Relationship Between Alcohol Co-Ingestion and Clinical Outcome in Pesticide Self-Poisoning: A Systematic Review and Meta-Analysis.

This article systematically reviews global literature on the impact of alcohol co-ingestion on clinical outcomes in pesticide self-poisoning, a major cause of suicide-related deaths especially in low- and middle-income countries. Meta-analysis of 13 studies, including case series and cohort studies, found that alcohol co-ingestion significantly increases the risk of death (odds ratio [OR] 4.9) and the need for intubation (OR 8.0) in organophosphorus insecticide poisoning. Alcohol co-ingestion is more common among older males and is associated with larger pesticide ingestions and more severe clinical complications, although one study noted a potential protective effect in glufosinate herbicide poisoning. The review highlights limitations such as inconsistent measurement of blood alcohol and pesticide levels and calls for larger studies to clarify the role of chronic alcohol exposure and different pesticide types in influencing outcomes.