Kavaliauskas Povilas, Jasilionis Domantas, Dulskas Audrius, Kazlauskas Evaldas, Smailyte Giedre
Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, M. K. Čiurlionio Str. 21/27, Vilnius, LT-03101, Lithuania.
National Cancer Institute, Vilnius, Lithuania.
BMC Health Serv Res. 2025 Jul 3;25(1):914. doi: 10.1186/s12913-025-13006-y.
Healthcare workers face health risks, including stress, burnout, and communicable diseases, leading to higher mortality rates. However, excess mortality diminishes with better disease control and lifestyle factors.
The study is based on the aggregated census-linked mortality dataset provided by Statistics Lithuania. The dataset was based on all 2011 census records, as well as death and emigration records from March 1, 2011, to December 31, 2019. The primary variable identified three groups: physicians, nurses and assistant nurses, and other healthcare workers. The reference groups consisted of individuals who were employed in all other sectors. We also conducted an analysis comparing highly educated healthcare workers to the highly educated workers in other sectors. The results are presented using age-adjusted sex-specific Poisson regression mortality rate ratios.
The four most common causes of death among healthcare employees were cancer, cardiovascular deaths, other causes of death, and external causes of death. Female nurses show significantly lower 0.86 (0.74–0.99) mortality due to malignant neoplasms than all other employees. Male physicians had lower mortality rates from smoking-related cancer (0.47 (0.24–0.95)); however, significantly higher mortality was found for digestive system diseases 6.29 (2.36–16.79) and liver diseases 5.1 (1.27–20.42). Highly educated male healthcare workers had 1.3–1.4 times higher all-cause, cardiovascular, and malignant neoplasm mortality than highly educated workers from all other sectors. Highly educated females working in health care had lower mortality for malignant neoplasms but significantly higher mortality for all other causes of death.
Excess mortality due to digestive system diseases and alcohol-related causes of death among nurses and other health care employees is a particular matter of concern and should be addressed by appropriate prevention policies. Further in-depth studies on risk factors are needed to explain mortality differences between the groups of healthcare and other sector employees in Lithuania.
The online version contains supplementary material available at 10.1186/s12913-025-13006-y.
医护人员面临健康风险，包括压力、职业倦怠和传染病，导致死亡率较高。然而，随着疾病控制和生活方式因素的改善，超额死亡率会降低。
该研究基于立陶宛统计局提供的与人口普查相关的汇总死亡率数据集。该数据集基于2011年所有人口普查记录以及2011年3月1日至2019年12月31日的死亡和移民记录。主要变量确定了三组：医生、护士和助理护士以及其他医护人员。参照组由所有其他部门的就业人员组成。我们还进行了一项分析，将高学历医护人员与其他部门的高学历工作人员进行比较。结果以年龄调整后的特定性别泊松回归死亡率比值呈现。
医护人员中四种最常见的死亡原因是癌症、心血管疾病死亡、其他死亡原因和外部死亡原因。女护士因恶性肿瘤导致的死亡率0.86（0.74 - 0.99）显著低于所有其他员工。男医生因吸烟相关癌症导致的死亡率较低（(0.47(0.24 - 0.95))）；然而，消化系统疾病（(6.29(2.36 - 16.79))）和肝脏疾病（(5.1(1.27 - 20.42))）的死亡率显著更高。高学历男性医护人员的全因、心血管疾病和恶性肿瘤死亡率比所有其他部门的高学历工作人员高1.3 - 1.4倍。从事医疗保健工作的高学历女性因恶性肿瘤的死亡率较低，但其他所有死亡原因的死亡率显著更高。
护士和其他医护人员因消化系统疾病和与酒精相关的死亡原因导致的超额死亡率是一个特别值得关注的问题，应通过适当的预防政策加以解决。需要进一步深入研究风险因素，以解释立陶宛医护人员组与其他部门员工组之间的死亡率差异。
在线版本包含可在10.1186/s12913 - 025 - 13006 - y获取的补充材料。
