William S. Shaw is with the Division of Occupational and Environmental Medicine, Department of Medicine, University of Connecticut School of Medicine, Farmington. Cora Roelofs and Laura Punnett are with the Department of Biomedical Engineering, Francis College of Engineering, University of Massachusetts Lowell.
Am J Public Health. 2020 Aug;110(8):1235-1241. doi: 10.2105/AJPH.2020.305716. Epub 2020 Jun 18.
Opioid use disorder (OUD) and opioid overdose deaths (OODs) are prevalent among US workers, but work-related factors have not received adequate attention as either risk factors or opportunities for OOD prevention. Higher prevalence of OOD in those with heavy physical jobs, more precarious work, and limited health care benefits suggest work environment and organizational factors may predispose workers to the development of OUD.Organizational policies that reduce ergonomic risk factors, respond effectively to employee health and safety concerns, provide access to nonpharmacologic pain management, and encourage early substance use treatment are important opportunities to improve outcomes. Organizational barriers can limit disclosure of pain and help-seeking behavior, and opioid education is not effectively integrated with workplace safety training and health promotion programs.Policy development at the employer, government, and association levels could improve the workplace response to workers with OUD and reduce occupational risks that may be contributing factors.
阿片类使用障碍（OUD）和阿片类药物过量死亡（OOD）在美国劳动者中普遍存在，但工作相关因素既未受到充分重视，也未被视为 OOD 预防的风险因素或机会。体力劳动强度大、工作稳定性差和医疗保健福利有限的劳动者中 OOD 发生率更高，这表明工作环境和组织因素可能使劳动者更容易出现 OUD。减少工效学风险因素、对员工健康和安全问题做出有效回应、提供非药物性疼痛管理以及鼓励早期药物使用治疗的组织政策，是改善结局的重要机会。组织障碍可能会限制疼痛和寻求帮助行为的披露，且阿片类药物教育并未与工作场所安全培训和健康促进计划有效结合。雇主、政府和协会各级的政策制定，可改善对 OUD 劳动者的工作场所反应，并降低可能是促成因素的职业风险。
