Company closure and mortality in a Greek bus company.

BACKGROUND Previous studies strongly support an association between unemployment and an increased risk of morbidity and mortality. AIMS To assess the impact of company closure on the mortality of redundant employees. METHODS The mortality of a cohort of male ex-employees of the Athens Bus Transportation Company Epixirisi Astikon Siginonion (EAS) was followed from September 1992 to October 1993. Information on causes of death was obtained from death certificates and classified according to the ninth revision of the International Classification of Diseases. The expected number of deaths was calculated based on 5 year age groups. Cause-specific mortality rates for the Greek population were obtained from the Greek National Statistics Service, and standardized mortality rates (SMRs) were calculated using population census data for 1991. RESULTS The cohort consisted of 4400 subjects. Thirty deaths were recorded. Crude mortality was significantly elevated (SMR = 1.75; 95% confidence interval (CI) 1.18-2.5; Table 1). A statistically significant excess in mortality from ischaemic heart disease was shown (18 deaths observed; SMR = 4.83; 95% CI 2.86-7.64). One year before the privatization and closure of EAS (1991), nine deaths were recorded among its 7400 employees (SMR = 0.34). CONCLUSIONS Our study found a significant increase in all-cause mortality and death from ischaemic heart disease in male workers who were made redundant and suggested a significant negative impact of unemployment resulting from company closure on mortality. These results may signal future mortality patterns in Greece if the current climate of austerity and recession continues.