Occupational
Suicide Mortality in Urban Career Firefighters and Emergency Medical Service Providers Compared with the US and NYC Adult Populations Ankura Singh* Ankura Singh Singh Singh Singh Singh Fire Department of the City of New York
Background
The evidence regarding whether suicide risk is elevated among first responders is mixed. We investigated whether career firefighters and emergency medical service providers (EMS) had higher suicide rates than the general population.
Methods
Firefighters and EMS from the Fire Department of the City of New York (FDNY) (N=32925) and responders from 3 other city fire departments (N=11917) were included in the study. Participant follow-up started at the later of hire date or 9/11/01 and ended at the earlier of death date or 12/31/23. We obtained death data via the National Death Index and demographic data from the fire departments. Demographic-specific US and NYC (for FDNY analyses only) suicide rates were used to calculate standardized mortality ratios (SMRs) and 95% CIs for suicide. Multivariable logistic regression models assessed associations between select participant characteristics, ascertained from routine health surveys, and suicide in the FDNY cohort.
Results
By 12/31/23 there were 41 and 11 suicide deaths in FDNY firefighters and EMS, respectively, and 52 in non-FDNY responders. FDNY firefighters had lower suicide rates than similar US (SMR=0.35 (0.25-0.48)) and NYC adults (SMR=0.57 (0.41-0.77)). FDNY EMS did not have significantly different suicide rates from the general populations (SMR=0.57 (0.28-1.02) and SMR=0.94 (0.47-1.69) vs US and NYC populations, respectively). The suicide rate in non-FDNY responders was also not different from that of US adults (SMR=0.94 (0.70-1.24)). Risk factors for suicide in the FDNY group were single marital status (OR=5.20 (2.67-10.14)), and screening positive for PTSD (OR=6.13 (3.00-12.52)), depression (OR=6.06 (3.14-11.68)) or alcohol abuse (OR=3.51 (1.53-8.08)).
Conclusion
In the largest cohort study of suicide in career firefighters and EMS to date, we did not find elevated suicide rates compared with general populations. Mental health screening in responder cohorts may help identify those at elevated risk for suicide.