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Suicide by occupation: Systematic review and meta-analysis
Open accessAbstract
Background: Previous research has shown that those employed in certain occupations, such as doctors and farmers, have an elevated risk of suicide, yet little research has sought to synthesise these findings across working-age populations. Aims: To summarise published research in this area through systematic review and meta-analysis. Method: Random effects meta-analyses were used to calculate a pooled risk of suicide across occupational skill-level groups. Results: Thirty-four studies were included in the meta-analysis. Elementary professions (e.g. labourers and cleaners) were at elevated risk compared with the working-age population (rate ratio (RR) = 1.84, 95% CI 1.46–2.33), followed by machine operators and deck crew (RR = 1.78, 95% CI 1.22–2.60) and agricultural workers (RR = 1.64, 95% CI 1.19–2.28). Results suggested a stepwise gradient in risk, with the lowest skilled occupations being at greater risk of suicide than the highest skill-level group. Conclusions: This is the first comprehensive meta-analytical review of suicide and occupation. There is a need for future studies to investigate explanations for the observed skill-level differences, particularly in people employed in lower skill-level groups. Declaration on interest: None.
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“People in unskilled professions have an increased risk of suicide, which is partly explained by greater psychosocial stress; however, people in professions with access to lethal means for suicide have high rates, such as farmers, nurses, veterinarians, physicians, and police.29”
From Suicide (2020) · cites this paper as [29]
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“At the other end of the job status spectrum, cleaners and low-skilled labourers with poorer socioeconomic conditions have been shown to suffer more stress and have significantly higher risk of suicide than the general population (Greiner et al., 2022; Milner et al., 2013).”
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“Lower socioeconomic individuals frequently face long working hours and high workloads, which contribute to higher suicide rates in low-skilled and low-income jobs, as well as poor working conditions in sectors like construction and manual labour (Milner et al., 2013).”
A social-ecological model to understand gun violence
Mehari, K. R., Smith, P. N., Coleman, J. N., Stevens, L. T., & Hancock, E. K. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-95272-9.00003-6 · Cited by 2
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“…be due to work-related access to a means of suicide (pesticide), harmful exposure to toxins, and psychosocial working conditions, e.g., long working hours, physically demanding work, and occupational stress due to capricious weather conditions (Milner et al., 2013; Klingelschmidt et al., 2018).”
“You Have to Make It Normal, That’s What We Do”: Construction Managers’ Experiences of Help-Offering
Roche, E., O’Donnell, S., & Richardson, N. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22040581 · Cited by 3
“The workers in these industries have a higher risk of suicide than the general male population [15,16] and are frequently exposed to risks such as long working hours and financial instability, which have been previously identified as the key drivers of poor mental health [17].”
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Agrarian suicides in India: Myth and reality
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Occupational class suicide risk: 12-year study of national coronial data
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Arregocés, J. D. S., Caballero‐Domínguez, C. C., López, C. F., & Ospino, G. A. C. (2017) · Cuadernos Hispanoamericanos de Psicología · doi:10.18270/chps..v17i1.2144 · Cited by 2
Examining the role of constrained occupational mobility in the experience of entrapment cognitions
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The Social Determinants of Male Suicide
Whitley, R. (2021) · Springer eBooks · doi:10.1007/978-3-030-86320-3_2 · Cited by 2
Chaudhury, S., Srivastava, K., Bhat, P. S., & Prakash, J. (2019) · Industrial Psychiatry Journal · doi:10.4103/ipj.ipj_77_19 · Cited by 2
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Extending Exit, Voice, and Loyalty: Managing Dissent in Public Lands Agencies
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Psychological vulnerability and suicidality within the ambulance service: a review
Faulkner, S. (2023) · Journal of Paramedic Practice · doi:10.12968/jpar.2023.15.12.506 · Cited by 1
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“…domains, namely: risk factors (Borges et al., 2017; Darvishi et al., 2015; Franklin et al., 2017; Kyung-sook et al., 2018; large et al., 2016; Milner et al., 2013; 2013; Niederkrotenthaler et al., 2012, 2020; Poorolajal et al., 2016; Poorolajal & Darvishi, 2016; Robinson et al., 2018; sisask…”
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“This is similar to the elevated risk (1.6) for Group 6 in the International Standard Classification of Occupations, including skilled forestry and fishery workers as well as farmers and agricultural workers [20].”
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“…studies showed consistently that both physicians (Dutheil et al. , 2019) and nurses (Davis et al. , 2021) are at high risk for suicide compared to other employed people (Milner et al. , 2013), in part related to high access to lethal means and low willingness to seek help (Harvey et al. , 2021).”
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Metadata
- Authors
- Milner, A., Spittal, M. J., Pirkis, J., & LaMontagne, A. D.
- Affiliations
- The University of Melbourne (AU)
- Corresponding author
- Milner, Allison
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2013-12
- Volume
- 203
- Issue
- 6
- Pages
- 409-416
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2159544002
- Cited by
- 387
- References
- 75
- Citations by year
- 2026: 22 · 2025: 41 · 2024: 42 · 2023: 31 · 2022: 46 · 2021: 39 · 2020: 26 · 2019: 39 · 2018: 29 · 2017: 23 · 2016: 18 · 2015: 20 · 2014: 9 · 2013: 1
- FWCI
- 2.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Own your potential (DEAKIN) (submittedVersion)
- Minerva Access (University of Melbourne) (submittedVersion)
- Funders
- Medical Research Council
- National Health and Medical Research Council (546248)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Workplace Health and Well-being
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Keywords
- suicide, occupational risk, occupational skill level, low-skilled workers, agricultural labor, machine operators, labourers, working-age population
- MeSH terms
- Employment, Humans, Occupations, Regression Analysis, Risk Factors, Social Class, Suicide, Odds Ratio, Sex Distribution
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