Massachusetts study links opioid deaths to occupations

The opioid-related death rate for those employed in construction and extraction occupations was six times the average rate for all Massachusetts workers, according to a report released Wednesday by the Massachusetts Department of Public Health.

The study links opioid-related deaths to industries and occupations, finding that those who work in high-risk fields tend to be at higher risk for opioid dependence. Construction and extraction workers accounted for more than 24% of all opioid-related deaths among the working population — 4,302 total worker deaths between 2011 and 2015.

Information from Massachusetts death certificates was used in studying opioid-related overdose deaths over the four-year period by industry and occupation, according to the study, which also relied on findings from several national surveys to explore factors that may potentially contribute to differences in the rates of fatal opioid overdose among workers in different industries and occupations. It found that overall, 25.1 workers died for every 100,000, the statewide average rate.

The study found that construction and extraction workers had both a high rate, at 150.6 deaths per 100,000 workers; and a high number of opioid-related overdose deaths, at 1,096 over the study’s four-year term.

Other findings from the Massachusetts study include:

  • Workers in the farming, fishing and forestry occupation group also had a high rate, at 143.9 deaths for every 100,000, accounting for more than more than five times the average rate.
  • Other occupations with significantly higher-than-average rates of opioid-related deaths included: 59.1 for material moving occupations; 54 for installation, maintenance and repair occupations; 42.6 for transportation occupations; 42.1 for production occupations; 39.5 for food preparation and serving related occupations; 38.3 for building and grounds cleaning and maintenance occupations; and 31.8 for health care support occupations.
  • The occupations with high rates of fatal opioid-related overdose varied by gender. Among male workers, the rate was 205.6 for those in farming, fishing and forestry occupations, 152.3 for construction and extraction occupations, and 71.9 for material moving occupations, significantly higher than the average rate of 38.2. Among female workers, the rate was 30.1 for those in health care support occupations and 28.9 for food preparation and serving occupations, compared with an average rate of 11.6.
  • The rate of fatal opioid-related overdose was higher among workers employed in industries and occupations known to have high rates of work-related injuries and illnesses. This finding is consistent with previous research documenting common use of prescribed opioids for management of acute and chronic pain following work-related injury. The rate was also higher among workers in occupations with lower availability of paid sick leave and lower job security. The study calls for more in-depth research to “characterize the potential contribution of these factors to opioid misuse and overdose.”