The epidemiology of work-related suicides remains poorly understood in France, despite the topic’s growing prominence in public discourse. With nearly 8,500 suicide deaths recorded in 2016, France’s suicide mortality rate is among the highest in Europe: a figure likely underestimated by about 10% because a number of suicides are recorded as deaths of undetermined intent or as deaths from unknown causes.

Suicide is a complex, multifactorial phenomenon that is difficult to attribute to a single cause. It is important to take action to reduce suicidal acts in the general population as well as in the workplace. This study does not aim to establish the role of work in the act of suicide but rather to estimate the proportion of suicides in which occupational exposures may have played a more or less significant role in an individual’s suicide.

Feasibility study of an epidemiological surveillance system for work-related suicides

Santé publique France, in collaboration with eight forensic medicine institutes and the CépiDc (Center for Epidemiology of Medical Causes of Death – Inserm), conducted a feasibility study. For each suicide or death of undetermined intent, forensic pathologists collected information on the individual’s sociodemographic and occupational data, as well as indicators of potential links between the death and work.

Objectives

• to propose a definition of suicides potentially linked to work,

• to test the feasibility of an epidemiological surveillance system for these suicides using data from the Institutes of Forensic Medicine (IML),

• to estimate their proportion among all suicides examined by the IMLs.

Key Results

• Between January 1 and December 31, 2018, 1,293 deaths were examined, of which 88% were suicides (n=1,135).

• Most suicides involved men (72%).

• In total, 10% of suicides were potentially work-related according to the definition used.

• Among those whose employment status was known, 28% were employed at the time of death. Among these, work appeared to have played a role in 42% of the suicides.

Key Takeaways

This study demonstrates the feasibility of developing a surveillance system for suicides potentially related to work using data from medical examiners’ offices. Expanding this system to the national level and ensuring its long-term sustainability are recommended. It is proposed to integrate or attach to the supplementary medical section of the death certificate a questionnaire containing the data deemed relevant by this study. Thus, in the long term, Santé publique France could monitor these suicides, which would complement its other work on suicidal behavior by occupational category and sector of activity (agriculture, prison administration, etc.).

Other studies conducted by Santé publique France or in collaboration with partners

• Suicide in the agricultural sector

Studies in the agricultural sector have shown an excess of suicide mortality among male farm owners in 2008, 2009, and 2010, particularly pronounced among those aged 45–64 and in the dairy cattle sector, and a lower rate of suicide mortality among agricultural employees compared to the general population of the same gender and age group.

• Suicide in the prison system

In the prison system, a statistically significant excess of suicides (+21%) was observed among men between 1990 and 2008, specifically among prison guards and technical assistants. No association was observed between the occupational indicators studied (type of facility, prison occupancy rate) and the risk of suicide.

• Publications by the National Suicide Observatory

The agency is also one of the contributors to the 4th report of the National Suicide Observatory, established in 2013: “Suicide: What Links to Work and Unemployment? Thinking About Prevention and Information Systems,” released in June 2020.