Occupational Injury and Suicide in Washington State, Adjusting For Pre-Injury Depression.

Details

• Alternative Title:
  American Journal of Industrial Medicine, 2025, v. 68, no. 2: Occupational Injury and Suicide in Washington State, Adjusting For Pre-Injury Depression.
• Journal Article:
  American Journal of Industrial Medicine
• Personal Author:
  Applebaum, Katie M. ; Asfaw, Abay ; O'Leary, Paul K. ; Fox, Matthew P. ; Tripodis, Yorghos ; Busey, Andrew ; Gradus, Jaimie L. ; Boden, Leslie I.
• Description:
  Occupational injuries have been associated with increased suicide mortality, but prior studies have not accounted for pre-injury depression.
  
  We linked injuries that occurred from 1994 to 2000 in the Washington State workers' compensation system with Social Security Administration data on earnings and mortality through 2018. We estimated the subdistribution hazard ratio (sHR) and 95% confidence interval using competing risks regression of suicide deaths with lost time compared with medical-only injuries separately for men and women, adjusting for age, pre-injury annual earnings, and industry. We further adjusted for pre-injury diagnosis of major depressive disorder by using a quantitative bias analysis (QBA), with the prevalence of this disorder in workers derived from an external health insurance claims data set.
  
  Elevated suicide mortality was observed following lost-time injuries compared with medical-only injuries for men (sHR = 1.49, 95% CI 1.14, 1.93) and women (sHR = 1.30, 95% CI 1.00, 1.69), adjusting for age, pre-injury earnings, and industry. Adjusted for pre-injury depression using a QBA, elevated suicide risk in men remained statistically significant (median sHR = 1.33, simulation interval 1.18, 1.47) but not for women.
  
  Workplace injury requiring time off work appeared to remain influential in increasing suicide risk among men, even after controlling for pre-injury depression. The relationship between mental health before and after occupational injury is complex and studies should better integrate mental health pre-injury.
  
  Though many questions remain on the complex relationship between work, depression, injuries, and suicide, employers should work to prevent injuries and consider implementing mental health programs, which could be helpful in reducing suicide risk.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Male
  • Female
  • Occupational Injuries
  • Adult
  • Middle Aged
  • Suicide
  • Workers' Compensation
  • Major Depressive Disorder
  • Risk Factors
  More +
• Source:
  American Journal of Industrial Medicine, 2025, v. 68, no. 2
• DOI:
  https://doi.org/10.1002/ajim.23682
• ISSN:
  0271-3586 ; 1097-0274
• Pubmed ID:
  39690720
• Pubmed Central ID:
  PMC11800232
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; R01 OH011511/OH/NIOSH CDC HHSUnited States/ ; R21 OH010555/OH/NIOSH CDC HHSUnited States/ ; This study was supported by Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health (grants R01 OH011511 and grants R21 OH010555)./
• Genre:
  Journal Article
• Place as Subject:
  Washington
• Pages in Document:
  122-131 (20 pdf pages)
• Volume:
  68
• Issue:
  2
• Download URL:
  https://stacks.cdc.gov/view/cdc/261850/cdc_261850_DS1.pdf
• File Type:
  [PDF - 361.55 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:c74b9e65ef662a32b33907bb143bd0363d3a03630dccb07eefe710590d775159b62fb6ae18588266075c447b436293fbb15f97f87ec969e03242e7dab67f553a