Break the Silence: Physician Suicide in the Time of COVID-19.

The rates of physician burnout, depression, and suicide have been on the rise over the past 50 years. Despite increased attention to these topics over the past decade these numbers have remained steady. In the age of SARS-Cov-2 and COVID-19 these numbers are predicted to show a steep increase due to the increased work demands, social isolation, decreased self-care, and increased exposure to emotionally traumatic events at work and home. The potential solutions to these issues generally remain the same; however, we are now in an environment with even more barriers to those solutions.

[Occupational factors associated with suicide among French employees from the special agricultural social security scheme (MSA) working between 2007 and 2013]. / Facteurs professionnels en lien avec le suicide au sein des salariés affiliés à la Mutualité sociale agricole (MSA) et en activité entre 2007 et 2013.

BACKGROUND: Work and related exposures may play a role in suicide and there has been evidence in the literature that some occupational factors may be associated with suicide. The identification of occupational risk factors of suicide mortality among employees affiliated to the French special agricultural social security scheme (MSA), an understudied population, appears important. The objective of this study was to identify the occupational factors associated with suicide mortality among French employees from the MSA working between 2007 and 2013. METHODS: The study population included all the employees affiliated to the MSA working between 1st January 2007 and 31st December 2013, i.e. 1,699,929 men and 1,201,017 women. The studied occupational factors included: economic activity, skill level, and work contract. Survival analyses (Cox models) stratified on gender were performed using age as time scale and region and year of contract as adjustment variables. RESULTS: Among men, the factors associated with an elevated suicide risk were: economic activities of forestry, agriculture and related activities, and manufacture of food products and beverages (e.g. meat, wine), low-skilled level and working in the regions of Brittany, Burgundy Franche-Comté, Pays de la Loire, Normandy, Grand Est and Centre-Val-de-Loire. No association was observed among women. CONCLUSION: These results suggest that economic activity and low-skilled level may be associated with suicide among men affiliated to the MSA and may contribute to the implementation of prevention interventions. Further studies are needed to confirm and better understand these associations.

Chinese nurses are at high risk for suicide: A review of nurses suicide in China 2007-2016.

OBJECTIVE: This study summarized the cases of Chinese nurses' suicide during 2007-2016. METHODS: We reviewed public reports on local media, and medical websites. RESULT: A total of 46 cases of nurse suicide reported or published from 2007 to 2016. In these 46 cases, the proportion of female suicide is 98%. Most cases of suicide occurred in nurses aged 18-50 years. The most common way of suicide was jump from building. Nurse suicide occurred more often in full-service tertiary hospitals. CONCLUSION: The Chinese Government and medical organization should be aware of severity of suicide, and take action to be avoided of more suicide in Chinese nurses.

[Surveillance of work-related suicide in France: An exploratory study]. / Surveillance des suicides liés au travail en France : une étude exploratoire.

BACKGROUND: Despite a large media coverage of the phenomenon, the number of work-related suicides is currently unknown in France. There are nevertheless some data available to document this important issue. The aim of this study was to explore the feasibility of an epidemiological surveillance system for work-related suicides designed to quantify and describe work-related suicides mainly according to economic sectors and occupational categories. METHODS: Existing data sources in France were identified and evaluated for their relevance and their potential use in a multi-sources surveillance system. A regional pilot study was performed using the main relevant sources identified to investigate different aspects of the system design. RESULTS: Four major data sources were identified to be used to describe work-related suicides: death certificates, social insurance funds, data collected by the officers of the labor inspectorate and data collected from autopsy reports in forensic departments. The regional pilot study gave an estimate of 28 cases of work-related suicide in two years. CONCLUSION: The findings point out the difficulties involved and the criteria for successful implement of such a system. The study provides some solutions for carrying out this system, the achievement of which will depend upon particular resources and partners' agreements. Recommendations for the next steps have been made based on this work, including possible collaboration with forensic departments, which collect essential data for surveillance.

Burnout as a predictor of all-cause mortality among industrial employees: a 10-year prospective register-linkage study.

OBJECTIVE: Burnout, a psychological consequence of prolonged work stress, has been shown to coexist with physical and mental disorders. The aim of this study was to investigate whether burnout is related to all-cause mortality among employees. METHODS: In 1996, of 15,466 Finnish forest industry employees, 9705 participated in the 'Still Working' study and 8371 were subsequently identified from the National Population Register. Those who had been treated in a hospital for the most common causes of death prior to the assessment of burnout were excluded on the basis of the Hospital Discharge Register, resulting in a final study population of 7396 people. Burnout was measured using the Maslach Burnout Inventory-General Survey. Dates of death from 1996 to 2006 were extracted from the National Mortality Register. Mortality was predicted with Cox hazard regression models, controlling for baseline sociodemographic factors and register-based health status according to entitled medical reimbursement and prescribed medication for mental health problems, cardiac risk factors, and pain problems. RESULTS: During the 10-year 10-month follow-up, a total of 199 employees had died. The risk of mortality per one-unit increase in burnout was 35% higher (95% CI 1.07-1.71) for total score and 26% higher (0.99-1.60) for exhaustion, 29% higher for cynicism (1.03-1.62), and 22% higher for diminished professional efficacy (0.96-1.55) in participants who had been under 45 at baseline. After adjustments, only the associations regarding burnout and exhaustion were statistically significant. Burnout was not related to mortality among the older employees. CONCLUSION: Burnout, especially work-related exhaustion, may be a risk for overall survival.

Karoshi: death from overwork--a nursing problem in Japan?

Japanese Nurses are overworked and underpaid; many of them leave the profession at about age 25 and get married. Will working conditions change so that more nurses remain nurses?