Investigating pesticide-related deaths admitted to Salt River mortuary in Cape Town, South Africa: a retrospective, descriptive analysis

Master Thesis


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Pesticide-related poisonings place a burden on the public health system in low- and middleincome countries. Notification of pesticide poisonings and deaths is a legal requirement in South Africa, however, our understanding of the prevalence and type of pesticides involved in poisoning cases remains limited. This is further complicated by the emergence of ‘street pesticides', which are unlabelled and illegally sold toxic pesticides. It is important to understand the role of these and other pesticides in local poisonings, and mortuary data provides an important resource to be able to investigate pesticide-related mortality specifically. This study aimed to build on previous research conducted at the Salt River mortuary (SRM) by expanding and updating our understanding of pesticide-related fatalities within the West Metropole of Cape Town. A retrospective, cross-sectional review of all unnatural death cases admitted to the SRM between January 2016 and December 2019 (inclusive) was conducted so as to identify pesticide-related deaths for further investigation. A total of 15 761 cases were admitted to SRM over the 4-year study period (mean: 3941 cases per annum). From this total, 92 cases (0.58%) were identified as pesticide related. Most decedents were male (59.8%), with the cohort's mean age being 26.2 years (range: 2 months to 66 years). The majority of cases were suicides (60.8%), and terbufos (an organophosphate) was detected in 50 cases (54.3%). Pesticiderelated fatalities were found to predominately occur in lower socio-economic areas. According to the data adults and adolescents are most at risk of being exposed to the harmful effects of these harmful compounds. Using a holistic approach to investigating pesticide-related fatalities could provide important clues that assist in gaining a better understanding of the factors that influence pesticide-related incidents. Combined efforts from healthcare practitioners and forensic investigators could help inform policy-makers on ways to minimise the use or distribution of pesticide compounds.