Which occupations are at high risk for suicide? : Psychol Med.June.2013.


High suicide rates have been reported among farmers , doctors, nurses, dentists , veterinarians , pharmacists , police , the military , seafarers  and artists .  Easy access to a means of committing suicide is considered as the main factor in these occupations. Social isolation at work  and the natural selection of high-risk people to certain occupations  are other factors to consider. Do socio economic factors linked to occupations play a role in this? Has it changed over the years?

S. E. Roberts B. Jaremin and K. Lloyd review the relationship between occupations and suicide using suicide data from England. They compared suicide rates across all occupations in Britain, and explored how they have changed over the past 30 years.The main outcome measures were suicide rates per 100 000 population, SMRs and PMRs.

Suicide rates per 100000 population ( of particular occupation)  were calculated with the numbers of deaths from suicide and open verdicts in each occupation as numerators and the census- based population counts for each occupation as denominators. SMR provide suicide mortality for a specific occupation compared with the corresponding age-matched general British population.SMRs >100 indicate increased suicide mortality. PMR provide a ratio of observed and expected deaths.PMRs >100 indicate increased suicide mortality. 

Findings: During 79-80,the highest suicide rates were among veterinarians (77 per 100 000 worker-years), followed by merchant seafarers (76), hotel porters (74), pharmacists (46), hospital porters (37) and dentists  (36).During the period 2001–2005, coal miners had the highest suicide rate (81 per 100 000 worker-years), followed by other manual occupations : merchant seafarers (68), labourers in building trades (59) and window cleaners (46). In both time periods, occupational suicide rates were much higher among men than women.

Five of the 55 occupations recorded increases over time in suicide rates : coal miners (224 %), labourers in building trades (200 %), plasterers (117 %), fork-lift drivers (71%) and carpenters (34%). Suicide decreased among many occupations (14/55 occupations) and this include doctors (63 %) and dentists (59 %). 

All five of the occupations with significant increases over time in suicide rates were manual occupations, whereas only three out of 13 occupations that had significant reductions were manual.  Suicide rates for professional occupations fell sharply while it increased significantly among manual occupations.

The variation in suicide rates that was explained by socio-economic group almost doubled over time.  It is important to note that the increases in suicide rates  for manual occupations occurred during a period of relative economic prosperity.

Comment: Socio-economic forces  seem to have become a major determinant of  occupational suicide rates in Britain.Increase in suicide among manual occupations at a time of relative  prosperity might be linked to  the psychological effects of inequality.

Summary of the article:

High-risk occupations for suicide. Roberts SE, Jaremin B, Lloyd K. Psychol Med. 2013 Jun;43(6):1231-40.




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