Journal of occupational medicine and toxicology (London, England) · 2026
Physical pain and risk of suicide and non-fatal self-harm among Swedish construction workers followed over three decades.
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Mehlig Kirsten, Sundvall Hannah, Jonsdottir Ingibjörg H, Nyberg Jenny, Stockfelt Leo, Waern Margda, Åberg Maria
Аннотация
AIM: This observational cohort study aimed to investigate the extent to which physical pain increases the long-term risk of suicidal behavior among construction workers.
METHODS: In 1989-93, 79,099 men from the Swedish construction workers cohort completed a questionnaire on working conditions and physical symptoms, including pain, in addition to their routine health examination. The participants assessed how often they had experienced pain in nine anatomical areas over the past year; this was summarized into four categories describing pain in the neck, shoulders and upper back; the lower back and hip; the upper limbs (hand, wrist, elbow); and the lower limbs (foot, ankle, knee). Frequent pain in at least one location, as well as location-specific frequencies, were considered main exposures. Multivariable Cox proportional hazard regression was used to examine associations between pain and risk of (1) suicide, and (2) non-fatal self-harm including suicide attempt, censored at emigration, disability pension, retirement, other causes of death and end of follow-up in 2018.
RESULTS: 55% of workers reported frequent pain in at least one location, with lower back being the most common site. Frequent pain increased the risk of non-fatal self-harm by 25% compared to no pain in any location and the risk of suicide was doubled. Frequent pain in hand, wrist or elbow was associated with excess risk of both fatal and non-fatal self-harm, while frequent pain in foot, ankle or knee was associated with non-fatal self-harm only, independent of socio-demographic factors, parental origin, body mass index, height and blood pressure. After adjustment for occupational group and unfavorable working position, the increased risk associated with pain in the limbs remained.
CONCLUSION: Our findings underscore the importance of recognizing and addressing the psychological consequences of physical pain among construction workers, particularly when the pain affects the arms or legs.
METHODS: In 1989-93, 79,099 men from the Swedish construction workers cohort completed a questionnaire on working conditions and physical symptoms, including pain, in addition to their routine health examination. The participants assessed how often they had experienced pain in nine anatomical areas over the past year; this was summarized into four categories describing pain in the neck, shoulders and upper back; the lower back and hip; the upper limbs (hand, wrist, elbow); and the lower limbs (foot, ankle, knee). Frequent pain in at least one location, as well as location-specific frequencies, were considered main exposures. Multivariable Cox proportional hazard regression was used to examine associations between pain and risk of (1) suicide, and (2) non-fatal self-harm including suicide attempt, censored at emigration, disability pension, retirement, other causes of death and end of follow-up in 2018.
RESULTS: 55% of workers reported frequent pain in at least one location, with lower back being the most common site. Frequent pain increased the risk of non-fatal self-harm by 25% compared to no pain in any location and the risk of suicide was doubled. Frequent pain in hand, wrist or elbow was associated with excess risk of both fatal and non-fatal self-harm, while frequent pain in foot, ankle or knee was associated with non-fatal self-harm only, independent of socio-demographic factors, parental origin, body mass index, height and blood pressure. After adjustment for occupational group and unfavorable working position, the increased risk associated with pain in the limbs remained.
CONCLUSION: Our findings underscore the importance of recognizing and addressing the psychological consequences of physical pain among construction workers, particularly when the pain affects the arms or legs.