title: Exposure to electromagnetic fields and suicide among electric utility workers: a nested case-control study.
abstract: OBJECTIVE
  This nested case-control study examines mortality from suicide in relation to estimated exposure to extremely low frequency electromagnetic fields (EMFs) in a cohort of 138,905 male electric utility workers.
  
  
  METHODS
  Case-control sampling included 536 deaths from suicide and 5348 eligible controls. Exposure was classified based on work in the most common jobs with increased exposure to magnetic fields and indices of cumulative exposure to magnetic fields based on a measurement survey.
  
  
  RESULTS
  Suicide mortality was increased relative to work in exposed jobs and with indices of exposure to magnetic fields. Increased odds ratios (ORs) were found for years of employment as an electrician (OR 2.18; 95% confidence interval (95% CI) 1.25 to 3.80) or lineman (OR 1.59; 95% CI 1.18 to 2.14), whereas a decreased OR was found for power plant operators (OR 0.67; 95% CI 0.33 to 1.40). A dose response gradient with exposure to magnetic fields was found for exposure in the previous year, with a mortality OR of 1.70 (95% CI 1.00 to 2.90) in the highest exposure category. Stronger associations, with ORs in the range of 2.12-3.62, were found for men <50 years of age.
  
  
  CONCLUSIONS
  These data provide evidence for an association between occupational electromagnetic fields and suicide that warrants further evaluation. A plausible mechanism related to melatonin and depression provides a direction for additional laboratory research as well as epidemiological evaluation.
authors.affiliation: Department of Epidemiology, School of Public Health, The University of North Carolina, Chapel Hill, NC, USA.
authors.forename: E
authors.initials: E
authors.lastname: van Wijngaarden
authors.forename: D A
authors.initials: DA
authors.lastname: Savitz
authors.forename: R C
authors.initials: RC
authors.lastname: Kleckner
authors.forename: J
authors.initials: J
authors.lastname: Cai
authors.forename: D
authors.initials: D
authors.lastname: Loomis
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D004574:Electromagnetic Fields / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D011210:Power Plants; D013405:Suicide / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology