperfusion after acute paraquat poisoning","volume":"7","author":"Wang","year":"2017"},{"key":"b23","series-title":"Biomed Res Int","first-page":"8894180","article-title":"Identify the early predictor of mortality in patients with acute paraquat poisoning","volume":"2020","author":"Wang","year":"2020"},{"key":"b24","series-title":"Asia Pac J Med Toxicol","first-page":"141","article-title":"Mortality analysis of patients with paraquat poisoning treated at two university hospitals in Shiraz, Iran","volume":"2","author":"Goudarzi","year":"2014"},{"key":"b25","article-title":"EU Court Reimposes Ban on Paraquat Weedkiller.","year":"2007"},{"key":"b26","article-title":"PAN Vietnam Welcomes the Ban of Paraquat and 2,4-D.","year":"2017"},{"issue":"2","key":"b27","series-title":"Int J Epidemiol","first-page":"470","article-title":"Impact of paraquat regulation on suicide in South Korea","volume":"45","author":"Cha","year":"2016"},{"issue":"1","key":"b28","series-title":"Health Policy Plan","first-page":"56","article-title":"Policymaking \u2018under the radar\u2019: A case study of pesticide regulation to prevent intentional poisoning in Sri Lanka","volume":"30","author":"Pearson","year":"2015"},{"issue":"3","key":"b29","series-title":"Weed Sci","first-page":"208","article-title":"Paraquat: Toxicology and impacts of its ban on human health and agriculture","volume":"68","author":"Kim","year":"2020"},{"issue":"3","key":"b30","series-title":"PLoS One","first-page":"e0172893","article-title":"Suicide prevention through means restriction: Impact of the 2008\u20132011 pesticide restrictions on suicide in Sri Lanka","volume":"12","author":"Knipe","year":"2017"},{"issue":"1","key":"b31","series-title":"Clin Toxicol (Phila)","first-page":"131","article-title":"The early impact of paraquat ban on suicide in Taiwan","volume":"60","author":"Chang","year":"2022"},{"issue":"1","key":"b32","series-title":"Int J Epidemiol","first-page":"175","article-title":"Bans of WHO Class I Pesticides in Bangladesh\u2014Suicide prevention without hampering agricultural output","volume":"47","author":"Chowdhury","year":"2018"},{"issue":"1","key":"b33","series-title":"Agronomy","first-page":"126","article-title":"Challenges and alternatives of herbicide-based weed management","volume":"14","author":"Nath","year":"2024"},{"issue":"1","key":"b34","series-title":"BMC Public Health","first-page":"3089","article-title":"Paraquat at 63-the story of a controversial herbicide and its regulations: It is time to put people and public health first when regulating paraquat","volume":"25","author":"Utyasheva","year":"2025"},{"issue":"7","key":"b1","series-title":"Environ Sci Pollut Res Int","first-page":"16984","article-title":"Agriculture without paraquat is feasible without loss of 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introduction of a new formulation in Sri Lanka","volume":"5","author":"Wilks","year":"2008"},{"issue":"6","key":"b6","series-title":"Lancet Glob Health","first-page":"e854","article-title":"Case fatality of agricultural pesticides after self-poisoning in Sri Lanka: A prospective cohort study","volume":"9","author":"Buckley","year":"2021"},{"issue":"1","key":"b7","series-title":"Clin Toxicol (Phila)","first-page":"29","article-title":"Dose ingested, vomiting, and outcome in patients ingesting a standard paraquat 20SL formulation","volume":"61","author":"Deuster","year":"2023"},{"key":"b8","series-title":"Hayes\u2019 Handbook of Pesticide Toxicology, 3rd Edition","first-page":"1771","author":"Lock","year":"2010"},{"issue":"11","key":"b9","series-title":"QJM","first-page":"809","article-title":"Prospects for treatment of paraquat-induced lung fibrosis with immunosuppressive drugs and the need for better prediction of outcome: A systematic review","volume":"96","author":"Eddleston","year":"2003"},{"issue":"1","key":"b10","series-title":"J Acute Med","first-page":"6","article-title":"Prediction of early mortality in patients with paraquat intoxication","volume":"3","author":"Liu","year":"2013"},{"issue":"2","key":"b11","series-title":"TAJ: J Teachers Assoc","first-page":"35","article-title":"Outcome of paraquat poisoning patients admitted in a tertiary hospital in Bangladesh","volume":"36","author":"Khan","year":"2023"},{"issue":"1","key":"b12","series-title":"BMC Public Health","first-page":"1441","article-title":"Importance of pesticides for lethal poisoning in India during 1999 to 2018: A systematic review","volume":"21","author":"Karunarathne","year":"2021"},{"issue":"1","key":"b13","series-title":"Toxicol Commun","first-page":"2272073","article-title":"Effectiveness of calcium channel blockade for organophosphorus and carbamate pesticide poisoning \u2013 Study protocol for an open label, pragmatic, 3-arm RCT repurposing two widely available medicines","volume":"7","author":"Chowdhury","year":"2023"},{"issue":"11","key":"b14","series-title":"J Korean Med Sci","first-page":"1441","article-title":"Diagnostic and therapeutic approach for acute paraquat intoxication","volume":"29","author":"Gil","year":"2014"},{"key":"b15","series-title":"Asia Pac J Med Toxicol","first-page":"74","article-title":"Medical management and outcome of paraquat poisoning in Ahvaz, Iran: A hospital-based study","volume":"4","author":"Rahmani","year":"2015"},{"key":"b16","series-title":"BMJ Case Rep","first-page":"bcr2014206581","article-title":"Paraquat tongue","volume":"2014","author":"Madhan","year":"2014"},{"issue":"9","key":"b17","series-title":"J Int Med Res","first-page":"4194","article-title":"Clinical features and risk factors of acute kidney injury in children with acute paraquat intoxication","volume":"47","author":"Song","year":"2019"},{"issue":"1","key":"b18","series-title":"PLoS One","first-page":"e0245363","article-title":"Association between liberal oxygen therapy and mortality in patients with paraquat poisoning: A multi-center retrospective cohort study","volume":"16","author":"Lin","year":"2021"},{"key":"b19","series-title":"J Pharm Policy Pract","first-page":"123","article-title":"Predicting mortality in paraquat poisoning through clinical findings, with a focus on pulmonary and cardiovascular system disorders","volume":"16","author":"Tajai","year":"2024"},{"issue":"4","key":"b20","series-title":"QJM","first-page":"251","article-title":"Prediction of outcome after paraquat poisoning by measurement of the plasma paraquat concentration","volume":"102","author":"Senarathna","year":"2009"},{"issue":"1","key":"b21","series-title":"PLoS One","first-page":"e87568","article-title":"Addition of immunosuppressive treatment to hemoperfusion is associated with improved survival after paraquat poisoning: A nationwide study","volume":"9","author":"Wu","year":"2014"},{"issue":"1","key":"b22","series-title":"Sci Rep","first-page":"2239","article-title":"Time-dependent haemoperfusion after acute paraquat poisoning","volume":"7","author":"Wang","year":"2017"},{"key":"b23","series-title":"Biomed Res Int","first-page":"8894180","article-title":"Identify the early predictor of mortality in patients with acute paraquat poisoning","volume":"2020","author":"Wang","year":"2020"},{"key":"b24","series-title":"Asia Pac J Med Toxicol","first-page":"141","article-title":"Mortality analysis of patients with paraquat poisoning treated at two university hospitals in Shiraz, Iran","volume":"2","author":"Goudarzi","year":"2014"},{"key":"b25","article-title":"EU Court Reimposes Ban on Paraquat Weedkiller.","year":"2007"},{"key":"b26","article-title":"PAN Vietnam Welcomes the Ban of Paraquat and 2,4-D.","year":"2017"},{"issue":"2","key":"b27","series-title":"Int J Epidemiol","first-page":"470","article-title":"Impact of paraquat regulation on suicide in South Korea","volume":"45","author":"Cha","year":"2016"},{"issue":"1","key":"b28","series-title":"Health Policy Plan","first-page":"56","article-title":"Policymaking \u2018under the radar\u2019: A case study of pesticide regulation to prevent intentional poisoning in Sri Lanka","volume":"30","author":"Pearson","year":"2015"},{"issue":"3","key":"b29","series-title":"Weed Sci","first-page":"208","article-title":"Paraquat: Toxicology and impacts of its ban on human health and agriculture","volume":"68","author":"Kim","year":"2020"},{"issue":"3","key":"b30","series-title":"PLoS One","first-page":"e0172893","article-title":"Suicide prevention through means restriction: Impact of the 2008\u20132011 pesticide restrictions on suicide in Sri Lanka","volume":"12","author":"Knipe","year":"2017"},{"issue":"1","key":"b31","series-title":"Clin Toxicol (Phila)","first-page":"131","article-title":"The early impact of paraquat ban on suicide in 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