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DPH Reports on Job-related Injuries Leading to Opioid Misuse

BOSTON — The rate of fatal opioid overdoses varied significantly by industry and occupation from 2011 to 2015, with construction workers dying from opioid overdoses at six times the average rate for all Massachusetts workers, according to a report released by the Massachusetts Department of Public Health (DPH).

Using available death-certificate data, DPH analyzed 4,302 opioid-related deaths in Massachusetts from 2011 to 2015 by industry and occupation to understand whether work, and specifically work-related injuries, might have contributed to opioid-use disorders.

Overall, workers employed in occupations known to have high rates of work-related injuries had higher rates of fatal opioid overdoses. In addition, workers in occupations with lower rates of paid sick leave and higher job insecurity had higher rates of opioid overdoses. Construction and extraction workers (quarrying and mining) accounted for more than 24% of all opioid-related deaths among the working population. This occupation group had a high death rate — 150.6 deaths per 100,000 workers — and a high number of opioid-related deaths — 1,096 — during this time period.

“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. “The Baker-Polito administration uses data to identify the highest risk in order to develop specific services to mitigate these trends.”

Despite the small number of workers employed in the farming, fishing, and forestry occupations, these jobs also had a high opioid death rate. While there were fewer deaths among this group (61) than in the construction occupations, the rate of opioid-related deaths — 143.9 per 100,000 workers — was more than five times the average rate of 25.1 per 100,000 for Massachusetts workers.

“Work-related injuries often serve as the initiation for opioid pain medication, which can subsequently lead to opioid misuse,” said Public Health Commissioner Dr. Monica Bharel. “Ensuring that jobs are safe, that the risk of injury is low, and that workers have the time for rehabilitation and are not self-medicating to keep working are all key to decreasing opioid overdose deaths among workers.”

Several other occupations also had rates of opioid-related overdose deaths that were significantly higher than the average rate for all Massachusetts workers. These included jobs in material moving; installation, maintenance, and repair; transportation; production; food preparation and serving; building and grounds cleaning and maintenance; and healthcare support.

Similar to findings for all opioid-related overdose deaths in Massachusetts, the majority — 77.3% — of deaths in this study were among males. However, there were several occupation groups where females had significantly elevated rates of opioid-related overdose deaths, particularly healthcare support and food preparation and serving.