PT - JOURNAL ARTICLE AU - Gianfranco Alicandro AU - Enrico Grande AU - Gabriella Sebastiani AU - Francesco Saverio Violante AU - Carlo La Vecchia AU - Luisa Frova TI - Mortality from suicide among agricultural, fishery, forestry and hunting workers in Italy and the contribution of work-related factors AID - 10.1136/oemed-2020-106743 DP - 2021 Feb 01 TA - Occupational and Environmental Medicine PG - 117--124 VI - 78 IP - 2 4099 - http://oem.bmj.com/content/78/2/117.short 4100 - http://oem.bmj.com/content/78/2/117.full SO - Occup Environ Med2021 Feb 01; 78 AB - 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.