Low Control and High Demands at Work as Risk Factors for Suicide: An Australian National Population-Level Case-Control Study

Objective: Previous research suggests that psychosocial job stressors may be plausible risk factors for suicide. This study assessed the relationship between psychosocial job stressors and suicide mortality across the Australian population. Methods: We developed a job exposure matrix to objectively measure job stressors across the working population. Suicide data came from a nationwide coronial register. Living controls were selected from a nationally representative cohort study. Incidence density sampling was used to ensure that controls were sampled at the time of death of each case. The period of observation for both cases and controls was 2001 to 2012. We used multilevel logistic regression to assess the odds of suicide in relation to 2 psychosocial job stressors (job control and job demands), after matching for age, sex, and year of death/ survey and adjusting for socioeconomic status. Results: Across 9,010 cases and 14,007 matched controls, our results suggest that low job control (odds ratio [OR], 1.35; 95% confidence interval [CI], 1.26-1.44; p < .001) and high job demands (OR, 1.36; 95% CI, 1.26-1.46; p <.001) were associated with increased odds ofmale suicide after adjusting for socioeconomic status. High demands were associated with lower odds of female suicide (OR, 0.81; 95% CI, 0.72-0.92; p = .002). Conclusions: It seems that adverse experiences at work are a risk factor for male suicide while not being associated with an elevated risk among females. Future studies on job stressors and suicide are needed, both to further understand the bio-behavioral mechanisms explaining the link between job stress and suicide, and to inform targeted prevention initiatives.