title: Increased suicide risk among workers following toxic metal exposure at the Paducah gaseous diffusion plant from 1952 to 2003: a cohort study.
abstract: BACKGROUND
  Suicide is a problem worldwide and occupation is an important risk factor. In  the last decade, 55 200 deaths in the US were attributed to occupational risk factors.
  
  
  OBJECTIVE
  To determine if toxic metal exposure was associated with suicide risk among  Paducah gaseous diffusion plant (PGDP) workers.
  
  
  METHODS
  We assembled a cohort of 6820 nuclear industry workers employed from 1952 to  2003. A job-specific exposure matrix (JEM) was used to determine metal exposure likelihood.  Uranium exposure was also assessed by urinalysis. All suicide/self-injury International Classification for Disease (ICD) codes were used to identify suicides. Standardized mortality ratios  (SMR), odds ratios (OR), and hazard ratios (HR) were used to estimate suicide risk.
  
  
  RESULTS
  PGDP suicide victims typically were younger white men. Within exposure likelihood  categories, several suicide SMRs were typically elevated for several metals. Only beryllium  exposure likelihood was associated with an increased HR. Uranium urine concentration was  associated with an elevated suicide risk after stratification by urinalysis frequency.
  
  
  CONCLUSIONS
  Suicide risk is associated with uranium exposure.
authors.affiliation: Department of Preventive Medicine and Environmental Health, College of Public Health, University of Kentucky, Lexington, KY 40536-0003, USA. lfiggs2@gmail.com
authors.forename: L W
authors.initials: LW
authors.lastname: Figgs
authors.forename: H
authors.initials: H
authors.lastname: Holsinger
authors.forename: S J
authors.initials: SJ
authors.lastname: Freitas
authors.forename: G M
authors.initials: GM
authors.lastname: Brion
authors.forename: R W
authors.initials: RW
authors.lastname: Hornung
authors.forename: C H
authors.initials: CH
authors.lastname: Rice
authors.forename: D
authors.initials: D
authors.lastname: Tollerud
mesh_terms: D000368:Aged; D002423:Cause of Death; D016009:Chi-Square Distribution; D015331:Cohort Studies; D019652:Extraction and Processing Industry / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007629:Kentucky / Q000453:epidemiology; D008297:Male; D019216:Metals, Heavy / Q000633:toxicity* / Q000652:urine; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data*; D052638:Particulate Matter / Q000633:toxicity*; D016016:Proportional Hazards Models; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*; D016482:Urinalysis
chemical_list: D019216:Metals, Heavy; D052638:Particulate Matter