Does the work environment contribute to excess male mortality?

It is sometimes assumed that male jobs are on average more unhealthy than female jobs. The aim of the present study is to examine whether work-related factors contribute to excess male mortality. All Swedish deaths during 1970-80 and 1980-86 were analysed with Poisson regressions--for all individuals and for labour force participants--in order to estimate gender mortality rate ratios for all causes, circulatory diseases and external causes. Results for all men and women, as well as results restricted to those in full-time employment, revealed that no work-related factors contribute to excess male mortality. For the period 1980-86, a more detailed analysis was performed, and work environment exposures were aggregated from a secondary data source. In accordance with previous studies, it was found that men experience unhealthier physical work environments than women and that women experience unhealthier psychosocial work environments than men. Among labour force participants, men's greater exposure to hazardous work contributed to men's excess of external causes of death. This finding however, applied only to part-time workers. In conclusion, when factors such as women's greater likelihood of having a low socioeconomic status, their poor psychosocial work environment (low levels of work control and workplace social support), and the fact that women working full-time are more likely than men to be unmarried, were taken into account, the work environment did not appear to contribute to excess male mortality. It is suggested that the lack of reduction in excess male mortality during the 1970 s could be a consequence of the following: women commonly took jobs with low mortality rates; the rapid increase in the numbers of Swedish women in paid employment probably lowered their mortality; other social, behavioural and bio-genetical factors are more important than work in determining excess male mortality. Causality considerations are also discussed.