Mortality among Norwegian doctors 1960-2000
Tóm tắt
To study the mortality pattern of Norwegian doctors, people in human service occupations, other graduates and the general population during the period 1960-2000 by decade, gender and age. The total number of deaths in the study population was 1 583 559. Census data from 1960, 1970, 1980 and 1990 relating to education were linked to data on 14 main causes of death from Statistics Norway, followed up for two five-year periods after census, and analyzed as stratified incidence-rate data. Mortality rate ratios were computed as combined Mantel-Haenzel estimates for each sex, adjusting for both age and period when appropriate. The doctors had a lower mortality rate than the general population for all causes of death except suicide. The mortality rate ratios for other graduates and human service occupations were 0.7-0.8 compared with the general population. However, doctors have a higher mortality than other graduates. The lowest estimates of mortality for doctors were for endocrine, nutritional and metabolic diseases, diseases in the urogenital tract or genitalia, digestive diseases and sudden death, for which the numbers were nearly half of those for the general population. The differences in mortality between doctors and the general population increased during the periods. Between 1960 and 2000 mortality for doctors converged towards the mortality for other university graduates and for people in human service occupations. However, there was a parallel increase in the gap between these groups and the rest of the population. The slightly higher mortality for doctors compared with mortality for other university graduates may be explained by the higher suicide rate for doctors.
Tài liệu tham khảo
Hämäläinen P, Takala J, Saarela KL: Global estimates of fatal work-related diseases. Am J Ind Med. 2007, 50: 28-41.
Ogle W: Statistics of mortality in the medical profession. Medico-Chirurgical Transactions. 1886, 69: 218-237.
Lindhardt M, Frandsen E, Hamtoft H, Mosbech J: Hvad læger dør af (What doctors die from, in Danish). Ugeskr Laeger. 1961, 123: 1819-1830.
Juel K, Mosbech J, Hansen ES: Mortality and causes of death among Danish medical doctors 1973-1992. Int J Epidemiol. 1999, 28: 456-460. 10.1093/ije/28.3.456.
Innos K, Rahu K, Baburin A, Rahu M: Cancer incidence and cause-specific mortality in male and female doctors: a cohort study in Estonia. Scand J Public Health. 2002, 30: 133-140. 10.1177/14034948020300020701.
Alexander BH, Checkoway H, Nagahama SI, Domino KB: Cause-specific mortality risks of anesthesiologists. Anesthesiology. 2000, 93: 922-930. 10.1097/00000542-200010000-00008.
Frank E: Physician health and patient care. JAMA. 2004, 291: 637-10.1001/jama.291.5.637.
Torre DM, Wang NY, Meoni LA, Young JH, Klag MJ, Ford DE, Torre DM, Wang NY, Meoni LA, Young JH, Klag MJ, Ford DE: Suicide compared to other causes of mortality in physicians. Suicide Life Threat Behav. 2005, 35: 146-153. 10.1521/suli.35.2.146.62878.
Frank E, Biola H, Burnett CA: Mortality rates and causes among U.S. physicians. Am J Prev Med. 2000, 19: 155-159. 10.1016/S0749-3797(00)00201-4.
Hem E, Haldorsen T, Aasland OG, Tyssen R, Vaglum P, Ekeberg Ø: Suicide rates according to education with a particular focus on doctors in Norway 1960-2000. Psychol Med. 2005, 35: 873-880. 10.1017/S0033291704003344.
Schernhammer ES, Colditz GA: Suicide rates among doctors: a quantitative and gender assessment (meta-analysis). Am J Psychiatry. 2004, 161: 2295-2302. 10.1176/appi.ajp.161.12.2295.
King H: Health in the medical and other learned professions. J Chronic Dis. 1970, 23: 257-281. 10.1016/0021-9681(70)90005-6.
Doll R, Peto R: Mortality among doctors in different occupations. BMJ. 1977, 1: 1433-1436. 10.1136/bmj.1.6074.1433.
Araki S, Murata K, Kumagai K, Nagasu M: Mortality of medical practitioners in Japan: social class and the "healthy worker effect". Am J Ind Med. 1986, 10: 91-99. 10.1002/ajim.4700100110.
Rimpelä AH, Nurminen MM, Pulkkinen PO, Rimpelä MK, Valkonen T: Mortality of doctors: do doctors benefit from their medical knowledge?. Lancet. 1987, 1: 84-86.
Borgan JK, Kristofersen LB: Mortality by occupation and socio-economic group in Norway 1970-1980. 1986, Oslo: Statistics Norway, (accessed January 25, 2011), [http://www.ssb.no/histstat/sagml/sagml_56.pdf]
McKinlay JB, Marceau LD: The end of the golden age of doctoring. Int J Health Serv. 2002, 32: 379-416. 10.2190/JL1D-21BG-PK2N-J0KD.
Smith R: Why are doctors so unhappy? There are probably many causes, some of them deep. BMJ. 2001, 322: 1073-1074. 10.1136/bmj.322.7294.1073.
Aasland OG, Nylenna M: Leger som røyker (Doctors who smoke. A survey of smoking habits and life style of Norwegian doctors, in Norwegian). Tidsskr Nor Laegeforen. 1997, 117: 332-337.
Disen A: Tobakksskadeforebyggende arbeid krever satsing på mange fronter (Preventive action against smoking-related injuries requires concentration on a wide front, in Norwegian. Tidsskr Nor Laegeforen. 1997, 117: 330-331.
Carpenter LM, Swerdlow AJ, Fear NT: Mortality of doctors in different specialties: findings from a cohort of 20000 NHS hospital consultants. Occup Environ Med. 1997, 54: 388-395. 10.1136/oem.54.6.388.
Legeforeningen. Legestatistikk (The Norwegian Medical Association: Statistics on physicians in Norway, in Norwegian), (accessed July 7, 2008), [http://www.legeforeningen.no/index.gan?id=18&subid=0]
Legeforeningen. Medisinstudenter i Norge (The Norwegian Medical Association: Medical students in Norway, in Norwegian), (accessed July 7, 2008), [http://www.legeforeningen.no/index.gan?id=136070]
Aasland OG: La salute dei medici è migliore di quella dei pazienti?. Salute e Società. 2004, 1: 1-21.
Børke S: Folketellingen 1960: ny organisering av datafilen (Census 1960: new organization of the data files, in Norwegian). 1983, Oslo: Statistics Norway
ISCED 1997: International Standard Classification of Education. 1997, United Nations Educational, Scientific and Cultural Organization. Paris: UNESCO
StataCorp: Stata Statistical Software. Texas: Stata Press 2003, Release 8.0
Eikemo TA, Bambra C, Joyce K, Dahl E: Welfare state regimes and income-related health inequalities: a comparison of 23 European countries. Eur J Public Health. 2008, 18: 593-599. 10.1093/eurpub/ckn092.
Drever F, Whitehead M, Roden M: Current patterns and trends in male mortality by social class (based on occupation). Popul Trends. 1996, 86: 15-20.
Statistics Norway: Forventet gjenstående levetid for menn og kvinner på utvalgte alderstrinn. 1866-2008. (in Norwegian) (accessed Sept 8, 2010), [http://www.ssb.no/dode/arkiv/tab-2009-04-16-03.html]
Feller DB, Hatch RL: Do doctors take care of their health?. Psychiatr Ann. 2004, 10: 763-768.
Rosvold EO: Doctors in illness and health. An epidemiological study on health- and illness behaviour among 19th and 20th century Norwegian doctors. 2002, Dissertation. Oslo: University of Oslo, (accessed January 25, 2011), [http://www.legeforeningen.no/asset/20570/1/20570_1.pdf]
Satoh H, Yamashita YT, Sekizawa K: Lung cancer among medical professionals. Chest. 2002, 122: 1500-1501. 10.1378/chest.122.4.1500.
Jougla E, Pavillon G, Rossollin F, De Smedt M, Bonte J: Improvement of the quality and comparability of causes-of-death statistics inside the European Community. EUROSTAT Task Force on "causes of death statistics". Rev Epidemiol Sante Publique. 1998, 46: 447-456.
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