Breaking Down Opioid Deaths by Occupation

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New research from the state of Massachusetts could help guide response efforts to the drug abuse epidemic.

Construction workers in Massachusetts died at especially high rates from opioid overdoses in recent years compared to people in other lines of work, new research from the state finds.

The Massachusetts Department of Public Health on Wednesday released a study assessing opioid-related deaths in the state by industry and occupation. “These findings are significant because they identify the industries and occupations where strategies can be developed to intervene before injuries occur,” said Health and Human Services Secretary Marylou Sudders.

Among those employed in construction and “extractive” industries, the opioid-related death rate over a recent five-year period was six times the average rate for all workers in Massachusetts.

(Extractive industries cover fields like mining, quarrying, and oil and gas drilling. Workers employed in these types of jobs accounted for only about three percent of the total deaths in the study category that included both construction and extractive industries.)

The study looked at overdose figures for 2011 to 2015. There were 5,580 total opioid-related deaths in the state during that time.

Of that total, there was usable occupation or industry information available for 4,302 of the people who died, which was incorporated into the analysis.

During the timeframe the study looked at, construction and extraction workers in the state had an opioid-related death rate of about 150.6 deaths per 100,000 workers, and there were 1,096 fatalities among the group. The average rate for all workers in Massachusetts was 25.1.

Click to expand the chart in a new window. (Massachusetts Department of Public Health)

Some of the other occupation groups with opioid-related death rates that exceeded the average rate for all workers included: farming, fishing, and forestry (143.9); material moving (59.1); installation, maintenance, and repair (54.0); transportation (42.6); food preparation and serving (39.5); building and grounds cleaning and maintenance (38.3), and healthcare support (31.8).

Mirroring other research, the study finds that fatal opioid overdoses are more common among workers employed in industries and occupations known to have high rates of work-related injuries and illnesses. The same is true for fields that provide employees less sick leave, or lower job security.

Workers in Massachusetts in occupations with less than 50 injuries per 10,000 full-time employees had an opioid-related death rate of nine per 100,000. For fields with 200 or more injuries and illnesses per 10,000 workers, the rate jumps to 68.4 per 100,000.

Click to expand the table in a new window. (Massachusetts Department of Public Health)

“Work-related injuries often serve as the initiation for opioid pain medication, which can subsequently lead to opioid misuse," said Public Health Commissioner Monica Bharel.

And the report points out that “construction is physically demanding work and the workers in this sector have among the highest rates of non-fatal and fatal occupational injuries.”

Other findings also tracked with prior research. For instance, 77 percent of the overdose deaths included in the analysis were men and death rates were higher among white, non-Hispanics.

“Educational and policy interventions targeting high rate worker groups identified in this study are needed,” the report says.

It adds that these should address workplace hazards, options for pain management following injuries, including safer opioid prescribing practices, access to treatment for opioid abuse, and overdose prevention education.

A full copy of the report can be found here.

Bill Lucia is a Senior Reporter for Government Executive's Route Fifty and is based in Washington, D.C.

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