Employment and Working Conditions and Risk of Suicidal Behaviors: a Systematic Review and Meta-Analysis of Longitudinal Studies

OBJECTIVES:Systematic research on employment/working conditions as risk or protective factors for suicidal behaviors is limited. In this study, we systematically reviewed the literature on a range of employment or working conditions and the risk of suicidal behaviors (suicide and suicide attempt), focusing on longitudinal studies. METHODS:We searched Web of Science, Scopus, PsycInfo, and Embase during 1995-2024 for cohort and case-control studies and performed meta-analysis to pool data if there were ≥2 studies on the same type of conditions and outcome. RESULTS:A total of 27 studies met the eligibility criteria, of which 14 studies were used in meta-analyses. Meta-analyses showed statistically significant associations between part-time work [relative risk (RR) 1.21, 95% confidence interval (CI) 1.12-1.30], job loss (RR 2.27, 95% CI 1.12-4.61), job insecurity (RR 1.64, 95% CI 1.36-1.96), high job demands (RR 1.14, 95% CI 1.08-1.20), low job control (RR 1.11, 95% CI 1.05-1.17), job strain (RR 1.32, 95% CI 1.29-1.36), workplace bullying (RR 1.78, 95% CI 1.16-2.73), and suicide. In terms of the evidence, we found moderate and low certainty for job loss and job insecurity, respectively. For other working conditions, certainty of evidence was considered very low or could not be assessed because of too few studies. Studies investigating suicide attempts were limited, and we only found very low evidence for workplace bullying and suicide attempt (RR 1.33, 95% CI 1.09-1.62, in a previously published meta-analysis). For all other conditions, we could not assess certainty of evidence of associations with suicide attempt. CONCLUSIONS:Although some working conditions may be risk factors for suicide, the number of studies is still too limited to allow for certainty of evidence on associations between specific working conditions and suicide.