Professor Michael Eddleston's research to prevent deaths from poisoning. Professor Michael Eddleston leads a number of research projects and initiatives to prevent deaths from poisoning. Much of this work is focused on low and middle-income countries, mainly in South Asia, where pesticide poisoning is a particular problem. It has involved performing observational studies and clinical trials in rural district hospitals to better understand the natural history of poisoning and the pharmacology and effectiveness of antidotes. This hospital-based work has been complemented by community-based controlled trials to identify effective public health interventions. Building on a proposal to prevent deaths through pesticide regulation, published in 2002, over the last six years he has worked closely with national pesticide regulators, the World Health Organization and the Food and Agriculture Organization to support global regulation of highly toxic pesticides. As shown by Sri Lanka’s example, where the overall suicide rate dropped by 70%, this approach is highly effective at rapidly bringing down deaths. More recently, he has begun to work on the drug death crisis hitting Scotland, looking for novel pre-hospital antidotes and better ways to diagnose unconscious patients. For this work he has been awarded the Royal College of Physicians of Edinburgh's Cullen Gold Medal for the ‘Greatest Benefit to the Practice of Medicine’ in 2017 and named on Vox's inaugural Future Perfect 50 list, 2022. All this research forms part of Edinburgh Clinical Toxicology - a partnership between the University of Edinburgh, NHS Lothian, and the UK National Poisons Information Service - Edinburgh unit. Professor Michael Eddleston Research Profile Edinburgh Clinical Toxicology Projects & Initiatives Centre for Pesticide Suicide Prevention (CPSP) Image A global research and policy initiative dedicated to preventing deaths from pesticide self-poisoning. Pesticide ingestion is one of the most common methods of suicides worldwide, responsible for an estimated 14 million deaths since the Green Revolution in the 1960s. The majority of these deaths occur in agricultural communities in low and middle-income countries where people have easy access to lethal pesticides. The most effective way to save lives is to ban acutely toxic highly hazardous pesticides. This is an approach recommended by the United Nations, including the World Health Organization and the Food and Agriculture Organization. The Centre for Pesticide Suicide Prevention works in countries where pesticide self-poisoning is a recognised and significant health problem. It works in partnership with national policy-makers, along with international organizations, supporting reforms to ban lethal pesticides. Centre for Pesticide Suicide Prevention website NIHR RIGHT4: Preventing Deaths from Acute Poisoning in Low-and Middle-Income Countries Image An international research programme that aims to improve diagnosis, treatment and knowledge of acute poisoning in low and middle-income countries (LMIC). Acute poisoning is a long-neglected issue that results in thousands of unnecessary deaths every year. The research programme aims to prevent deaths by developing new knowledge, diagnostics, treatments, informed policies and capacity. The work will directly benefit countries involved in the research, including Bangladesh, Sri Lanka, and India. The project comprises 5 work packages focused on methanol, pesticides, guidance, research capacity, and poison information centres. It also includes an academic training programme (the Global Academy for Clinical Toxicology) to develop and train the clinical toxicology researchers of the future. It is funded by the NIHR Research and Innovation for Global Health Transformation (RIGHT) programme. Key partners include the South Asian Clinical Toxicology Research Collaboration, Toxicology Society of Bangladesh and Postgraduate Institute of Medical Education and Research, Chandigarh. NIHR RIGHT4: Preventing Deaths from Acute Poisoning in LMIC website Effectiveness of Calcium Channel Blockade for OP and Carbamate Pesticide Poisoning (CCBOC) Image A large-scale randomised controlled clinical trial in Bangladesh, exploring new treatments for patients with organophosphorus (OP) or carbonate poisoning, in partnership with the Toxicology Society of Bangladesh. Organophosphorus and carbamate insecticides are responsible for around two thirds of pesticide poisoning deaths across the world. Current treatments do not always work and, despite thousands of studies and millions of deaths, no new treatments have been introduced in 50 years. Previous studies have suggested that calcium channel blocking medicines [CCB] or magnesium may help to reduce the pesticides’ effects and prevent deaths. However, there is no clear information on whether these medicines work. This study hopes to determine whetehr these relatively cheap, widely available treatments can help treat patients poisoned by these anticholinesterase insecticides. It is funded by the Joint Global Health Trials initiative, a collaboration between MRC, Wellcome Trust, DFID and NIHR. If successful, the study will result in the first new treatment for these forms of poisoning for 50 years. Project overview on Toxicology Society of Bangladesh website Cluster RCT to Determine whether Pesticide Vendor Training Reduces Pesticide Self-poisoning in Rural Asia Image A large-scale randomised controlled study testing whether pesticide vendor training is an effective way to reduce pesticide self-poisoning in rural Asia, in partnership with the Rajarata University of Sri Lanka and South Asian Clinical Toxicology Research Collaboration. The project involves delivering training to shopkeepers to help them identify people at risk of drinking pesticides, so that they do not sell to them. The vendors are taught how to observe customer behaviour, check for intoxication, and ask questions which farmers should know the answer to. It follows a previous pilot study that suggested this might possibly be an effective approach. The study is taking place over 5 years in 71 divisional secretariats within North Central, Eastern, Northern and Central Provinces of Sri Lanka. This covers a population of 2.5 million people, working with around 1,500 vendors from 1,000 pesticide shops. It will compare the effect of training on the number of patients presenting to hospital with pesticide self-poisoning in the province. It will also look for evidence of people switching to other methods of self-harm. Expand all Collapse all This article was published on 2024-03-19
