Suicide mortality among electricians in the Swedish construction industry

B Järvholm; A Stenberg

doi:10.1136/oem.59.3.199

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Suicide mortality among electricians in the Swedish construction industry

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Re: Suicide mortality among electricians
Bengt G Jarvholm
Published on: 27 April 2016
Suicide mortality among electricians
Edwin van Wijngaarden
Published on: 27 April 2016

Published on: 27 April 2016
Re: Suicide mortality among electricians
- Bengt G Jarvholm, Professor
- Other Contributors:
  Anita Stneberg
Dear Editor,
We appreciate dr Wijngaarden´s interest in our report and his suggestion for understanding the differences in risk. Dr Wijngaarden suggests that difference in unemployment rate between electricians and glassworker and wood workers could be an explanation.
We have no data on employment status at time of death and can therefore not test this hypothesis. However, if employment status is an...
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Dear Editor,
We appreciate dr Wijngaarden´s interest in our report and his suggestion for understanding the differences in risk. Dr Wijngaarden suggests that difference in unemployment rate between electricians and glassworker and wood workers could be an explanation.
We have no data on employment status at time of death and can therefore not test this hypothesis. However, if employment status is an important predictor, this could explain some of the difference as the wood workers had a different employment than the other groups. Electricians and glass workers have had permanent positions since a long time, while wood workers had an employment for a certain object, e.g. a house before 1990s. When the object was finished he had to find another employer. Today, most construction workers have permanent positions in Sweden.
In our search of literature to understand differences in suicide rates between occupations we found little knowledge. This might be an important area of research in the future.
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Conflict of Interest:
None declared.
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Published on: 27 April 2016
Suicide mortality among electricians
- Edwin van Wijngaarden, Research Assistant
Dear Editor,
Järvholm and Stenberg [1] evaluated suicide mortality rates among electricians ("exposed to electromagnetic fields (EMFs)") and glass and woodworkers ("unexposed to EMFs") in the Swedish construction industry. Standard mortality rates were lower for the two job groups as compared to the Swedish general population. This is likely due to the healthy worker effect. The internal cohort analysis showed...
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Dear Editor,
Järvholm and Stenberg [1] evaluated suicide mortality rates among electricians ("exposed to electromagnetic fields (EMFs)") and glass and woodworkers ("unexposed to EMFs") in the Swedish construction industry. Standard mortality rates were lower for the two job groups as compared to the Swedish general population. This is likely due to the healthy worker effect. The internal cohort analysis showed that electricians had a lower suicide mortality rate than glass and woodworkers.
As the authors rightfully point out, these results should not be seen as evidence against the association between exposure to EMFs and suicide, in particular because no quantitative estimates of exposure were obtained to directly evaluate this association. Jarvholm and Stenberg cited a small measurement survey in the Swedish construction industry, which indicated that exposure levels were low and comparable between the two occupational groups. Therefore, one would not expect to see an EMF-mediated increase in suicide risk among electricians as compared to glass and woodworkers, if an association between EMF exposure and suicide truly exists.
Järvholm and Stenberg suggested that the difference in suicide rate between the two job groups was unlikely to be due to differences in socioeconomic factors, but they did not provide an alternative explanation. One possible explanation may be a healthy survivor worker effect related to employment status (e.g., at time of death) within this cohort. That is, active workers may be more physically and mentally fit than those who left the industry or are unemployed, and may therefore be at lower risk of committing suicide [2]. A large body of literature suggests that unemployment and suicide are positively related [3,4], and being out of work was positively associated with suicide in the electric utility industry [2]. Since cessation of work also leads to cessation of work-related exposures, employment status may be an important potential confounder (or perhaps effect modifier) for the association between work-related exposures and suicide. The lower suicide rate among electricians as compared to glass and wood workers may be explained by a larger proportion of glass and wood workers with an inactive employment status at the time of death.
Although it is unlikely that consideration of employment status, if possible, would greatly alter the conclusions reached by Järvholm and Stenberg [1], it would be informative to see its influence on the rate ratio.
References:
(1) Jarvholm B, Stenberg A. Suicide mortality among electricians in the Swedish construction industry Occup Environ Med 2002; 59: 199-200.
(2) van Wijngaarden E, Savitz DA, Kleckner RC, Cai J, Loomis D. Exposure to electromagnetic fields and suicide among electric utility workers: A nested case-control study. Occup Environ Med 2000;57:258-263.
(3)Dooley D, Fielding J, Levi L. Health and unemployment. Annu Rev Public Health 1996;17:449-465.
(4)Kposowa AJ. Suicide mortality in the United States: differentials by industrial and occupational groups. Am J Ind Med 1999;36:645-652.
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Conflict of Interest:
None declared.
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