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Mortality patterns following lay-offs from a large international airline.

Steenland-K; Pinkerton-L
Occup Environ Med 2007 Dec; 64(12):e36
Objectives: There are a relatively small number of studies on the health effects due to involuntary unemployment, and results are contradictory. We sought to compare mortality among involuntary and voluntary leavers at a large airline. Methods: We have studied the mortality through 2002 of 13 370 employees of a large airline who were born before 1940 and whose personnel files were available after the company's bankruptcy in 1991. The cohort was divided into those who left work voluntarily (55%), involuntarily (39%) and because of illness (6%). Results: The mean year of first employment was 1962, the mean year of last employment was 1986, and the mean age at leaving the company was 55. Of those who left involuntarily, 56% left at the time of bankruptcy in December 1991 or after. Twenty-two percent of the cohort died during follow-up, which began at the time of leaving the company. Standardised mortality ratios relative to the US population for all causes for those who left voluntarily, involuntarily and due to illness were 0.72 (0.69-0.87), 0.69 (0.65-0.74), and 2.40 (2.21-2.60) respectively. Mortality from heart disease showed a similar pattern. Internal analyses using Poisson regression compared rates between involuntary and voluntary leavers after adjusting for age, race, sex, calendar time and education, and yielded a rate ratio of 0.96 (0.87-1.07) for all causes and a rate ratio of 1.11 (0.93-3.56) for heart disease. Sub-analyses of those who left involuntarily at age 55 or older, or those who left involuntarily at the time of bankruptcy, did not indicate any excess mortality (all cause SMRs of 0.65 and 0.64, respectively). Conclusion: These data do not indicate that those who left involuntarily had higher mortality than those who left voluntarily. Both groups showed a strong healthy worker effect. Our data are limited by lack of knowledge of re-employment patterns after leaving the company, reliance on mortality rather than morbidity data, and by the relatively short length of follow-up after leaving work (mean 13 years).
Statistical-analysis; Mortality-rates; Mortality-surveys; Transportation; Aircrews
Publication Date
Document Type
Journal Article
Fiscal Year
Issue of Publication
NIOSH Division
Priority Area
Transportation, Warehousing and Utilities
Source Name
Occupational and Environmental Medicine
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division