Suicide across occupational groups in Australia, 2001-2022: a retrospective mortality study.

OBJECTIVES: The study aims to examine suicide mortality across occupational groups by sex and to assess temporal trends between 2001 and 2022 among the employed working-age population in Australia. METHODS: We analysed data from the National Coronial Information System (NCIS), restricted to individuals aged 15-64 who were employed at the time of death. Suicide risk was estimated for 43 occupational groups for both males and females. Joinpoint regression was used to assess suicide trends and identify statistically significant changes in suicide rates over time. RESULTS: A total of 20 055 suicides were included, 16 708 males and 3347 females. 10 occupational groups were identified as high-risk for suicide, characterised by significantly elevated incident rate ratio (IRR) with no significant change in suicide rates over time. This included Arts and Media Professionals (IRR 1.31); Health Professionals (IRR 1.43); Construction Trades Workers (IRR 1.27); Skilled Animal, Agricultural and Horticultural Workers (IRR 1.26); Hospitality Workers (IRR 1.39); Protective Service Workers (IRR 1.60); Clerical and Office Support Workers (IRR 1.50); Machine and Stationary Plant Operators (IRR 2.11); Construction and Mining Labourers (IRR 4.79) and Farm, Forestry and Garden Workers (IRR 1.85). Males working at the higher skill level occupations demonstrated a significantly lower risk of suicide when compared with other workers; whereas those working in low-skilled level occupations have a significantly higher risk of suicide. This skill-level gradient was not observed among females. Occupations where elevated suicide risk was observed only among female workers included Health Professionals (IRR 2.13), Automotive and Engineering Trades Workers (IRR 3.33) and Mobile Plant Operators (IRR 2.62). CONCLUSIONS: These results highlight the intersecting impact of sex, occupation and skill levels on suicide risk. Prevention efforts must address structural and contextual factors within high-risk occupations, especially where occupational demands override typical protective factors.