Sector of Employment and Mortality: A Cohort Based on Different Administrative Archives

Abstract

Administrative data can be precious in connecting information from different sectors. For the first time, we used data from the National Social Insurance Agency (INPS) to investigate the association between the occupational sectors and both non-accidental and accidental mortality. We retrieved information on occupational sectors from 1974 to 2011 for private sector workers included in the 2011 census cohort of Rome. We classified the occupational sectors into 25 categories and analyzed occupational exposure as ever/never have been employed in a sector or as the lifetime prevalent sector. We followed the subjects from the census reference day (9 October 2011) to 31 December 2019. We calculated age-standardized mortality rates for each occupational sector, separately in men and women. We used Cox regression to investigate the association between the occupational sectors and mortality, producing hazard ratios (HRs) and 95% confidence intervals (95%CI). We analyzed 910,559 30+-year-olds (53% males) followed for 7 million person-years. During the follow-up, 59,200 and 2560 died for non-accidental and accidental causes, respectively. Several occupational sectors showed high mortality risks in men in age-adjusted models: food and tobacco production with HR = 1.16 (95%CI: 1.09–8.22), metal processing (HR = 1.66, 95%CI: 1.21–11.8), footwear and wood (HR = 1.19, 95%CI: 1.11–1.28), construction (HR = 1.15, 95%CI: 1.12–1.18), hotels, camping, bars, and restaurants (HR = 1.16, 95%CI: 1.11–1.21) and cleaning (HR = 1.42, 95%CI: 1.33–1.52). In women, the sectors that showed higher mortality than the others were hotels, camping, bars, and restaurants (HR = 1.17, 95%CI: 1.10–1.25) and cleaning services (HR = 1.23, 95%CI: 1.17–1.30). Metal processing and construction sectors showed elevated accidental mortality risks in men. Social Insurance Agency data have the potential to characterize high-risk sectors and identify susceptible groups in the population.

Cancer mortality and sectors of employment: a cohort study in Italy, 2011-2019

“…In Italy, numerous studies have used record linkage methods to estimate the risk of cancer diagnosis and the permanence in a particular economic sector, considering the employment histories acquired from current data sources as a measure of exposure (21,50,51). The use of such type of "electronic data linkage" has been demonstrated as a powerful tool in epidemiological studies such as case-control studies (50), mortality studies (51) and cohort studies (21).…”

“…The study population refers to the Rome Longitudinal Study (ROLs), including the Roman residents who lled in the 2011 census questionnaire (19)(20) which has been already described elsewhere (21). Brie y each subject is followed from the Census reference day (9th October 2011) to the 31st of December 2019, or the date of migration from Rome, or the death, whichever comes rst.…”

“…The study population includes all residents aged 30 + years who had worked, for at least one year, in one of the private economic sectors listed in INPS les and amount to 910,559 subjects (53% males). A detailed description of the cohort is reported elsewhere (21). The study is performed for neoplasms mortality classi ed in 20 cancer sites according to the International Classi cation of Diseases (ICD-9), codes 140-239 (24).…”

“…We analyzed, as the principal analysis, the association between the sector of employment and the cancer speci c cause of death in men and women through a Cox regression models with age as the time scale producing hazard ratios (HR) and 95%CI. We considered the employment sector as the primary exposure, denoting the sector with the longest duration throughout an individual's working life (referred to as the lifetime prevalent sector), and utilized insurance activities as the reference category due to its lower baseline hazard risks compared to other categories, as demonstrated in Bauleo (21).…”

Cancer-Specific Mortality Odds Ratios in the Food, Accommodation, and Beverage Activities in Italy

“…A recent Italian cohort study investigated nonaccidental mortality by sector of employment, finding that there was an excess of mortality risk in both men and women in the hotels, camping, bars, and restaurants activities as a whole. 21 A specific risk assessment study focused in the food service and accommodation sector is missing in Italy, particularly for the cancer risk.…”