Advertisement

Social Psychiatry and Psychiatric Epidemiology

, Volume 54, Issue 12, pp 1483–1495 | Cite as

Suicide mortality follow-up of the Swiss National Cohort (1990–2014): sex-specific risk estimates by occupational socio-economic group in working-age population

  • Irina Guseva CanuEmail author
  • Nicolas Bovio
  • Zakia Mediouni
  • Murielle Bochud
  • Pascal Wild
  • For the Swiss National Cohort (SNC)
Original Paper

Abstract

Purpose

To identify occupations and socio-economic groups with detrimental or protective effect on suicide mortality.

Methods

For every occupation and economic activity/industry, we computed directly age-standardized mortality rates (DSRs) using the age structure of the European population (2010) and standardized mortality ratios (SMRs) for suicide using national cause-specific mortality rates. We further stratified analyses by socio-economic variables, job-skill level, and by three calendar periods (1990–1998/1999–2006/2007–2014).

Results

The study sample comprised 5,834,618 participants (94,918,456 person-years). The highest DSRs were observed among unemployed/job-seeking group, in agricultural, fishery and related male workers, and in health and social activities female workers. The lowest DSRs were observed in real estate and renting, research and development, IT and other business activities in men and in agriculture, hunting and forestry industry in women. A consistent reduction in DSRs across three calendar periods was observed in men. In female corporate managers, DSRs increased over the 2007–2014 period compared with 1999–2006. Compared to general working-age population, unemployed/job-seeking people, manufacturing labourers, personal care and related workers, and motor vehicle drivers of both sexes were identified at risk of suicide. Moreover, an excess of suicide was observed among male material recording and transport clerks; nursing and midwife-associated professionals; and agricultural workers as well as among female writers and performing artists.

Conclusions

The findings suggest the detrimental effect of low socioeconomic positions, including unemployment, with respect to suicide mortality and a relationship between suicide and poor psychosocial working conditions in elementary occupations. Sex-specific results need further investigation.

Keywords

Longitudinal study Job-skill level Psychosocial conditions Gender differences Social inequality Managers 

Notes

Acknowledgements

We thank the Swiss federal statistical office for providing mortality and census data, and for the support that made the Swiss National Cohort (SNC) and this study possible. This work was supported by the Swiss National Science Foundation (Grant nos. 3347CO-108806, 33CS30_134273 and 33CS30_148415). The members of the Swiss National Cohort Study Group are Matthias Egger (Chairman of the Executive Board), Adrian Spoerri and Marcel Zwahlen (all Bern), Milo Puhan (Chairman of the Scientific Board), Matthias Bopp (both Zurich), Martin Röösli (Basel), Michel Oris (Geneva) and Murielle Bochud (Lausanne). We also thank Claudia Berlin from ISPM Bern for her help in data management of federal census data and Saheil Nazeri from IST, Lausanne for his help in translation and data management of the economic activity variable in the SNC database.

Compliance with ethical standards

Conflict of interest

This work was conducted in frame of the SNC nested study contract no. 2365. The authors have no conflicts of interest to declare.

Ethical approval

The SNC and the present study were approved by the Cantonal Ethics Committees of Bern and Zurich, and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The manuscript does not contain clinical studies or patient data.

Supplementary material

127_2019_1728_MOESM1_ESM.docx (64 kb)
Supplementary material 1 (DOCX 63 kb)

References

  1. 1.
    WHO (2014) Preventing suicide: a global impreative. World Health Organization, GenevaGoogle Scholar
  2. 2.
    Ostertag L, Golay P, Dorogi Y, Brovelli S, Bertran M, Cromec I et al (2019) The implementation and first insights of the French-speaking Swiss program for monitoring self-harm. Swiss Med Week 149:w20016Google Scholar
  3. 3.
    Lorant V, de Gelder R, Kapadia D, Borrell C, Kalediene R, Kovacs K et al (2018) Socioeconomic inequalities in suicide in Europe: the widening gap. Br J Psychiatry J Ment Sci 212(6):356–361Google Scholar
  4. 4.
    Walter E, Duetz Schmucki M, Bürli C, Amstad F, Haas A, Schibli D et al (2016) Suicide prevention in Switzerland context, action plan and action plan. Federal Off Public Health, BernGoogle Scholar
  5. 5.
    Milner A, Spittal MJ, Pirkis J, LaMontagne AD (2013) Suicide by occupation: systematic review and meta-analysis. Br J Psychiatry J Ment Sci 203(6):409–416Google Scholar
  6. 6.
    Halonen JI, Koskinen A, Varje P, Kouvonen A, Hakanen JJ, Vaananen A (2018) Mental health by gender-specific occupational groups: profiles, risks and dominance of predictors. J Affect Disord 238:311–316PubMedGoogle Scholar
  7. 7.
    Milner AJ, Spittal MS, Pirkis J, LaMontagne AD (2016) Does gender explain the relationship between occupation and suicide? Findings from a meta-analytic study. Community Ment Health J 52(5):568–573PubMedGoogle Scholar
  8. 8.
    Milner A, Witt K, LaMontagne AD, Niedhammer I (2018) Psychosocial job stressors and suicidality: a meta-analysis and systematic review. Occup Environ Med 75(4):245–253PubMedGoogle Scholar
  9. 9.
    Bopp M, Spoerri A, Zwahlen M, Gutzwiller F, Paccaud F, Braun-Fahrlander C et al (2009) Cohort profile: the Swiss National Cohort—a longitudinal study of 6.8 million people. Int J Epidemiol 38(2):379–384PubMedGoogle Scholar
  10. 10.
    Steck N, Zwahlen M, Egger M (2015) Time-trends in assisted and unassisted suicides completed with different methods: Swiss National Cohort. Swiss Med Week 145:w14153Google Scholar
  11. 11.
    SFSO (2004) Methodology report—coverage estimation for the Swiss Population Census 2000. Swiss Federal Statistical Office, Neuchâtel, pp 1–147. https://www.bfs.admin.ch/bfsstatic/dam/assets/341896/master. Accessed 27 Aug 2018
  12. 12.
    Roberts SE, Jaremin B, Lloyd K (2013) High-risk occupations for suicide. Psychol Med 43(06):1231–1240PubMedGoogle Scholar
  13. 13.
    Agerbo E, Gunnell D, Bonde JP, Mortensen PB, Nordentoft M (2007) Suicide and occupation: the impact of socio-economic, demographic and psychiatric differences. Psychol Med 37(8):1131–1140PubMedGoogle Scholar
  14. 14.
    Picciotto S, Hertz-Picciotto I (2015) Commentary: healthy worker survivor bias: a still-evolving concept. Epidemiology (Cambridge, Mass) 26(2):213–215Google Scholar
  15. 15.
    Milner A, Niven H, LaMontagne AD (2015) Occupational class differences in suicide: evidence of changes over time and during the global financial crisis in Australia. BMC Psychiatry 15:223PubMedPubMedCentralGoogle Scholar
  16. 16.
    Violanti JM (2010) Police suicide: a national comparison with fire-fighter and military personnel. Policing Int J Police Strat Manag 33(2):270–286Google Scholar
  17. 17.
    Schmidlin K, Clough-Gorr KM, Spoerri A, Egger M, Zwahlen M (2013) Impact of unlinked deaths and coding changes on mortality trends in the Swiss National Cohort. BMC Med Inform Decis Mak 13:1PubMedPubMedCentralGoogle Scholar
  18. 18.
    Hepp U, Ring M, Frei A, Rossler W, Schnyder U, Ajdacic-Gross V (2010) Suicide trends diverge by method: Swiss suicide rates 1969–2005. Eur Psychiatry J Assoc Eur Psychiatr 25(3):129–135Google Scholar
  19. 19.
    Classen TJ, Dunn RA (2012) The effect of job loss and unemployment duration on suicide risk in the United States: a new look using mass-layoffs and unemployment duration. Health Econ 21(3):338–350PubMedGoogle Scholar
  20. 20.
    Milner A, Morrell S, Lamontagne AD (2014) Economically inactive, unemployed and employed suicides in Australia by age and sex over a 10-year period: what was the impact of the 2007 economic recession? Int J Epidemiol 43(5):1500–1507PubMedGoogle Scholar
  21. 21.
    Solano P, Pizzorno E, Gallina AM, Mattei C, Gabrielli F, Kayman J (2012) Employment status, inflation and suicidal behaviour: an analysis of a stratified sample in Italy. Int J Soc Psychiatry 58(5):477–484PubMedGoogle Scholar
  22. 22.
    Yuryev A, Vaernik A, Vaernik P, Sisask M, Leppik L (2012) Employment status influences suicide mortality in Europe. Int J Soc Psychiatry 58(1):62–68Google Scholar
  23. 23.
    Cohidon C, Santin G, Geoffroy-Perez B, Imbernon E (2010) Suicide and occupation in France. Rev Epidemiol Sante Pub 2:139–150Google Scholar
  24. 24.
    Hawton K, Agerbo E, Simkin S, Platt B, Mellanby RJ (2011) Risk of suicide in medical and related occupational groups: a national study based on Danish case population-based registers. J Affect Disord 134(1):320–326PubMedGoogle Scholar
  25. 25.
    McIntosh WL, Spies E, Stone DM, Lokey CN, Trudeau AR, Bartholow B (2016) Suicide rates by occupational group—17 States, 2012. MMWR Morb Mortal Wkly Rep 65(25):641–645PubMedGoogle Scholar
  26. 26.
    Milner AJ, Maheen H, Bismark MM, Spittal MJ (2016) Suicide by health professionals: a retrospective mortality study in Australia, 2001–2012. Med J Aust 205(6):260–265PubMedGoogle Scholar
  27. 27.
    Andersen K, Hawgood J, Klieve H, Kõlves K, De Leo D (2010) Suicide in selected occupations in Queensland: evidence from the State suicide register. Aust N Z J Psychiatry 44(3):243–249PubMedGoogle Scholar
  28. 28.
    Stuart H (2008) Suicidality among police. Curr Opin Psychiatry 21(5):505–509PubMedGoogle Scholar
  29. 29.
    Meltzer H, Griffiths C, Brock A, Rooney C, Jenkins R (2008) Patterns of suicide by occupation in England and Wales: 2001–2005. Br J Psychiatry J Ment Sci 193(1):73–76Google Scholar
  30. 30.
    Mahon MJ, Tobin JP, Cusack DA, Kelleher C, Malone KM (2005) Suicide among regular-duty military personnel: a retrospective case-control study of occupation-specific risk factors for workplace suicide. Am J Psychiatry 162(9):1688–1696PubMedGoogle Scholar
  31. 31.
    Reisch T, Steffen T, Habenstein A, Tschacher W (2013) Change in suicide rates in Switzerland before and after firearm restriction resulting from the 2003 “Army XXI” reform. Am J Psychiatry 170(9):977–984PubMedGoogle Scholar
  32. 32.
    Alexopoulos EC, Kavalidou K, Messolora F (2016) Suicide mortality across broad occupational groups in Greece: a descriptive study. Sh@w 7(1):1–5PubMedGoogle Scholar
  33. 33.
    Bossard C, Santin G, Guseva Canu I (2016) Suicide among farmers in France: occupational factors and recent trends. J Agromed 21(4):310–315Google Scholar
  34. 34.
    Klingelschmidt J, Milner A, Khireddine-Medouni I, Witt K, Alexopoulos EC, Toivanen S et al (2018) Suicide among agricultural, forestry, and fishery workers: a systematic literature review and meta-analysis. Scand J Work Environ Health 44(1):3–15PubMedGoogle Scholar
  35. 35.
    Ringgenberg W, Peek-Asa C, Donham K, Ramirez M (2018) Trends and characteristics of occupational suicide and homicide in farmers and agriculture workers, 1992–2010. J Rural Health Off J Am Rural Health Assoc Natl Rural Health Care Assoc 34(3):246–253Google Scholar
  36. 36.
    Howard M, Krannitz M (2017) A reanalysis of occupation and suicide: negative perceptions of the workplace linked to suicide attempts. J Psychol 151(8):467–788Google Scholar
  37. 37.
    Fridner A, Belkic K, Marini M, Minucci D, Pavan L, Schenck-Gustafsson K (2009) Survey on recent suicidal ideation among female university hospital physicians in Sweden and Italy (the HOUPE study): cross-sectional associations with work stressors. Gend Med 6(1):314–328PubMedGoogle Scholar
  38. 38.
    Fridner A, Belkic K, Minucci D, Pavan L, Marini M, Pingel B et al (2011) Work environment and recent suicidal thoughts among male university hospital physicians in Sweden and Italy: the health and organization among university hospital physicians in Europe (HOUPE) study. Gend Med 8(4):269–279PubMedGoogle Scholar
  39. 39.
    Tiesman HM, Konda S, Hartley D, Chaumont Menendez C, Ridenour M, Hendricks S (2015) Suicide in US Workplaces, 2003–2010: a comparison with non-workplace suicides. Am J Prev Med. 48(6):674–682PubMedPubMedCentralGoogle Scholar
  40. 40.
    Schneider PB (2002) Writers and suicide. Swiss Arch Neurol Psychiatr 153:221–231Google Scholar
  41. 41.
    Maier T, Schmidt M, Mueller J (2010) Mental health and healthcare utilisation in adult asylum seekers. Swiss Med Week.  https://doi.org/10.4414/smw.2010.13110 CrossRefGoogle Scholar
  42. 42.
    Chan CH, Caine ED, Sungeun YOU, Wa FU, Chang SS, Yip SJ (2014) Suicide rates among working-age adults in South Korea before and after the 2008 economic crisis. J Epidemiol Community Health (1979) 68(3):246–252Google Scholar
  43. 43.
    Wada K, Eguchi H, Prieto-Merino D, Smith DR (2016) Occupational differences in suicide mortality among Japanese men of working age. J Affect Disord 190:316–321PubMedGoogle Scholar
  44. 44.
    Hanebuth D, Aydin D, Scherf T (2012) Burnout and related conditions in managers: a 5-year longitudinal study. Psychol Everyday Act 5(2):4–39Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Irina Guseva Canu
    • 1
    Email author
  • Nicolas Bovio
    • 1
  • Zakia Mediouni
    • 1
  • Murielle Bochud
    • 2
  • Pascal Wild
    • 1
    • 3
  • For the Swiss National Cohort (SNC)
  1. 1.Department of Occupational and Environmental Health, Center for Primary Care and Public Health (unisanté)University of LausanneLausanneSwitzerland
  2. 2.Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (unisanté)University of LausanneLausanneSwitzerland
  3. 3.INRSVandoeuvre Les Nancy CedexFrance

Personalised recommendations