Suicides at work: misclassification and prevention implications.

Abstract

To determine the extent of misclassification of suicides with regard to work-relatedness and the implication for intervention, a matched case-control design was used. Cases were identified from California's master mortality file using ICD 9-CM external cause codes E950-959 and a positive response to the "injury-at-work" designation on the death certificate. Two controls matched on the same external cause of death codes, age, date of death, and county of occurrence were randomly selected. Outcome measures were odds ratios and accuracy assessments. Over 11% of cases and 23% of controls were misclassified. Extrapolation to the United States suggests thousands of suicides are misclassified as to a work-related connection. The findings point to misappropriation of the work-relatedness of suicide and hence, an inaccurate understanding of underlying risk factors and their intervention potential.