Axing staff can worsen the health of fellow employees left behind, researchers have warned.
Workers suffer when colleagues leave
A Finnish study of local government personnel found those whose departments suffered major cuts doubled their risk of dying from cardiovascular disease.
Major downsizing - cutting more than 18% of staff - was also linked to an increase in workers taking sick leave.
The study in the British Medical Journal said employers and occupational health staff should recognise the risk.
University of Helsinki researchers identified 22,430 employees who kept their jobs during a recession between 1991 and 1993.
They monitored rates of sickness absence and deaths over seven years.
They say the link between job cuts and poor health in remaining staff is probably linked to stress at work.
The workers left behind still had to provide the same services, leading to heightened demand and job insecurity.
The researchers, led by Dr Jussi Vahtera, say such changes are linked to an increased likelihood of health problems - including the risk of developing, and dying from, cardiovascular disease.
Writing in the BMJ, they add: "This study indicates that downsizing may lead to elevated absence rates and increase cardiovascular mortality among people who remain employees.
"Policy makers, employers, and occupational health professionals should recognise that downsizing may pose a severe risk to health."
TUC General Secretary Brendan Barber said: "This report confirms what we've been saying all along - unemployment and redundancies are a tragedy for everyone affected.
"Bosses wishing to avoid potentially tragic consequences should aim to work closely with unions whenever job losses loom.
"By keeping workers informed, helping redundant employees find new jobs quickly, and providing support for those colleagues still in work, employers can help limit the damaging effects of big job cuts."