Physicians mortality in Uruguay (Second part)
Analysis of death causes from 1998 to 2002
Abstract
Background: causes of physicians death have been studied worldwide. A previous study showed diverse results related to general population, women and some specialities.
Objective: to determine death causes of physicians in Uruguay from 1998 to 2002 in order to promote prevention and control actions.
Method: a retrospective transversal study of causes of death occurred from January 1, 1998 to December 31, 2002. Data was obtained from death certifications of the Ministry of Public Health (Ministerio de Salud Pública) in Uruguay. Causes of death were classified according to international categorization (CIE-10), and were subsequently compared to overall values.
Results: the physician population considered accounted for 298 people: 76.6% were men (mean age, 71 years) and 23.4% women (mean age, 60 years). The first cause of death was heart related (35%), neoplasic cause ranked in the second place (30%), and 7% died from violent causes (for this group, mean age of death in women was higher compared to mean age of men).
Discussion: there is a prevalence of chronic diseases: 66% died from diseases which risk factor was smoking and in 38%, risk factor was alcohol. Mortality pattern was similar to overall population, except for women ages of death. Social and labour conditions should be included in further studies.
Conclusions: main causes of death coincide with causes for general population in Uruguay. Rates of respiratory diseases smoking-related and rates of chronic hepatopathies in young physicians.
References
(2) Doll R, Peto R, Hall E, Wheatley K, Gray R. Mortality in relation to consumption of alcohol: 13 years´ observations on male British doctors. BMJ 1994; 309: 911-8.
(3) Doll R, Peto R, Wheatley K, Gris R, Sutherland I. Mortality in relation to smoking: 40 years´ observations on male British doctors. BMJ 1994; 309: 910-1.
(4) Carpenter L, Swerdlow A, Fera N. Mortality of doctors in different specialties: findings from a cohort of 20000 NHS hospital consultants. Occup Environ Med 1997; 54 (6): 388-95.
(5) Doll R, Peto R. Mortality among doctors in different occupations. BMJ 1977; (6074): 1433-6.
(6) Arnetz S, Horte L, Hedberg A, Theorel T, Allander E, Malker H. Suicide patterns among physicians related to other academics as well as to the general population: Results from a national long-term prospective study and a retrospective study. Acta Psychiatr Scand 1987; 75: 139-43.
(7) Svardsudd K, Wedel H, Gordh T. Mortality rates among Swedish physicians: a population-based nationwide study with special reference to anesthesiologists. Acta Anaesthesiol Scand 2002; 46(10): 1187-95.
(8) Ohtonen P, Alahuhta S. Mortality among Finnish anesthesiologists from 1984-2000. Acta Anaesthesiol Scand 2002; 46(10): 1196-9.
(9) Rimpela AH, Nurmien MM, Pulkkinen PO, Rimpela MK, Valkonen T. Mortality of doctors: do doctors benefit from their medical knowledge?. Lancet 1987; 10: 84-6.
(10) Aasland OG. Mortality of anesthesiologists, pediatricians, and other specialists in Norway. Acta Anaesthesiol Scand 2002; 46(10): 1200-2.
(11) Goodman LJ. The longevity and mortality of American physicians, 1969-1973. Milbank Mem Fund Q Health Soc 1975; 53(3): 353-75.
(12) Simon W. Suicide among physicians: prevention and postvention. Crisis 1986; 7(1): 1-13.
(13) Sargent DA, Jensen VW, Petty TA, Raskin H. Preventing physician suicide: The role of family, colleagues, and organized medicine. JAMA 1977; 237(2): 143-5.
(14) American Medical Association. American Psychiatric Association Results and implications of the AMA-APA Physician Mortality Project. Stage II: Council on Scientific Affairs. JAMA 1987; 257(21): 2949-53.
(15) American Medical Association. American Psychiatric Association Physician mortality and suicide: Results and implications of the AMA-APA Pilot Study, AMA Council on Scientific Affairs. Conn Med 1986; 50(1): 37-43.
(16) Blachly P. Which MDs are likely candidates far suicide?. Med World News 1979; 19: 20-2.
(17) 17 Craig G, Pitts FN. Suicide by physicians. Dis Nerv Syst 1968; 29: 763-72.
(18) Rose KD, Rosow I. Physicians who kill themselves. Arch Gen Psychiatry 1973; 29: 800-5.
(19) Franck E, Biola H, Burnett CA. Mortality rates and causes among US physicians. Am J Med Prev 2000; 19(3): 155-9.
(20) Alexander BH, Checkoway H, Nagahama SI, Domino KB. Cause-specific mortality risk of anesthesiologists. Anesthesiology 2000; 93(4): 922-30.
(21) Berry AJ, Fleisher LA. Cause-specific mortality risks of anesthesiologists: New evidence for the existence of old problems. Anesthesiology 2000; 93(4): 919-21.
(22) Lew EA. Mortality experience among anesthesiologists, 1954-1976. Anesthesiology 1979; 51: 195-9.
(23) 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(1): 91-9.
(24) Kono S, Ikeda M, Tokudome S, Nishizumi M, Kuratsune M. Smoking and mortalities from cancer, coronary heart disease and stroke in male Japanese physicians. J Cancer Res Clin Onco1 1985; 110(2): 161-4.
(25) Kono S, Ikeda M, Tokudome S, Nishizumi M, Kuratsune M. Alcohol and mortality: a cohort study of male Japanese physicians. Int J Epidemiol 1986; 15(4): 527-32.
(26) Armijo R, Monreal T. Causas de mortalidad en médicos chilenos. Rev Med Chile 1962; 347-52.
(27) Jiménez-Navarrete MF. Mortalidad en el cuerpo médico nacional. Acta Med Costarric 1997; 39(2): 38-43.
(28) Jiménez-Navarrete MF, González-Blandón R, Seel-Salazar V. Caracterización de algunos hábitos y enfermedades de los médicos costarricenses. Acta Med Costarric 2000; 42(3): 121-30.
(29) Valverde Caravaca CA. Mortalidad comparada entre profesionales en Costa Rica, años 1988-1992. Rev Med Costa Rica 1994; 61(527): 57-60.
(30) Casilla De León E, Céspedes R, Concepción Borroughs J, Sosa Ortiz, M, Méndez S, Cruz Arias J, et al. Principales características de la muerte del médico en República Dominicana. Rev Med Dom 1993; 54(1): 3-4.
(31) Vidal L, Gambón E, Contera M, Fernández M. Mortalidad de profesionales universitarios en el Uruguay. Estudio epidemiológico. Montevideo: Facultad de Medicina, 1976. (Mimeografiado).
(32) Rosasco CL. Riesgo profesional en la sala de operaciones: Efecto de los agentes anestésicos. Cir Urug 1976; 46(4): 288-92.
(33) Barreiro G. La polución ambiental en sala de operaciones: un problema aún sin solución. Rev Med Urug 1990; 6: 6-8.
(34) Ullmann D, Phillips RL, Besson L, Dewey HG, Brin BN, Kuzma JW, et al. Cause-specific mortality among physicians with differing life-styles. JAMA 1991; 265(16): 2352-9.
(35) Uruguay. Ministerio de Salud Pública, División Estadística. Mortalidad clasificada por causa, sexo, y edad. Montevideo: MSP, 1998.
(36) Vassallo JA, Barrios E. Actualización ponderada de los factores de riesgo del cáncer. Montevideo: Comisión Honoraria de Lucha Contra el Cáncer, 2003: 9-119.
(37) Ríos E, Ronco A, Fierro L, De Stéfani E, Vassallo JA. Tendencias de la mortalidad por cáncer en Uruguay 1953-1997. Rev Med Urug 2002; 18: 167-74.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
