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Mortality from suicide among agricultural, fishery, forestry and hunting workers in Italy and the contribution of work-related factors
  1. Gianfranco Alicandro1,
  2. Enrico Grande1,
  3. Gabriella Sebastiani1,
  4. Francesco Saverio Violante2,
  5. Carlo La Vecchia3,
  6. Luisa Frova1
  1. 1Directorate for Social Statistics and Welfare, Integrated System for Health, Social Assistance and Welfare, National Institute of Statistics (ISTAT), Rome, Italy
  2. 2Occupational Health Unit, Department of Medical and Surgical Sciences, Università di Bologna, Bologna, Italy
  3. 3Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
  1. Correspondence to Dr Gianfranco Alicandro, National institute of Statistics (ISTAT), Rome 00198, Italy; gianfranco.alicandro{at}


Objectives Excess risk of suicide has been reported among workers in agriculture, fishery, forestry and hunting (AFFH). However, there is still uncertainty in the quantification of the risk and in the contribution of work-related factors. We aimed to quantify the suicide mortality risk among these workers in Italy.

Methods We carried out a historical cohort study based on record linkage between the 2011 Italian census and the mortality archives for years 2012–2017. The mortality rate ratio (MRR) was used as a measure of risk. MRR was estimated through quasi-Poisson regression models using workers in other sectors as reference category. Models were adjusted for age, citizenship, marital status, area of residence, education, employment status and hours worked per week.

Results The cohort included 1 004 655 workers employed in the AFFH sector and 15 269 181 workers in other sectors. During the 6-year follow-up, 559 deaths from suicide (500 men and 59 women) occurred among AFFH workers and 5917 (4935 men and 982 women) among workers in other sectors. The MRR for suicide was 1.36 (95% CI 1.19 to 1.55) among men and 1.18 (95% CI 0.87 to 1.60) among women. The excess risk was remarkably high for casual and fixed-term contract workers (3.01, 95% CI 1.50 to 6.04).

Conclusions Male workers in AFFH are at high risk of suicide mortality, and casual and fixed-term contract workers are at exceedingly high risk. Our study also suggests a higher risk among single, highly educated and long-hours workers. Female workers in AFFH do not have an appreciably increased risk.

  • agriculture
  • mortality studies
  • longitudinal studies

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  • Contributors GA, CLV and FSV designed the study. GA analysed the data and wrote the first draft of the manuscript. GA and LF have full access to the data. All authors participated in the interpretation of the results and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. The ISTAT, which holds the database containing data on this cohort, is open to collaborations with national and international research institutions. Open access to data is not possible and access to data is limited to the authorised personnel of the ISTAT since the Italian independent authority of data privacy does not allow providing microdata of the project. Nevertheless, collaborations in specific projects with other research groups or institutes are possible upon collaboration agreement approval from the Presidential Committee of the ISTAT. Further request of information on the cohort and on collaborations can be addressed to the principal investigator (LF, ISTAT,, +39 0646737382).