台灣南投地區2008年至2012年農藥中毒自殺死亡案例分析

The Analysis of Fatal Pesticide Self-poisoning in Nantou County, Taiwan, 2008-2012

鄭兆峰(Chao-Fung Cheng)

指導教授 ： 孫家棟

國立臺灣大學/醫學院/法醫學研究所/碩士(2014年)

https://doi.org/10.6342/NTU.2014.00006

摘要

台灣自殺方式明顯存有城鄉之間的差距，都會地區大多以燒炭為主，而鄉村地區則以農藥自殺為大宗。以全台統計，農藥自殺為所有自殺方式第三位。南投是以農業經濟為主的縣市，統計發現從2008年至2012年間以農藥自殺占總自殺案件數30.99%，相較其他自殺方式為最多者，足見農藥自殺在法醫實務中之重要性，因此本研究收集上述地區及時間範圍內以農藥自殺者共143例，按照個人因素、農藥因素、環境因素逐項分析,發現以男性(69.2％)、職業為務農者(62.2%)以及大於45歲中老年族群(74.9%)為主。所使用的農藥以巴拉刈(37.1%)，氨基甲酸鹽 (25.2%)，有機磷殺蟲劑 (16.8%)為前三位。農藥自殺事件發生時大多會在現場遺留農藥(86.7%)，並且多發生在室內(67.8%)，家中原有存放農藥比例較高(65.7%)。另外以農藥種類與住院天數、屍體各項表徵進行費雪精確性檢定，發現住院天數、瞳孔大小、屍體表面農藥染色、鞏膜黃疸變化在統計上有顯著相關(p<0.05)。由於台灣對於農藥的販售管制並不嚴謹，取得農藥容易，因而成為主要的自殺方式之一，因此，因農藥造成的相關死亡問題，成為法醫實務上重要的課題，希望藉由本篇研究，能清楚描繪出農藥自殺死亡的基本樣態，希對未來法醫實務上之使用有所幫助。

關鍵字

台灣 ； 自殺 ； 農藥中毒

並列摘要

In Taiwan, the means of suicide significantly vary between urban and rural area. The most common mean in urban is charcoal burn, while in rural is pesticide-ingested. Previous study showed that suicide with pesticide is the third of all suicidal deaths in Taiwan. In Nantou, an agricultural-economic county, we collected 143 case of pesticide-ingested from 2008 to 2012, which is the most means of all (30.99%). In this study, we analyzed the factors related self-poisoning with pesticide, including hosts, the kinds of pesticides and circumstance. Most cases occurred among male (69.25), farmer (62.2%) and larger than 45 years old people (74.9%). Compared all kinds of pesticides for self-poisoning, the most common pesticide is paraquat (37.1%), followed by carbamate (25.2%) and organophosphate (16.8%). In 124(86.7%) cases, the pesticide had been found in the scene, and the most of scene was inside the house (67.8%). In 94(65.7%) cases, the pesticide had been stored either inside or outside the house. In addition, among the kinds of pesticide, the pesticide related sign and admission days were assessed by Fisher’s exact test. We found that admission days, pupil size, related stain on corpse and sclera icterus vary significantly with different kinds of pesticide (p<0.05). In Taiwan, because of convenient access to pesticide, pesticide ingestion becomes a major of means of suicide. From the study, we sketch the findings of the pesticide ingestion. We hope those results will give some help in future forensic practice.

並列關鍵字

Taiwan ； suicide ； pesticide poisoning

參考文獻

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