Epidemiological studies on suicides and occupation published since 1982 in the United States and selected studies from other countries were reviewed. Clinical case reports, studies on the effect of unemployment on suicide rates, and sociological literature were excluded. Use of a standardized mortality ratio and proportionate mortality ratio to analyze study data is reviewed. Occupations discussed included: actor, automobile mechanic, chemical worker, chemist, dentist, electric utility worker, farmer, forestry workers, highway maintenance worker, military personnel, nurse, pharmaceutical worker, physician, police officer, social worker, tobacco industry worker, and veterinarian. Other areas reviewed included the relationship between suicide and socioeconomic status, suicides in female workers, and suicide in the workplace. The difficulties in comparing studies with variations in methodology were discussed. The authors conclude that physicians of both sexes have higher rates of suicide, with female physicians at greater risk. Factors such as work stress, access to means, age, and mental disorders also play important roles in suicides.
Peter A Boxer, MD, MPH, Medical Director, Green Spring of Ohio, One Corporate Plaza, 4675 Cornell Road, Suite 270, Cincinnati, OH 45241