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. 2026 Aug 7;105(32):e49903. doi: 10.1097/MD.0000000000049903

Occupational risk factors for suicide: A systematic review and meta-analysis

Sohrab Amiri a,*, Moien AB Khan b
PMCID: PMC13456902  PMID: 42566567

Abstract

Background:

Suicide is one of the major health problems that imposes a heavy burden on the health system. Currently, there is a notable absence of review and meta-analysis studies capable of exploring a broader spectrum of occupational factors associated with dimensions of suicide. This study was conducted to investigate occupational risk factors related to suicide dimensions by systematic review and meta-analysis.

Methods:

Preferred Reporting Items for Systematic Reviews and Meta-analyses have been used. The databases searched in this study included: PubMed, Web of Science, and Scopus. The defined period included the beginning of the formation of these databases until August 2023, and this search was limited to studies published and available in English. The random effects method was used in a pool of different studies. In this research, the odds ratio with a 95% confidence interval (CI) was used in the report of findings.

Results:

The relationship between job demands and suicide dimensions was equal to the odds ratio of 1.29 with a CI between 1.11 and 1.50. This relationship was equal to the odds ratio1.15 with a CI between 1.08 and 1.23. Also, other risk factors for suicide were: conflict at work, job strain, job insecurity, workplace bullying, job stress, burnout, and work-family conflict.

Conclusion:

This study showed how much the work environment and related risk factors can play a role in different aspects of suicide. Therefore, in the policies related to health at work, it is necessary to pay attention to the field of monitoring and screening of mental health in the work environment.

Keywords: job, meta-analysis, occupational risk factor, suicidal ideation, suicide, suicide attempt, systematic review

1. Introduction

Suicide is one of the health-related phenomena that imposes a heavy burden on society[1]; so this phenomenon is recognized by the World Health Organization (WHO) as an important public health issue.[2] Suicide is defined as an intentional death caused by self-directed injury[3], whose rate is different based on gender and age group.[4,5] According to the latest report published by WHO in 2023, more than 700,000 people in the world die by suicide every year.[6] More than 77% of suicides occurred in low- and middle-income countries in 2019.[6] There are far more people with suicide attempts than there are deaths by suicide.[6] A suicide attempt is defined as “non-fatal, self-directed, potentially injurious behavior with intent to die as a result of the behavior. A suicide attempt might not result in injury and suicidal ideation is defined as “thinking about, considering, or planning suicide.”[7] The lifetime prevalence of suicide attempts in the general population is reported to be 0.8%.[8] The ratio of suicide in men to women is reported to be 1.7.[9] In another study, the lifetime prevalence of suicidal ideation and suicide attempts was reported as 13.5% and 4.6%, respectively.[10] According to the nature of the suicide phenomenon, various risk factors have been expressed in this regard, including mental illness,[11–14] physical diseases,[15–18] body mass index,[19] low income and unemployment,[20–22] immigration,[23] alcohol and substance use,[24,25] and eating disorders.[26] One of the important factors in mental health is the work environment in which a person works.[27]

Psychosocial factors in which people work are known as important factors in health.[28] Various studies show that facing psychosocial risks in the workplace is associated with an increased risk of mental health problems.[27,29] People who experience high job strain are at risk of depression, so this group is 77% more exposed to clinical depression,[30] it is also associated with increased burnout,[31] musculoskeletal pain,[32] and mortality.[33] Workplace bullying is associated with an increased risk of sleep problems,[34] sickness absence,[35] depression,[36,37] and anxiety.[38] The existing literature about the role of occupational risk factors and mental health is very extensive. Other factors that can play a role in different aspects of suicide are occupational risk factors.[39,40]

Studies on occupational risk factors for suicide have yielded some results, according to which workplace bullying has been associated with the odd risk of suicidal ideation and behavior 2.03-times and 2.67-times, respectively.[39] Also, another meta-analysis study on occupational stressors and suicidality has shown that poor social support at work, job insecurity, and low job control are associated with suicidal ideation or suicidal mortality.[40] Also, some other studies are limited to the role of working conditions,[41] job strain,[42] and workplace[43] bullying with suicidal ideation and behavior. Another study has demonstrated that stress and job-related factors significantly influence cognitive functions, leading to notable impairments in areas such as verbal memory, planning, cognitive flexibility, set-shifting, and both simple and complex attention among middle-aged miners when compared to control groups.[44] The findings also highlight that the duration of employment and the level of education play a crucial role in shaping executive functions.[44]

Although the studies conducted on occupational factors for mental health are very extensive, and the occupational factors related to the dimensions of suicide are very extensive, there are no review and meta-analysis studies that can examine a wider range of occupational factors related to suicide dimensions and provide a comprehensive review. The review and meta-analysis studies mentioned in the previous sections have only addressed some occupational risk factors or only some aspects of suicide, such as suicidal thoughts and suicide attempts, which have been examined.

While there are various review studies and meta-analyses that examine the connection between occupational factors and instances of suicide [40–43], these works often fall short of offering a truly comprehensive perspective. Within this domain of prior research, suicide has garnered relatively limited attention despite representing the most extreme manifestation of suicidal behavior. Notably, certain studies have exclusively focused on male subjects [45], neglecting to account for both sexes in their analyses. Research on suicidal ideation has been less frequently subjected to meta-analysis when examining its connection to occupational risk factors.[46] Occupational risk factors like workplace conflict, job-related stress, and burnout have not been thoroughly assessed in relation to their potential impact on different forms of suicidal behavior, such as suicidal thoughts, attempts, or suicide mortality.

The references mentioned in earlier discussions make it evident that certain critical aspects of occupational health, particularly those tied to suicidal behaviors, remain underrepresented or entirely absent in prior research. This gap highlights the need for a more exhaustive exploration of how workplace-related elements contribute to such behaviors, ensuring that overlooked dimensions are brought to light for a fuller understanding. This study offers a more up-to-date and thorough exploration of the evidence concerning the connection between various occupational factors and the risk of suicide. By delving deeper into the intricacies of this relationship, the research aims to shed light on how job-related variables might influence mental health outcomes, ultimately contributing to a broader understanding of potential risk factors linked to suicide within workplace settings. Based on what was stated, the purpose of this research was to conduct a systematic review and meta-analysis to investigate occupational risk factors related to suicidal ideation, suicide attempts, and suicide mortality.

2. Method

2.1. Protocol

In the current research, the steps recommended in Preferred Reporting Items for Systematic Reviews and Meta-analyses have been used to conduct this research.[47]

2.2. Inclusion and exclusion criteria

The criteria for inclusion in this study were as follows: First, studies employing cross-sectional, longitudinal, or case-control designs were deemed eligible for consideration. Second, to qualify, these studies needed to report on the association between occupational risk factors and at least one aspect of suicide, such as suicidal ideation, suicide attempts, or suicide mortality. Finally, the metrics used to evaluate the relationship between occupational risk factors and suicide had to include one of the following: odds ratio, risk ratio, or relative risk with a 95% confidence interval (CI), or correlation coefficients accompanied by sample size.

The following categories of studies were deemed ineligible for inclusion in this research: studies employing case study or review-based methodologies, and investigations examining the relationship between a specific occupational risk factor and suicide, where meta-analysis or data pooling with other studies was unfeasible due to an insufficient number of studies addressing that particular relationship. Pooling studies should have a minimum threshold. This means that there was a single study that could not be pooled. Studies that failed to provide the essential data required for calculating odds ratios were excluded. Additionally, in cases where multiple studies were derived from the same dataset, only 1 study was chosen for inclusion.

2.3. Information sources

In the search for studies for this research, 3 databases were systematically searched using a comprehensive syntax, which is mentioned in Supplemental Digital Content 1, Supplemental Digital Content 1. The databases searched in this study included: PubMed, Web of Science, and Scopus. The defined period included the beginning of the formation of these databases until August 2023, and this search was limited to studies published and available in English.

2.4. Search strategy

In Supplemental Digital Content 1, Supplemental Digital Content 1, the syntax of keywords is included, which is based on different dimensions of occupational risk factors as an exposure variable and suicide as an outcome variable.

2.5. Selection process

The process of selecting studies is based on Figure 1, which includes 3 main steps: identification, screening, and inclusion. The studies were screened and selected based on the titles, then based on the abstract, and finally based on the full text. In the search process of selecting studies, some studies were not found, and the authors were contacted; only 4 authors responded.

Figure 1.

Figure 1.

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Flowchart of studies screening for this study.

2.6. Data collection process

In the data collection process, the researchers entered jointly the extracted data, including the following items: Authors and year of publication of the study, country, type of population, demographic characteristics of participants, type of exposure variable, type of outcome variable, and its measurement method, statistical result, and controlled variables. Data extraction was conducted independently by researchers.

2.7. Data items

Occupational risk variables that were defined as exposure variables in this research include: job demands, job control, conflict at work, job insecurity, lack of reward, occupational climate, work-family conflict, job strain, burnout, workload, job satisfaction, long working hours, job stress, workplace bullying, social support at work, and shift work. The outcome variables included 3 subjects related to suicide: suicidal ideation, suicide attempts, and suicide mortality.

2.8. Quality assessment

Effective Public Health Practice Project Quality Assessment Tool[48,49] was used to measure the qualitative dimensions related to each of the studies. Based on this, 4 dimensions of this adapted tool were used in the present study: selection bias, confounders bias, data collection method, and withdrawals and dropouts.

2.9. Effect measures

For the pool of different studies in the meta-analysis, the odds ratio and 95% CI were used as the reporting method.

2.10. Statistical analysis

After extracting data from each study, these data were pooled based on the levels of independent and dependent variables. In some studies, multiple levels of a variable were reported, and these were pooled using the fixed effects method. The random effects method was used in a pool of different studies. In this research, the odds ratio with a 95% CI was used in the report of findings. For dependent exposure variables, existing procedures were used to pool them.[50] This approach is based on the average of the sum of dependent outcomes. Publication bias and heterogeneity across studies were also examined using the heterogeneity chi-squared test and I2,[51,52] funnel plot, Egger’s test, and the trim-and-fill method.[53–55] In the review of publication bias, the number of 10 studies was considered as a cutoff point.[56] Stata version 14 software (Stata Corp., College Station, TX) and Comprehensive meta-analysis-3 software[57] were used for analysis.

3. Result

3.1. Study selection

Figure 1 shows the stages of selection and exclusion of studies. After screening the studies based on the inclusion and exclusion criteria, sixty-five studies were found to be eligible. Among these studies, 5 studies[58–62] that reported the hazard ratio were excluded, and finally, sixty studies[63–122] were included in the meta-analysis, and the detailed characteristics of each study are listed in Table S1, Supplemental Digital Content 2.

3.2. Study characteristics

From the total number of studies included in this research, which included sixty-six studies, 3 were selected from cross-sectional, longitudinal, and case-control designs. These included genders and age groups, mostly adults. For each of these studies, a set of data is reported in Table S1, Supplemental Digital Content 2.

3.3. Risk of bias in studies

The 4 dimensions of measuring the quality of the studies (selection bias, confounder bias, data collection method, and withdrawals and dropouts) are included in Table S1, Supplemental Digital Content 2 for each of the studies. What is reported indicates the level of low, medium, and high quality of the different studies?

3.4. Results of individual studies

Various indices were reported for the relationship between exposure and outcome variables, the most common of which was the odds ratio with a 95% CI, and this ratio was used to report the pool of studies.

3.5. Results of analysis

Figure 2 shows the association between job demands and suicide dimensions. This association is equal to the odds ratio1.29 with a CI between 1.11 to 1.50 (n = 18; Z = 3.31; P = .001; I2 = 93.63%).

Figure 2.

Figure 2.

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Forest plot of job demands and suicide dimensions. CI = confidence interval.

Figure 3 shows the association between job demands and suicidal ideation, suicide mortality, and suicidality. This association is equal to the odds ratio1.36 with a CI between 1.12 and 1.66 (n = 13; Z = 3.09; P = .002; I2 = 95.33%) for suicidal ideation. This association is equal to the odds ratio1.25 with a CI between 1.16 and 1.35 (n = 2; Z = 5.72; P < .001; I2 = 0%) for suicidal mortality. This association is equal to the odds ratio1.26 with CI between 1.02 to 1.55 (n = 2; Z = 2.14; P = .033; I2 = 0%) for suicidality.

Figure 3.

Figure 3.

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Forest plot of job demands and suicidal ideation, suicide mortality, and suicidality. CI = confidence interval.

Figure 4 shows the association between job control and suicide dimensions. This association is equal to the odds ratio1.15 with CI between 1.08 to 1.23 (n = 14; Z = 4.06; P < .001; I2 = 76.48%).

Figure 4.

Figure 4.

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Forest plot of job control and suicide dimensions. CI = confidence interval.

Figure 5 shows the association between job control, suicidal ideation, and suicide mortality. This association is equal to the odds ratio1.21 with a CI between 1.08 and 1.35 (n = 10; Z = 3.32; P = .001; I2 = 76.89%) for suicidal ideation. This association is equal to the odds ratio1.89 with a CI between 0.56 and 6.47 (n = 2; Z = 1.02; P = .307; I2 = 79.24%) for suicidal mortality.

Figure 5.

Figure 5.

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Forest plot of job control and suicidal ideation and suicide mortality. CI = confidence interval.

Figure 6 shows the association between conflict at work, job strain, lack of reward, occupational climate, social support at work and suicide dimensions. This association is equal to the odds ratio1.17 with a CI between 1.03 to 1.33 (n = 7; Z = 2.45; P = .014; I2 = 52.49%). This association is equal to the odds ratio1.17 with a CI between 1.02 and 1.34 (n = 6; Z = 2.30; P = .021; I2 = 59.36%) for suicidal ideation (not shown in the figure). The association between job strain and suicidal ideation is equal to the odds ratio 2.36 with a CI between 1.21 and 4.58 (n = 2; Z = 2.52; P = .012; I2 = 50.44%). The association between lack of reward, occupational climate, social support at work, and suicide dimensions was not significant.

Figure 6.

Figure 6.

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Forest plot of conflict at work, job strain, lack of reward, occupational climate, social support at work, and suicide dimensions. CI = confidence interval.

Figure 7 shows the association between job insecurity and suicide dimensions. This association is equal to the odds ratio1.42 with a CI between 1.13 to 1.78 (n = 10; Z = 3.02; P = .002; I2 = 75.11%).

Figure 7.

Figure 7.

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Forest plot of job insecurity and suicide dimensions. CI = confidence interval.

Figure 8 shows the association between job insecurity, suicidal ideation, and suicidality. This association is equal to the odds ratio1.50 with a CI between 1.19 and 1.89 (n = 8; Z = 3.45; P = .001; I2 = 68.01%) for suicidal ideation. This association is equal to the odds ratio1.27 with CI between 0.55 to 2.95 (n = 2; Z = 0.56; P = .578; I2 = 80.71%) for suicidality.

Figure 8.

Figure 8.

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Forest plot of job insecurity, suicidal ideation, and suicidality. CI = confidence interval.

Figure 9 shows the association between job stress, workload, and suicide dimensions. This association is equal to the odds ratio1.48 with a CI between 1.31 and 1.66 (n = 11; Z = 6.47; P < .001; I2 = 94.34%) for job stress. This association is equal to the odds ratio1.64 with CI between 0.95 to 2.86 (n = 4; Z = 1.76; P = .078; I2 = 94.27%) for workload.

Figure 9.

Figure 9.

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Forest plot of job stress, workload, and suicide dimensions. CI = confidence interval.

Figure 10 shows the association between job stress, workload, and suicidal ideation. This association is equal to the odds ratio1.47 with a CI between 1.31 and 1.66 (n = 10; Z = 6.35; P < .001; I2 = 94.87%) for job stress. This association is equal to the odds ratio1.53 with CI between 0.97 to 2.39 (n = 4; Z = 1.85; P = .065; I2 = 92.11%) for workload.

Figure 10.

Figure 10.

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Forest plot of job stress, workload, and suicidal ideation. CI = confidence interval.

Figure 11 shows the association between workplace bullying and suicide dimensions. This association is equal to the odds ratio 2.08 with a CI between 1.58 and 2.74 (n = 9; Z = 5.20; P < .001; I2 = 76.80%). This association is equal to the odds ratio1.96 with a CI between 1.51 and 2.54 (n = 9; Z = 5.05; P < .001; I2 = 85.42%) for suicidal ideation. This association is equal to the odds ratio 2.99 with a CI between 0.98 and 9.14 (n = 2; Z = 1.92; P = .054; I2 = 93.59%) for suicide attempts (not shown in the figure).

Figure 11.

Figure 11.

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Forest plot of workplace bullying and suicide dimensions. CI = confidence interval.

Figure 12 shows the association between burnout and suicide dimensions. This association is equal to the odds ratio 1.84 with a CI between 1.20 and 2.83 (n = 9; Z = 2.80; P = .005; I2 = 93.02%). This association is equal to the odds ratio1.73 with a CI between 1.15 and 2.60 (n = 8; Z = 2.63; P = .009; I2 = 89.75%) for suicidal ideation. (not shown in the figure).

Figure 12.

Figure 12.

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Forest plot of burnout and suicide dimensions. CI = confidence interval.

Figure 13 shows the association between job dissatisfaction and suicidal ideation. This association is equal to the odds ratio 1.12 with a CI between 0.96 and 1.31 (n = 6; Z = 1.44; P = .151; I2 = 67.60%).

Figure 13.

Figure 13.

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Forest plot of job dissatisfaction and suicidal ideation. CI = confidence interval.

Figure 14 shows the relationship between long working hours and suicidal ideation. This relationship is equal to the odds ratio 1.41 with a CI between 0.91 and 2.18 (n = 19; Z = 1.54; P = .122; I2 = 99.85%).

Figure 14.

Figure 14.

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Forest plot of long working hours and suicidal ideation. CI = confidence interval.

Figure 15 shows the association between shift work and suicidal ideation. This relationship is equal to the odds ratio 1.12 with a CI between 0.93 and 1.34 (n = 6; Z = 1.17; P = .241; I2 = 83.39%).

Figure 15.

Figure 15.

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Forest plot of shift work and suicidal ideation. CI = confidence interval.

Figure 16 shows the association between work-family conflict and suicide dimensions. This association is equal to the odds ratio 1.91 with a CI between 1.16 and 3.16 (n = 6; Z = 2.54; P = .011; I2 = 91.48%). This association is equal to the odds ratio 2.05 with a CI between 1.39 and 3.03 (n = 6; Z = 3.60; P < .001; I2 = 90.84%) for suicidal ideation.

Figure 16.

Figure 16.

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Forest plot of work-family conflict and suicide dimensions. CI = confidence interval.

3.6. Publication bias and heterogeneity

In the association between job demands and suicide dimensions, the funnel plot is in Figure 17. The Egger test was (P = .341), and publication bias was not shown. The trim-and-fill[55] imputed 3 studies. Adjusted odds ratio was 1.21 (95% CI 1.03–1.41). Heterogeneity was I2 = 93.63%, this is a high-heterogeneity[123] and the heterogeneity of chi-square was 266.887 (d.f = 17; P < .001).

Figure 17.

Figure 17.

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Funnel plot of job demands and suicide dimensions.

In the association between job control and suicide dimensions, the funnel plot is in Figure 18. The Egger test was (P < .001), and publication bias was shown. The trim-and-fill[55] imputed 7 studies. Adjusted odds ratio was 1.10 (95% CI 1.03–1.18). Heterogeneity was I2 = 76.48%, this is a high- heterogeneity[123] and the heterogeneity of chi-square was 55.262 (d.f = 13; P < .001).

Figure 18.

Figure 18.

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Funnel plot of job control and suicide dimensions.

In the association between job insecurity and suicide dimensions, the funnel plot is in Figure 19. The Egger test was (P = .431), and publication bias was not shown. The trim-and-fill[55] imputed 2 studies. Adjusted odds ratio was 1.33 (95% CI 1.07–1.66). Heterogeneity was I2 = 75.11%, this is a high- heterogeneity[123] and the heterogeneity of chi-square was 36.161 (d.f = 9; P < .001).

Figure 19.

Figure 19.

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Funnel plot of job insecurity and suicide dimensions.

In the association between job stress and suicidal ideation, the funnel plot is in Figure 20. The Egger test was (P = .040), and publication bias was shown. The trim-and-fill[55] imputed 4 studies. Adjusted odds ratio was 1.25 (95% CI 1.11–1.40). Heterogeneity was I2 = 94.34%, this is a high- heterogeneity[123] and the heterogeneity of chi-square was 176.80 (d.f = 10; P < .001).

Figure 20.

Figure 20.

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Funnel plot of job stress and suicidal ideation.

In the association between long working hours and suicidal ideation, the funnel plot is in Figure 21. The Egger test was (P = .298), and publication bias was not shown. The trim-and-fill[55] has not been imputed in any study. Heterogeneity was I2 = 99.85%, this is a high- heterogeneity[123] and the heterogeneity of chi-square was 12358.624 (d.f = 19; P < .001).

Figure 21.

Figure 21.

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Funnel plot of long working hours and suicidal ideation.

4. Discussion

This study employed a systematic review and meta-analysis to investigate occupational factors linked to suicidal ideation, suicide attempts, and suicide mortality. A total of sixty studies met the inclusion criteria, enabling a comprehensive analysis. Sixteen specific occupational risk factors were systematically examined, with their contributions to suicidal ideation, suicide attempts, and suicide mortality thoroughly evaluated.

The findings derived from this research indicate an association between occupational factors and an elevated risk of experiencing suicidal ideations, engaging in suicide attempts, and facing suicide-related mortality. However, it is worth noting that certain relationships observed within the study did not reach a level of statistical significance, suggesting variability in the strength of these associations across different occupational influences. This finding is in line with previous review and meta-analysis studies that investigated some occupational factors, including working conditions [41] job strain [42] and workplace bullying.[39,43] With the difference that in past research, they focused on a few occupational risk factors, but in this meta-analysis, a wide set of occupational risk factors related to suicide dimensions were studied. The effect of work and work environment on health is a matter that has been well shown in your previous study.[27,124] Therefore, having a job and doing this type of activity can increase the feeling of mental health[125]; also, not having a job and unemployment are related to increasing mental health problems such as depression and suicide.[22,126] When job conditions become unfavorable, it leads a person to be prone to mental and physical health problems.[127,128] On the other hand, improvement in working conditions is associated with improvement in mental health.[129]

In general, people of working age spend an important part of their time in the work environment; whether this work environment is a risk factor or a factor that improves mental health depends on the conditions in it. Some mechanisms can be considered through which occupational risk factors affect suicide dimensions. Depression is one of the most important factors affecting the risk of suicide, and therefore, when job conditions are unfavorable, it leads a person to helplessness, fatigue, and depression.[130–132] It can be said that the effect of occupational risk factors on suicide dimensions is mediated through depression. That is, when a person is in an unfavorable job situation, the person becomes depressed, and this depression leads the person to be prone to suicide behaviors. Also, some occupational risk factors, such as being a victim of bullying at work, can lead to psychological trauma for a person, and trauma is a risk factor for suicidal behaviors.[133] Regarding occupational stressors, a previous study has pointed out the role of mental health problems as an important factor in suicide.[40]

According to the report published by the WHO, 12 billion working days are lost annually as a result of depression and anxiety, and the resulting economic burden is estimated at 1 trillion.[134] According to that report, almost 60% of the working population is working; therefore, it is necessary to pay attention to effective strategies in reducing the risk of mental health facts at work and also try to follow up on mental problems and their recovery.[134]

5. Conclusion

This study highlights the significant influence of the work environment and its associated risk factors on various dimensions of suicide. Consequently, workplace health policies must emphasize the importance of monitoring and screening mental health within professional settings. This approach can help identify potential causes contributing to mental health challenges while keeping track of the current situation. Simultaneously, efforts should be directed toward mitigating and reducing these effects. It is important to recognize that suicide-related outcomes are complex and multidimensional, requiring a comprehensive approach. Alongside general monitoring, workplace organizations should implement tailored programs for individuals to actively foster and enhance mental health. To summarize, the findings of the current study highlight the significant impact that occupational factors can have on diminishing mental health. Specifically, this research focuses on the mental health issue of suicide, including its various forms. By gaining a deeper understanding of these workplace-related factors, it becomes possible to play a pivotal role in alleviating the burden of mental health challenges within professional environments.

5.1. Limitations

This research provided a perspective on a wide range of occupational risk factors related to suicide dimensions, which can be used in other studies in the field of mental health. However, the current research has limitations. Firstly, it was not possible to investigate gender differences, and considering that suicide has a different prevalence in both genders, this issue needs to be taken into account when generalizing the results. This research analyzed a study that demonstrated considerable heterogeneity. Such pronounced variability diminishes the accuracy of pooled estimates and highlights the inherent challenges in the process. The authors openly recognize this limitation and offer a thoughtful discussion on potential factors contributing to heterogeneity, such as variations in populations, outcome measures, participant characteristics, and study designs. Considering the diverse range of studies included, a certain level of heterogeneity is to be anticipated within this body of literature. Furthermore, the subgroup analyses seem to mitigate concerns related to interoperability to some extent by categorizing outcomes and exposures separately. Most of the studies included in this study focused on suicidal ideation, and suicide attempts and suicide death were less studied. The studies obtained in this research were mostly cross-sectional, so caution should be taken in establishing causal relationships. The plan of suicide and self-harm concerning occupational risk factors had almost no research background; this issue can be investigated in the future. The identified limitations also encompassed the absence of subgroup or meta-regression analyses, the omission of studies employing hazard ratio data, the possible impact of publication bias on the results, and the language-based restrictions applied to the selection of included studies.

Author contributions

Conceptualization: Sohrab Amiri, Moien A.B. Khan.

Data curation: Sohrab Amiri.

Formal analysis: Sohrab Amiri.

Writing – original draft: Sohrab Amiri, Moien A.B. Khan.

Writing – review & editing: Sohrab Amiri, Moien A.B. Khan.

medi-105-e49903-s001.docx (15.9KB, docx)
medi-105-e49903-s002.docx (106KB, docx)

Abbreviations:

CI
confidence interval
WHO
World Health Organization

The authors have no funding and conflicts of interest to disclose.

All data generated or analyzed during this study are included in this published article (and its supplementary information files).

Supplemental Digital Content is available in the online version of this article (http://dx.doi.org/10.1097/MD.0000000000049903).

How to cite this article: Amiri S, Khan MAB. Occupational risk factors for suicide: A systematic review and meta-analysis. Medicine 2026;105:32(e49903).

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