Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Access to means of suicide, occupation and the risk of suicide: a national study over 12 years of coronial data

Authors: A Milner, K Witt, H Maheen, AD LaMontagne

Published in: BMC Psychiatry | Issue 1/2017

Login to get access

Abstract

Background

Availability of lethal means is a significant risk factor for suicide. This study investigated whether occupations with greater access to lethal means had higher suicide rates than those without access, and further, whether this relationship differed for females versus males.

Methods

A retrospective mortality study was conducted across the Australian population over the period 2001 to 2012. Data from the Australian Bureau of Statistics, which collects Census information on occupation for the Australian population, and the National Coroners Information System, which records information on suicide deaths, were combined. Employed suicide records were coded by occupation and work-related access to lethal means. Descriptive analysis and negative binomial regression were used to assess the relationship between access to means and suicide.

Results

Persons in occupations with access to firearms, medicines or drugs, and carbon monoxide more frequently used these methods to end their lives than those without access to means. Females employed in occupations with access to means had suicide rates that were 3.02 times greater (95% CI 2.60 to 3.50, p < 0.001) than those employed in occupations without access. Males in occupations with access had suicide rates that were 1.24 times greater than those without access (95% CI 1.16 to 1.33, p < 0.001).

Conclusion

Work-related access to means is a risk factor for suicide in the employed population, but is associated with a greater risk for females than males. The findings of this study suggest the importance of controlling access to lethal methods in occupations where these are readily available.
Appendix
Available only for authorised users
Literature
1.
Barber CW, Miller MJ: Reducing a Suicidal Person’s Access to Lethal Means of Suicide: A Research Agenda. Am J Prev Med 2014, 47(3, Supplement 2):S264-S272.
2.
Mann JJ, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, Hegerl U, Lonnqvist J, Malone K, Marusic A, et al. Suicide prevention strategies: a systematic review. JAMA. 2005;294(16):2064–74.CrossRefPubMed
3.
Reisch T, Steffen T, Habenstein A, Tschacher W. Change in suicide rates in Switzerland before and after firearm restriction resulting from the 2003 “Army XXI” reform. Am J Psychiatry. 2013;170(9):977–84.CrossRefPubMed
4.
Yip PS, Law CK, Fu KW, Law YW, Wong PW, Xu Y. Restricting the means of suicide by charcoal burning. Br J Psychiatry. 2010;196(3):241–2.CrossRefPubMed
5.
Pirkis J, Spittal MJ, Cox G, Robinson J, Cheung YTD, Studdert D. The effectiveness of structural interventions at suicide hotspots: a meta-analysis. Int J Epidemiol. 2013;42(2):541–8.CrossRefPubMed
6.
Law CK, Sveticic J, De Leo D. Restricting access to a suicide hotspot does not shift the problem to another location. An experiment of two river bridges in Brisbane, Australia. Aust N Z J Public Health. 2014;38(2):134–8.CrossRefPubMed
7.
Charlton J. Trends and patterns in suicide in England and Wales. Int J Epidemiol. 1995;24(Suppl 1):S45–52.CrossRefPubMed
8.
Hawton K, Agerbo E, Simkin S, Platt B, Mellanby RJ. Risk of suicide in medical and related occupational groups: a national study based on Danish case population-based registers. J Affect Disord. 2011;134(1–3):320–6.CrossRefPubMed
9.
Hawton K, Clements A, Simkin S, Malmberg A. Doctors who kill themselves: a study of the methods used for suicide. QJM Int J Med. 2000;93(6):351–7.CrossRef
10.
Hawton K, Fagg J, Simkin S, Harriss L, Malmberg A. Methods used for suicide by farmers in England and Wales. The contribution of availability and its relevance to prevention. Br J Psychiatry. 1998;173:320–4.CrossRefPubMed
11.
Marzuk PM, Nock MK, Leon AC, Portera L, Tardiff K. Suicide among New York City police officers, 1977-1996. Am J Psychiatry. 2002;159(12):2069–71.CrossRefPubMed
12.
Meltzer H, Griffiths C, Brock A, Rooney C, Jenkins R. Patterns of suicide by occupation in England and Wales: 2001–2005. Br J Psychiatry. 2008;193(1):73–6.CrossRefPubMed
13.
Mahon MJ, Tobin JP, Cusack DA, Kelleher C, Malone KM. Suicide among regular-duty military personnel: a retrospective case-control study of occupation-specific risk factors for workplace suicide. Am J Psychiatry. 2005;162(9):1688–96.CrossRefPubMed
14.
Gullestrup J, Lequertier B, Martin G. MATES in construction: impact of a multimodal, community-based program for suicide prevention in the construction industry. Int J Environ Res Public Health. 2011;8(11):4180–96.CrossRefPubMedPubMedCentral
15.
Heller TS, Hawgood JL, Leo DD. Correlates of suicide in building industry workers. Arch Suicide Res. 2007;11(1):105–17.CrossRefPubMed
16.
Anestis MD, Bryan CJ. Means and capacity for suicidal behavior: a comparison of the ratio of suicide attempts and deaths by suicide in the US military and general population. J Affect Disord. 2013;148(1):42–7.CrossRefPubMed
17.
Skegg K, Firth H, Gray A, Cox B. Suicide by occupation: does access to means increase the risk? Aust N Z J Psychiatry. 2010;44(5):429–34.CrossRefPubMed
18.
Denning DG, Conwell Y, King D, Cox C. Method Choice, Intent, and Gender in Completed Suicide. Suicide Life Threat Behav. 2000;30(3):282–8.PubMed
19.
Värnik A, Kõlves K, van der Feltz-Cornelis CM, Marusic A, Oskarsson H, Palmer A, Reisch T, Scheerder G, Arensman E, Aromaa E, et al. Suicide methods in Europe: a gender-specific analysis of countries participating in the “European Alliance Against Depression”. J Epidemiol Community Health. 2008;62(6):545–51.CrossRefPubMedPubMedCentral
20.
Bugeja L, Clapperton AJ, Killian JJ, Stephan KL, Ozanne-Smith J. Reliability of ICD-10 external cause of death codes in the National Coroners Information System. Health Inf Manag J. 2010;39(3):16–26.
21.
Daking L, Dodds L. ICD-10 Mortality Coding and the NEIS: A Comparative Study. Health Inf Manag J. 2007;36(2):11–23.
22.
De Leo D, Dudley MJ, Aebersold CJ, Mendoza JA, Barnes MA, Harrison JE, Ranson DL. Achieving standardised reporting of suicide in Australia: rationale and program for change. Med J Aust. 2010;192(8):452–6.PubMed
23.
WHO. Chapter XX - External causes of morbidity and mortality. (V01-Y98) Intentional self-harm (X60-X84). Geneva: World Health Organization; 2015.
24.
ABS. Australian and New Zealand Standard Classification of Occupations. Version 1.2. Cat. No. 1220.0. Canberra: ABS; 2013.
25.
ABS. Customised Report. Age 10 Year Age Groups (AGEP) and Occupation 06 (ANZSCO) (OCC06P) by ASGC Upper and Sex Male/Female (SEXP). In: Census of Population and Housing. Canberra: Australia ustralian Bureau of Statistics; 2006.
26.
ABS. Standard population for use in age-standardisation. In: Cat No 31010 Australian Bureau of Statistics. Canberra: Australia Australian Bureau of Statistics; 2015.
27.
StataCorp: Stata Statistical Software: Release 13. College Station, TX: StataCorp LP; 2013.
28.
Clarke RVG, Lester D. Suicide: Closing the exits. New York: Springer Verlag; 1989.CrossRef
29.
Daigle MS. Suicide prevention through means restriction: Assessing the risk of substitution: A critical review and synthesis. Accid Anal Prev. 2005;37(4):625–32.CrossRefPubMed
30.
Florentine JB, Crane C. Suicide prevention by limiting access to methods: a review of theory and practice. Soc Sci Med. 2010;70(10):1626–32.CrossRefPubMed
31.
Yip PSF, Caine E, Yousuf S, Chang S-S, Wu KC-C, Chen Y-Y. Means restriction for suicide prevention. Lancet. 2012;379(9834):2393–9.CrossRefPubMed
32.
Large MM, Nielssen OB. Suicide in Australia: meta-analysis of rates and methods of suicide between 1988 and 2007. Med J Aust. 2010;192(8):432–7.PubMed
33.
Klieve H, Barnes M, Leo D. Controlling firearms use in Australia: has the 1996 gun law reform produced the decrease in rates of suicide with this method? Soc Psychiatry Psychiatr Epidemiol. 2009;4:285.CrossRef
34.
Skopek MA, Perkins R. Deliberate exposure to motor vehicle exhaust gas: the psychosocial profile of attempted suicide. Aust N Z J Psychiatry. 1998;32(6):830–8.CrossRefPubMed
35.
Tsai C-W, Gunnell D, Chou Y-H, Kuo C-J, Lee M-B, Chen Y-Y. Why do people choose charcoal burning as a method of suicide? An interview based study of survivors in Taiwan. J Affect Disord. 2011;131(1–3):402–7.CrossRefPubMed
36.
Milner A, Spittal MJ, Pirkis J, LaMontagne AD. Suicide by Occupation: A systematic review and meta-analysis. Br J Psychiatry. 2013;203:409–16.CrossRefPubMed
37.
Milner A, Niven H, LaMontagne AD. Suicide by occupational skill level in the Australian construction industry: Data from a national register of deaths over the period 2001 to 2010. Aust N Z J Public Health. 2014;38(3):281–5.CrossRefPubMed
38.
Milner AJ, Niven H, LaMontagne AD. Occupational class differences in suicide: evidence of changes over time and during the global financial crisis in Australia. BMC Psychiatry. 2015;15:223.CrossRefPubMedPubMedCentral
39.
Niedhammer I, Chastang JF, Levy D, David S, Degioanni S, Theorell T. Study of the validity of a job-exposure matrix for psychosocial work factors: results from the national French SUMER survey. Int Arch Occup Environ Health. 2008;82(1):87–97.CrossRefPubMed
40.
Milner A, Page K, Spencer-Thomas S, Lamotagne AD. Workplace suicide prevention: a systematic review of published and unpublished activities. Health Promotion International. 2014. doi:10.​1093/​heapro/​dau085.
41.
WHO: Preventing suicide - a resource at work. In: Preventing suicide - a resource series. Geneva Switzerland: WHO; 2006.
Metadata
Title
Access to means of suicide, occupation and the risk of suicide: a national study over 12 years of coronial data
Authors
A Milner
K Witt
H Maheen
AD LaMontagne
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1288-0

Other articles of this Issue 1/2017

BMC Psychiatry 1/2017 Go to the issue

Research article

Experiences of antipsychotic use in patients with early psychosis: a two-year follow-up study

Research article

Neuropsychiatric symptoms following metal-on-metal implant failure with cobalt and chromium toxicity

Research article

How effective is the comprehensive approach to rehabilitation (CARe) methodology? A cluster randomized controlled trial

Research article

Recovery and decision-making involvement in people with severe mental illness from six countries: a prospective observational study

Research article

Trends in treatment with antipsychotic medication in relation to national directives, in people with dementia – a review of the Swedish context

Research article

Prevalence and factors associated with depression among medical students in Cameroon: a cross-sectional study