College of Arts and Sciences, Public Health Program, MCPHS University, Boston, Massachusetts.
Department of Biomedical Engineering, University of Massachusetts Lowell, Lowell, Massachusetts.
Am J Ind Med. 2019 Oct;62(10):815-825. doi: 10.1002/ajim.23029. Epub 2019 Jul 26.
Thousands of people in the United States continue to die from opioid overdoses every year. Work-related injuries and other factors associated with work may increase exposure to opioids and, subsequently, opioid-related overdose deaths (OROD). This study sought to determine whether OROD rates differed by industry and occupation and explored work-related factors that might contribute to these differences.
We coded industry and occupation information on death certificates for all OROD among Massachusetts residents from 2011 to 2015. We estimated rates of OROD by industry and occupation using Massachusetts employment data. National survey data were used to explore whether work-related factors known to vary by occupation (occupational injury and illness, job insecurity, and paid sick leave) correlate to observed differences in OROD.
Several industries and occupation groups had rates of OROD that were significantly higher than the rates for other workers. Construction workers and fishing workers stood out for having OROD rates many times higher than the average for all workers. Occupation groups with high rates of occupational injuries and illnesses, high job insecurity, and low availability of paid sick leave had higher rates of OROD.
These findings underscore the need for policy and educational interventions to reduce OROD tailored to the needs of high rate worker populations. Interventions should address workplace hazards that cause injuries for which opioids are prescribed, as well as best practices in medical management and return to work following injury, safer prescribing, enhanced access to treatment for opioid use disorders, and overdose prevention education.
每年,美国仍有成千上万的人因阿片类药物过量而死亡。与工作相关的伤害和其他与工作相关的因素可能会增加接触阿片类药物的机会,进而导致与阿片类药物相关的过量死亡(OROD)。本研究旨在确定 OROD 率是否因行业和职业而异,并探讨可能导致这些差异的与工作相关的因素。
我们对 2011 年至 2015 年马萨诸塞州居民的所有 OROD 死亡证明进行了行业和职业编码。我们使用马萨诸塞州就业数据估算了按行业和职业划分的 OROD 率。国家调查数据用于探讨已知因职业而异的与工作相关的因素(职业伤害和疾病、工作保障不足和带薪病假)是否与观察到的 OROD 差异相关。
一些行业和职业群体的 OROD 率明显高于其他工人。建筑工人和渔民的 OROD 率是所有工人平均水平的数倍,这两个群体尤为突出。职业伤害和疾病发生率高、工作保障不足、带薪病假机会少的职业群体,OROD 率较高。
这些发现强调了需要针对高风险工人群体的需求,制定和实施减少 OROD 的政策和教育干预措施。干预措施应针对导致开具阿片类药物的伤害的工作场所危害,以及在受伤后进行医疗管理和重返工作岗位的最佳实践、更安全的处方、增加获得阿片类药物使用障碍治疗的机会以及进行预防过量用药教育。