Fatal accidents and suicide among reindeer-herding Sami in Sweden.

OBJECTIVE: Over the last decades, reindeer-herding management has experienced dramatic changes, e.g. increased motorization and socio-economic pressure. The aim of the present study was to investigate whether these changes have increased the risk of fatal, work-related accidents and suicide between 1961 and 2000. STUDY DESIGN AND METHODS: A cohort containing 7,482 members of reindeer-herding Sami families was extracted from national population registers. Information on fatal accidents and suicide was obtained from the Swedish Causes of Death Register, and compared to the expected number of deaths in a demographically matched control population of non-Sami. RESULTS: The male reindeer herding Sami showed a significantly increased risk of dying from accidents such as vehicle accidents and poisoning. No significant increased risk of suicide was observed. A comparison between the periods of 1961-1980 and 1981-2000 showed non-significant differences in risk, although a trend towards increased risks was observed for most types of external causes of death except suicide. CONCLUSIONS: It is suggested that the increased socio-economic pressure and the extensive use of terrain vehicles have increased the risk for fatal accidents among Swedish reindeer herders, and that commercial reindeer management is one of the most dangerous occupations in Sweden.