Background: Recent studies both in the UK and in the USA have indicated a higher mortality rate among anesthesiologists than among other physicians. We therefore decided to investigate the situation in Sweden during the years 1993-99.
Methods: All 26086 doctors in Sweden with a specialist licence in 1993, including those who were retired or who received one until 1999, were identified in official records and followed up regarding survival until 1999; generating approximately 179300 person-years.
Results: Overall, 893 deaths occurred during the 7-year follow up. Mean age at death was 72.9 years in the whole population, the lowest being 64.1 years among the anesthesiologists and the highest 77.0 among the pediatricians. However, there were large differences in the age and sex distribution among the specialties. For this reason a series of proportional hazard regression analyses (Cox's) of the mortality rates in the various specialty groups were performed, taking into account the influence of age and gender differences. After this procedure anesthesiologists had a 46% higher mortality rate and pediatricians a 24% lower mortality rate than other specialist groups; both deviations being statistically significant. All other specialties had a mortality risk within the expected range. Anesthesiologists tended to have higher rates than other specialists for most underlying causes of death.
Conclusion: Anesthesiologists have a higher mortality rate than other specialties. The cause is so far unknown. However, it is unlikely to be caused by obvious confounders such as age, gender, or smoking habits. Other factors linked to occupational exposure should be investigated.