title: Low Control and High Demands at Work as Risk Factors for Suicide: An Australian National Population-Level Case-Control Study.
abstract: 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 of male 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 biobehavioral mechanisms explaining the link between job stress and suicide, and to inform targeted prevention initiatives.
authors: From the Work, Health, and Wellbeing Unit (Milner, LaMontagne), Centre for Population Health Research, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia; Centre for Health Equity (Milner, LaMontagne), and Centre for Mental Health (Spittal, Pirkis), Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia; INSERM (Chastang, Niedhammer), and Sorbonne Universités, UPMC University Paris (Chastang, Niedhammer), UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Department of Social Epidemiology, Paris, France.
authors: Allison
authors: A
authors: Milner
authors: Matthew J
authors: MJ
authors: Spittal
authors: Jane
authors: J
authors: Pirkis
authors: Jean-François
authors: JF
authors: Chastang
authors: Isabelle
authors: I
authors: Niedhammer
authors: Anthony D
authors: AD
authors: LaMontagne
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D016022:Case-Control Studies; D002423:Cause of Death; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D013405:Suicide / Q000706:statistics & numerical data*; D055815:Young Adult