Risk factors include stress and depression combined with access to a means of suicide at work.
The study looked into suicide numbers in the US between 2003 and 2013. The rate of suicides for every 1 million people were:
- 1.5 suicide deaths occurring in the workplace for every million workers (just over 1,700 people across the decade)
- 144.1 for every million people in the total population for suicide deaths taking place outside of the workplace.
More suicides take place outside of work, clearly, but when they do occur at work, the study finds that, looking across occupational lines, suicides are "15 times higher for men than for women and almost four times higher for workers aged 65-74 than for workers 16-24."
The researchers say several work roles are identified, with consistent trends, as at high risk for suicide:
- Law enforcement officers
- Medical doctors
Protective service workers included "supervisors of protective service workers, firefighting and prevention workers, law enforcement workers, and other protective service workers (animal control workers, private detectives and investigators and miscellaneous protective service workers)."
Discussing why certain professions are at higher risk, the paper states:
"Exposure to high-stress events can lead to negative mental health outcomes such as post-traumatic stress disorder, generalized anxiety disorders and depression."
The study is introduced with evidence that suicide in general is a growing problem in the US, and describes the family impacts. It also enumerates a financial cost: "On average, suicides result in an estimated $45 billion in worker loss and medical costs every year in the US."
The authors believe there are several ways in which suicide rates can be reduced, including "educating physicians to screen and recognize clinical depression, restricting access to lethal means and educating important 'gatekeepers' who have contact with potentially vulnerable populations."
Hope Tiesman, PhD, lead researcher for the study and epidemiologist in the safety research division at the National Institute for Occupational Safety and Health, says:
"Occupation can largely define a person's identity, and psychological risk factors for suicide, such as depression and stress, can be affected by the workplace."
Dr. Tiesman calls for suicide risk factors to be better understood through "a more comprehensive view of work life, public health and work safety."
Answering the question of how workplace interventions to reduce suicide could meet difficulties with the taboo of the subject, Dr. Tiesman told MNT: "Stigmatization is a real concern, regardless of the location of the prevention program."
Dr. Tiesman added, however, that several national and international suicide prevention coalitions have recently called for the implementation of suicide prevention programs in the workplace, including the National Action Alliance for Suicide Prevention and the World Health Organization.
"We agree that this is an important distinction that could be more fully studied and described," Dr. Tiesman told us when asked how many suicides might be work-related but committed outside of the workplace. She added, however that the research aim "was not to understand the role of workplace stressors in suicides" and that the government "databases are not capable of accomplishing such a research goal."
On the question of why work is where some suicides happen - apart from the reason of access to a means of it - one possible explanation was given by Dr. Tiesman:
"We hypothesize in the manuscript that an individual may choose suicide in the workplace versus at home in order to protect family and loved ones from discovering the suicide after the fact."
Databases for death rates and suicidal causes
The study used the WISQARS database for suicides taking place outside of the workplace.
The Centers for Disease Control and Prevention (CDC) database is publicly available for data searches. For fatal injuries data, running a search under leading causes of death, and selecting national and regional stats for the years 1999-2013, returns the 20 leading causes of death.
Suicide ranks highly in the data overall for these age groups:
- Among the 25- to 34-year-olds, it is second only to accidental deaths
- In both the 15-19 years and 20-24 years age group, it is third behind accidents and homicides
- For people aged 35-44 years, suicide is pushed down to fourth place by heart disease
- Suicide takes fifth place in the list of causes for 35-44-year-olds, and eighth place for people aged 55-64.
That work-related suicide increases with age is a key finding. The authors report: "Generally, as age increased, so did workplace suicide rates until age 75 years."
US-wide population data on all causes of death, including by suicide, are also in another publicly-held database from the CDC, called Wonder.
Using the detailed mortality tool, it is possible to run a search for causes of death by numerous factors, including age, state, and so on. Every death is given the medical cause from the long list of classifications in the ICD, which includes the "nonmedical" causes of an intentional, accidental or suicidal nature.
The following two for suicide, for example, appear in the top 10 causes of all deaths among adolescents and young adults (15- to 24-year-olds):
- "Intentional self-harm by hanging, strangulation and suffocation" (third-leading cause)
- "Intentional self-harm by other and unspecified firearm discharge" (at sixth).
Place of death is searchable, but does not break down the data beyond medical facilities, home, hospice, nursing or care home, "other," and "place of death unknown" - so deaths at workplaces would fall into "other" against such a search.
Instead, US statistics on workplace suicides, as for this study, come from the census of fatal occupational injuries at the US Bureau of Labor Statistics.
The estimates in the census come from multiple data, with cross-referencing of different sources, and deaths in the workplace include those occurring off the workplace if the death happened in work time.
When it comes to suicide, there seems to be no simple source of statistical information to measure occupational risk.
Access to a means of committing suicide - which goes with certain jobs - was one of the factors to explain a disparity for suicide deaths in a study we reported on last week - in this case, more common ownership and use of firearms in nonmetropolitan counties.