Mortality among Medical Doctors Based on the Registered Cause of Death in Korea 1992-2002

통계청 사망자료를 이용한 우리나라 의사들의 사망률에 관한 연구 1992-2002

  • Shin, You-Cheol (Department of Family Medicine, Inje University, Seoul Paik Hospital) ;
  • Kang, Jae-Heon (Department of Family Medicine, Inje University, Seoul Paik Hospital) ;
  • Kim, Cheol-Hwan (Department of Family Medicine, Inje University, Seoul Paik Hospital)
  • 신유철 (인제대학교 서울백병원 가정의학과) ;
  • 강재헌 (인제대학교 서울백병원 가정의학과) ;
  • 김철환 (인제대학교 서울백병원 가정의학과)
  • Published : 2005.03.01

Abstract

Objective : To compare the mortality rate of Korean medical doctors to that of the general Korean population for the period 1992-2002. Methods : The membership records of the Korean Medical Association were linked to the 1992-2002 death certificate data of Korea s National Statistical Office using 13-digit unique personal identification numbers. The study population consisted of 61,164 medical doctors with a follow-up period of 473,932 person-years. Standardized mortality ratios(SMRs) were calculated to compare cause-specific mortality rates of medical doctors to those of the general population. Results : We confirmed 1,150 deaths at ages from 30 to 75 years from 1 January 1992 to 31 December 2002. The SMR for all-cause of death was 0.47(95% CI : $0.44{\sim}0.50$). The SMRs for smoking-related diseases such as cerebrovascular accidents and chronic obstructive pulmonary disease were smaller than the SMR of all-cause of death. However, the SMRs for colorectal and pancreatic cancers were not significantly lower than those of the general population. Transport accidents and suicides accounted for 72% (94 of 131) of external causes of death. The SMR for suicide was 0.51 (95% CI : $0.38{\sim}0.68$). Conclusions : The mortality rate of South Korean medical doctors was less than 50% that of the general population of South Korea. Cause-specific analysis showed that mortality rates in leading causes of death were lower among medical doctors although differences in mortality rates between medical doctors and the general population varied with the causes of death. These health benefits found among medical doctors may be attributable to the lower level of health damaging behaviors (e.g., lower smoking rates) and better working conditions.

Keywords

References

  1. Kunst AE, Groenhof F, Mackenbach JP, Health EW. Occupational class and cause specific mortality in middle aged men in 11 European countries: comparison of population based studies. EU Working Group on Socioeconomic Inequalities in Health. BMJ 1998; 316 (7145):1636-1642 https://doi.org/10.1136/bmj.316.7145.1636
  2. Rimpela AH, Nurminen MM, Pulkkinen PO, Rimpela MK, Valkonen T. Mortality of doctors: do doctors benefit from their medical knowledge? Lancet 1987; 1(8524): 84-86
  3. Ackermann-Liebrich U, Wick SM, Spulhler T. urvival of female doctors in switzerland. BMJ 1991; 302(6782): 959
  4. Office of Population, Censuses and Surveys. In: Drever F, ed. Occupational health. Decennial supplement. Series DS no 10. London: HMSO, 1995
  5. Juel K, Mosbech J, Hansen ES. Mortality and causes of death among Danish medical doctors 1973-1992. Int J Epidemiol 1999; 28(3): 456-460 https://doi.org/10.1093/ije/28.3.456
  6. Tyssen R, Vaglum P. Mental health problems among young doctors: an updated review of prospective studies. Harv Rev Psychiatry 2002; 10(3): 154-165 https://doi.org/10.1080/10673220216218
  7. Kumar P, Basu D. Substance abuse by medical students and doctors. J Indian Med Assoc 2000; 98(8): 447-452
  8. Wilks M, Freeman A'. Doctors in Difficulty': a way forward? BMJ 2003;29;326(7391):S99
  9. British Medical Association. Stress and the medical profession. London: BMA, 1992
  10. British Medical Association. The morbidity and mortality of the medical profession. A literature review and suggestion for future research. London: BMA, 1993
  11. 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(6):388-395 https://doi.org/10.1136/oem.54.6.388
  12. Alexander BH, Checkoway H, Nagahama SI, Domino KB. Cause-specific mortality risks of anesthesiologists. Anesthesiology 2000; 93 (4):922-930 https://doi.org/10.1097/00000542-200010000-00008
  13. Uhari M. Mortality rates among physicians - how should the data be interpreted? Acta Amaesthe Scand 2002; 46(10): 1183-1184 https://doi.org/10.1034/j.1399-6576.2002.461001.x
  14. Chung EK, Shin HY, Shin JH, Nam HS, Ryu SY, Im JS, Rhee JA. Accuracy of the Registered Cause of Death in a County and its Related Factors. Korean J Prev Med 2002; 35(2): 153-159 (Korean)
  15. 대한 의사 협회. 작고회원의 파악 및 사망 원인에 관한 연구보고서;2000
  16. MarkW. Epidemiology study design and data analysis: CHAPMAN & HALL/CRC; 1999. p. 223-229
  17. Berry G. The analysis of mortality by the subject-years method. Biometrics 1983; 39(1): 173-184 https://doi.org/10.2307/2530817
  18. Asp S, Hernberg S, Collan Y. Mortality among Finnish doctors, 1953-1972. Scand J Soc Med. 1979; 7(2): 55-62
  19. Oh JY, Lee YM, Suh HE, Cho KH, Hong MH. A study of behavioral aspect for the health promotion among physician and general population. J Korean Acad Fam Med 1992; 13(11): 870-890 (Korean)
  20. 통계청. 2002년 사망원인통계결과; 2003
  21. Penninx BW, van Tilburg T, Kriegsman DM, et al. Effects of social support and personal coping resources on mortality in older age: the Longitudinal Aging Study Amsterdam. Am J Epidemiol 1997; 146(6): 510-539 https://doi.org/10.1093/oxfordjournals.aje.a009305
  22. 김정룡. 소화기계질환. 일조각; 2000,(408-409쪽, 883-884쪽)
  23. Kim YS, Park HS, Cho BS, Kim YW, Koh KW, Kang SY, Cha AR, Yi CH, Hwang IK, Cho BM, Lee SI, Kim DK. A study on obesity pattern and related factors of the doctors. Korean J Prev Med 1997; 30(4): 708-718(Korean)
  24. Davey Smith G, Hart C, Blane D, Hole D. Adverse socioeconomic conditions in childhood and cause-specific adult mortality: prospective observational study. BMJ 1998; 316: 1631-1635 https://doi.org/10.1136/bmj.316.7145.1631
  25. Leon D, Davey Smith G. Infant mortality, stomach cancer, stroke and coronary heart disease: ecological analysis. BMJ 2000; 320: 1705-1706 https://doi.org/10.1136/bmj.320.7251.1705
  26. Surawicz TS, McCarthy BJ, Kupelian V, Jukich PJ, Bruner JM, Davis FG. Descriptive epidemiology of primary brain and CNS tumors: results from the Central Brain Tumor Registry of the United States, 1990-1994. Neuro-oncol 1999;1(1): 14-25
  27. Hardell L, Nsaman A, Pahlson A, Hallquist A. Case-control study on radiology work, medical x-ray investigations, and use of cellular telephones as risk factors for brain tumor. Med GenMed 2000; 2(2): E2
  28. Smith PG, Doll R. Mortality from cancer and all causes among British radiologists. Br J Radiol 1981 ;54(639): 187-194 https://doi.org/10.1259/0007-1285-54-639-187
  29. Logue JN, Barrick MK, Jessup GL Jr. Mortality of radiologists and pathologists in the radiation registry of physician. J Occup Med 1986; 28(2); 91-99
  30. Matanoski GM, Seltser R, Sartwell PE, Diamond EL, Elliott EA. The current mortality rates of radiologists and other physician specialists: deaths from all causes and from cancer. Am J Epidemiol 1975; 101:188-198 https://doi.org/10.1093/oxfordjournals.aje.a112086
  31. Matanoski GM, Seltser R, Sartwell PE, Diamond EL, Elliott EA. The current mortality rates of radiologists and other physician specialists: specific causes of death. Am J Epidemiol 1975; 101: 199-210 https://doi.org/10.1093/oxfordjournals.aje.a112087
  32. Seo HG. The Smoking Rate Among Doctors and Its Various Implications. J Korean Med Asso 2002; 45(6): 685-694 (Korean) https://doi.org/10.5124/jkma.2002.45.6.685
  33. Lindeman S, Laara E, Hakko H, Lonnqvist J. A systematic review on gender-specific suicide mortality in medical doctors. Br J Psychiatry 1996; 168(3): 274-279 https://doi.org/10.1192/bjp.168.3.274
  34. Harrington JM, Oakes D. Mortality study of British pathologists 1974-80. Br J Ind Med 1984; 41(2): 188-191
  35. Boxer PA, Burnett C, Swanson N. Suicide and occupation: a review of the literature. J Occup Environ Med 1995; 37(4): 442-452 https://doi.org/10.1097/00043764-199504000-00016
  36. Park JS, Lee JY, Kim SD. A study for Effects of Economic Growth Rate and Unemployment Rate to Suicide Rate in Korea. Korean J Prev Med 2003; 36(1): 85-91 (Korean) https://doi.org/10.1006/pmed.2002.1127
  37. Suh DW. Current Situation and Trends of Suicidal Deaths, Ideas and Attempts in Korea. Health Soc Welfare Rev 2001; 21(1): 106-125 (Korean)
  38. Kim CH, Moon OR. A study on the Most Frequent Disease of Health Insurance Program and the Primary Care Physicians in Korea. Korean J Health Policy Adm 1993; 3(1): 124-145 (Korean)