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The participants assessed how often they had experienced pain in nine anatomical areas over the past year; this was summarized into four categories describing pain in the neck, shoulders and upper back; the lower back and hip; the upper limbs (hand, wrist, elbow); and the lower limbs (foot, ankle, knee). Frequent pain in at least one location, as well as location-specific frequencies, were considered main exposures. Multivariable Cox proportional hazard regression was used to examine associations between pain and risk of (1) suicide, and (2) non-fatal self-harm including suicide attempt, censored at emigration, disability pension, retirement, other causes of death and end of follow-up in 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>55% of workers reported frequent pain in at least one location, with lower back being the most common site. Frequent pain increased the risk of non-fatal self-harm by 25% compared to no pain in any location and the risk of suicide was doubled. Frequent pain in hand, wrist or elbow was associated with excess risk of both fatal and non-fatal self-harm, while frequent pain in foot, ankle or knee was associated with non-fatal self-harm only, independent of socio-demographic factors, parental origin, body mass index, height and blood pressure. After adjustment for occupational group and unfavorable working position, the increased risk associated with pain in the limbs remained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings underscore the importance of recognizing and addressing the psychological consequences of physical pain among construction workers, particularly when the pain affects the arms or legs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12995-026-00532-6","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:42:09Z","timestamp":1791826929000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Physical pain and risk of suicide and non-fatal self-harm among Swedish construction workers followed over three decades"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2653-0734","authenticated-orcid":false,"given":"Kirsten","family":"Mehlig","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3630-2906","authenticated-orcid":false,"given":"Hannah","family":"Sundvall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2289-9646","authenticated-orcid":false,"given":"Ingibj\u00f6rg H.","family":"Jonsdottir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4336-3886","authenticated-orcid":false,"given":"Jenny","family":"Nyberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6050-9904","authenticated-orcid":false,"given":"Leo","family":"Stockfelt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8330-6915","authenticated-orcid":false,"given":"Margda","family":"Waern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0323-1061","authenticated-orcid":false,"given":"Maria","family":"\u00c5berg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"issue":"6","key":"532_CR1","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1192\/bjp.bp.113.128405","volume":"203","author":"A Milner","year":"2013","unstructured":"Milner A, Spittal MJ, Pirkis J, LaMontagne AD. 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Also, the steering committee for the Byggh\u00e4lsan register at Ume\u00e5 University approved the study (01\/20, 200402). Participants agreed that their data could be used in future scientific studies.","order":1,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Participants\u2019 personal data were protected through anonymization and secure storage of data files. Furthermore, no information about individual participants or small subgroups that could lead to the identification of individuals was presented in the publication.","order":2,"name":"Ethics","label":"Protection of research participants","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This work was supported by AFA Insurance (an organization owned by Sweden\u2019s labor market parties; M.\u00c5., DNR 20240111) and by the Swedish governmental funding of clinical research (ALF, M.\u00c5., ALFGBG-1005368). Study sponsors were not involved in the study design, the collection, analysis and interpretation of the data, the writing of the report, and the decision to submit the paper for publication.","order":3,"name":"Ethics","label":"Financial material support","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"34"}}