Windsor-Shellard Ben, Gunnell David
Head of Lifestyle and Risk Factors Analysis,Health Analysis and Life Events,Office for National Statistics,UK.
Professor of Epidemiology,Population Health Sciences,Bristol Medical School,University of Bristol; andNational Institute of Health Research Biomedical Research Centre at the University Hospitals Bristol National Health Service Foundation Trust and the University of Bristol,UK.
Br J Psychiatry. 2019 Apr 1:1-6. doi: 10.1192/bjp.2019.69.
Previous research has documented marked occupational differences in suicide risk, but these estimates are 10 years old and based on potentially biased risk assessments.AimsTo investigate occupation-specific suicide mortality in England, 2011-2015.
Estimation of indirectly standardised mortality rates for occupations/occupational groups based on national data.
Among males the highest risks were seen in low-skilled occupations, particularly construction workers (standardised mortality ratio [SMR] 369, 95% CI 333-409); low-skilled workers comprised 17% (1784/10 688) of all male suicides (SMR 144, 95% CI 137-151). High risks were also seen among skilled trade occupations (SMR 135 95% CI 130-139; 29% of male suicides). There was no evidence of increased risk among some occupations previously causing concern: male healthcare professionals and farmers. Among females the highest risks were seen in artists (SMR 399, 95% CI 244-616) and bar staff (SMR 182, 95% CI 123-260); nurses also had an increased risk (SMR 123, 95% CI 104-145). People in creative occupations and the entertainment industry - artists (both genders), musicians (males) and actors (males) - were at increased risk, although the absolute numbers of deaths in these occupations were low. In males (SMR 192, 95% CI 165-221) and females (SMR 170, 95% CI 149-194), care workers were at increased risk and had a considerable number of suicide deaths.
Specific contributors to suicide in high-risk occupations should be identified and measures - such as workplace-based interventions - put in place to mitigate this risk. The construction industry seems to be an important target for preventive interventions.Declaration of interestNone.
以往研究记录了自杀风险存在显著的职业差异，但这些估计数据已有10年之久，且基于可能存在偏差的风险评估。
调查2011 - 2015年英格兰特定职业的自杀死亡率。
基于国家数据估算职业/职业群体的间接标准化死亡率。
在男性中，低技能职业的自杀风险最高，尤其是建筑工人（标准化死亡比[SMR]为369，95%可信区间为333 - 409）；低技能工人占所有男性自杀人数的17%（1784/10688）（SMR为144，95%可信区间为137 - 151）。熟练贸易职业的自杀风险也较高（SMR为135，95%可信区间为130 - 139；占男性自杀人数的29%）。之前一些引起关注的职业，如男性医疗保健专业人员和农民，没有证据表明其自杀风险增加。在女性中，艺术家（SMR为399，95%可信区间为244 - 616）和酒吧工作人员（SMR为182，95%可信区间为123 - 260）的自杀风险最高；护士的自杀风险也有所增加（SMR为123，95%可信区间为104 - 145）。创意职业和娱乐行业的人员——艺术家（男女皆有）、音乐家（男性）和演员（男性）——自杀风险增加，尽管这些职业的死亡绝对人数较少。在男性（SMR为192，95%可信区间为165 - 221）和女性（SMR为170，95%可信区间为149 - 194）中，护理人员的自杀风险增加且自杀死亡人数相当可观。
应确定高风险职业中自杀的具体影响因素，并采取措施，如基于工作场所的干预措施，以降低这种风险。建筑业似乎是预防性干预的重要目标。
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