Directorate for Social Statistics and Welfare, Integrated System for Health, Social Assistance and Welfare, National Institute of Statistics (ISTAT), Rome, Italy
Directorate for Social Statistics and Welfare, Integrated System for Health, Social Assistance and Welfare, National Institute of Statistics (ISTAT), Rome, Italy.
Occup Environ Med. 2021 Feb;78(2):117-124. doi: 10.1136/oemed-2020-106743. Epub 2020 Oct 1.
Excess risk of suicide has been reported among workers in agriculture, fishery, forestry and hunting (AFFH). However, there is still uncertainty in the quantification of the risk and in the contribution of work-related factors. We aimed to quantify the suicide mortality risk among these workers in Italy.
We carried out a historical cohort study based on record linkage between the 2011 Italian census and the mortality archives for years 2012-2017. The mortality rate ratio (MRR) was used as a measure of risk. MRR was estimated through quasi-Poisson regression models using workers in other sectors as reference category. Models were adjusted for age, citizenship, marital status, area of residence, education, employment status and hours worked per week.
The cohort included 1 004 655 workers employed in the AFFH sector and 15 269 181 workers in other sectors. During the 6-year follow-up, 559 deaths from suicide (500 men and 59 women) occurred among AFFH workers and 5917 (4935 men and 982 women) among workers in other sectors. The MRR for suicide was 1.36 (95% CI 1.19 to 1.55) among men and 1.18 (95% CI 0.87 to 1.60) among women. The excess risk was remarkably high for casual and fixed-term contract workers (3.01, 95% CI 1.50 to 6.04).
Male workers in AFFH are at high risk of suicide mortality, and casual and fixed-term contract workers are at exceedingly high risk. Our study also suggests a higher risk among single, highly educated and long-hours workers. Female workers in AFFH do not have an appreciably increased risk.
已有报道称，农业、渔业、林业和狩猎（AFFH）工人的自杀风险过高。然而，在风险的量化和与工作相关因素的贡献方面仍存在不确定性。我们旨在量化意大利这些工人的自杀死亡率。
我们开展了一项基于 2011 年意大利人口普查和 2012-2017 年死亡档案之间记录链接的历史队列研究。死亡率比（MRR）被用作风险的衡量标准。通过使用其他部门的工人作为参考类别，使用准泊松回归模型估计 MRR。模型调整了年龄、公民身份、婚姻状况、居住地区、教育程度、就业状况和每周工作小时数。
该队列包括 1004655 名在 AFFH 部门工作的工人和 15269181 名在其他部门工作的工人。在 6 年的随访期间，AFFH 工人中有 559 人死于自杀（500 名男性和 59 名女性），而其他部门工人中有 5917 人（4935 名男性和 982 名女性）。男性自杀的 MRR 为 1.36（95%可信区间 1.19 至 1.55），女性为 1.18（95%可信区间 0.87 至 1.60）。临时工和固定期限合同工的超额风险极高（3.01，95%置信区间 1.50 至 6.04）。
AFFH 男性工人的自杀死亡率风险很高，临时工和固定期限合同工的风险极高。我们的研究还表明，单身、受过高等教育和工作时间长的工人风险更高。AFFH 的女性工人的风险没有明显增加。
