Mortality among workers employed in the mining industry in the United States: A 29-year analysis of the National Health Interview Survey-Linked Mortality File, 1986-2014

Suicide Rates and Risks Across U.S. Industries: A 29-Year Population-Based Survey

OBJECTIVE

Suicide rates in the working-age U.S. population have increased by over 40% in the last two decades. Although suicide may be linked with characteristics of workplaces and their industries, few studies have reported industry-level suicide rates. No study has reported suicide rates by industry using nationally representative data. This study estimates suicide risks across industries in the U.S. working population.

METHODS

Industry-level estimates of suicide risks require substantial data; we combined 29 years of U.S. suicide data using the National Health Interview Survey (NHIS)-Mortality Linked data from 1986 through 2014, with mortality follow-up through 2015. We conducted survey-weighted Poisson regression analyses to estimate suicide mortality rates and rate ratios across all populations and stratified by gender. All analyses were adjusted first for age, and then for age, employment status, marital status, race/ethnicity, and rurality/urbanicity (demographic-adjusted). Rate ratios compared results for workers in each industry to those for all industries, accounting for the NHIS survey design.

RESULTS

A total of 1,943 suicide deaths were recorded. Age-adjusted suicide rates per 100,000 were highest in the furniture, lumber, and wood industry group (29.3), the fabricated metal industry (26.3), and mining (25.8). Demographic-adjusted rates were higher among men than women in most industries. Demographic-adjusted rate ratios were significantly elevated in the furniture, lumber, and wood industries (Rate Ratio, RR = 1.60, 95% confidence interval, CI = 1.18-2.18); chemicals and allied products (RR = 1.49, 95%CI = 1.04-2.13); and construction (RR = 1.21, 95% CI = 1.03-1.41).

CONCLUSION

Several industries had significantly high suicide rates. Suicide prevention efforts may be particularly useful for workers in those industries.

Estimating mortality from coal workers' pneumoconiosis among Medicare beneficiaries with pneumoconiosis using binary regressions for spatially sparse data

Background

Coal workers' pneumoconiosis (CWP) is an occupational lung disease due to inhalation of coal dust. We estimated mortality from CWP and other pneumoconioses among Medicare beneficiaries.

Methods

We used the 5% Medicare Limited Claims Data Set, 2011–2014, to identify patients diagnosed with ICD‐9‐CM 500 (CWP) through 505 (Asbestosis, Pneumoconiosis due to other silica or silicates, Pneumoconiosis due to other inorganic dust, Pneumonopathy due to inhalation of other dust, and Pneumoconiosis, unspecified) codes. We applied binary regression models with spatial random effects to determine the association between CWP and mortality. Our inferences are based on Bayesian spatial hierarchical models, and model fitting was performed using Integrated Nested Laplace Approximation (INLA) algorithm in R/RStudio software.

Results

The median age of the sample was 76 years. In a sample of 8531 Medicare beneficiaries, 2568 died. Medicare beneficiaries with CWP had 25% higher odds of death (adjusted OR: 1.25, 95% CI: 1.07, 1.46) than those with other types of pneumoconiosis. The number of comorbid conditions elevated the odds of death by 10% (adjusted OR: 1.10, 95% CI: 1.09, 1.10).

Conclusion

CWP increases the likelihood of death among Medicare beneficiaries. Healthcare professionals should make concerted efforts to monitor patients with CWP to prevent premature mortality.

Inequalities in External-Cause Mortality in 2018 across Industries in Republic of Korea

Background

External-cause mortality is an important public health issue worldwide. Considering its significance to workers’ health and inequalities across industries, we aimed to describe the state of external-cause mortality and investigate its difference by industry in Republic of Korea based on data for 2018.

Methods

Data obtained from the Statistics Korea and Korean Employment Information System were used. External causes of death were divided into three categories (suicide, transport accident, and others), and death occurred during employment period or within 90 days after unemployment was regarded as workers’ death. We calculated age- and sex-standardized mortalities per 100,000, standardized mortality ratios (SMRs) compared to the general population and total workers, and mortality rate ratios (RRs) across industries using information and communication as a reference. Correlation analyses between income, education, and mortality were conducted.

Results

Age- and sex-standardized external-cause mortality per 100,000 in all workers was 29.4 (suicide: 16.2, transport accident: 6.6, others: 6.6). Compared to the general population, all external-cause and suicide SMRs were significantly lower; however, there was no significant difference in transport accidents. When compared to total workers, wholesale, transportation, and business facilities management showed higher SMR for suicide, and agriculture, forestry, and fishing, mining and quarrying, construction, transportation and storage, and public administration and defense showed higher SMR for transport accidents. A moderate to strong negative correlation was observed between education level and mortality (both age- and sex-standardized mortality rates and SMR compared to the general population).

Conclusion

Inequalities in external-cause mortalities from suicide, transport accidents, and other causes were found. For reducing the differences, improved policies are needed for industries with higher mortalities.