Occupational Injury and Suicide in Washington State, Adjusting for Pre-Injury Depression

Area of Science:

• Occupational health
• Epidemiology
• Mental health research

Background:

• Previous studies linked occupational injuries to higher suicide rates.
• However, these studies did not account for pre-existing depression.
• This research addresses that gap by examining the role of pre-injury mental health.

Purpose of the Study:

• To investigate the association between occupational injuries and suicide mortality.
• To determine if pre-injury depression influences this relationship.
• To analyze these risks separately for men and women.

Main Methods:

• Linked Washington State workers' compensation injury data (1994-2000) with mortality data through 2018.
• Used competing risks regression to estimate suicide risk for lost-time vs. medical-only injuries.
• Employed quantitative bias analysis (QBA) to adjust for pre-injury major depressive disorder.

Main Results:

• Lost-time injuries were associated with increased suicide mortality in both men and women, adjusting for demographics and earnings.
• After adjusting for pre-injury depression using QBA, the elevated suicide risk remained significant for men (median sHR=1.33).
• The association was not statistically significant for women after adjusting for pre-injury depression.

Conclusions:

• Workplace injuries requiring time off work are linked to increased suicide risk in men, independent of pre-injury depression.
• The interplay between mental health, occupational injury, and suicide is complex.
• Integrating pre-injury mental health data is crucial for future research and prevention efforts.