High-risk occupations for suicide

Abstract

Background: High occupational suicide rates are often linked to easy occupational access to a method of suicide. This study aimed to compare suicide rates across all occupations in Britain, how they have changed over the past 30 years, and how they may vary by occupational socio-economic group. Method We used national occupational mortality statistics, census-based occupational populations and death inquiry files (for the years 1979-1980, 1982-1983 and 2001-2005). The main outcome measures were suicide rates per 100 000 population, percentage changes over time in suicide rates, standardized mortality ratios (SMRs) and proportional mortality ratios (PMRs).

Results: Several occupations with the highest suicide rates (per 100 000 population) during 1979-1980 and 1982-1983, including veterinarians (ranked first), pharmacists (fourth), dentists (sixth), doctors (tenth) and farmers (thirteenth), have easy occupational access to a method of suicide (pharmaceuticals or guns). By 2001-2005, there had been large significant reductions in suicide rates for each of these occupations, so that none ranked in the top 30 occupations. Occupations with significant increases over time in suicide rates were all manual occupations whereas occupations with suicide rates that decreased were mainly professional or non-manual. Variation in suicide rates that was explained by socio-economic group almost doubled over time from 11.4% in 1979-1980 and 1982-1983 to 20.7% in 2001-2005.

Conclusions: Socio-economic forces now seem to be a major determinant of high occupational suicide rates in Britain. As the increases in suicide rates among manual occupations occurred during a period of economic prosperity, carefully targeted suicide prevention initiatives could be beneficial.

Fig. 1.

Suicide rates for the 30 occupations with the highest suicide rates in (a) 1979–1980, 1982–1983 and (b) 2001–2005. Horizontal bars represent 95% confidence intervals. This figure includes only those occupations with at least 10 suicides. Occupations with high suicide rates (>20 per 100 000) that have been excluded because of low suicide numbers (<10 cases) are as follows: clothes designers (suicide rate = 51.6 per 100 000 in 1979–1980, 1982–1983); chemical engineers (46.2 in 2001–2005) and traffic wardens (26.8 in 2001–2005).

Fig. 2.

Suicide rates for the 30 occupations with the highest suicide rates in (a) men, 1979–1980, 1982–1983, (b) women, 1979–1980, 1982–1983, (c) men, 2001–2005, and (d) women, 2001–2005. Values in parentheses are standardized mortality ratios (SMRs) and proportional mortality ratios (PMRs) for men and PMRs for women. Horizontal bars represent 95% confidence intervals. This figure includes only those occupations with at least 10 suicides among men, and three among women, in either time period, 1979–1980 and 1982–1983 or 2001–2005 (suicide rates were about three times higher among men than among women). n.a., Not available.