Nunn Alexandra, Perri Amanda M, Gordon Hilary, Harding John P D, Loo C K Jennifer, Tuinema John
Algoma Public Health, Sault Ste. Marie, ON, Canada.
Public Health Agency of Canada, Ottawa, ON, Canada.
Can J Public Health. 2024 Jul 29. doi: 10.17269/s41997-024-00906-5.
In the first year of pandemic measures, opioid-related deaths across Ontario's (ON) 34 public health units (PHUs) increased by 60%. Death rates for all seven Northern ON PHUs were above the provincial average. This study describes and compares factors surrounding opioid-related deaths before and after pandemic measures were introduced, for Northern ON compared to the rest of ON.
Aggregate data were provided for Northern ON and the rest of the province by the Office of the Chief Coroner/Ontario Forensic Pathology Services. Opioid-related deaths were cohorted by date of death for the year before and after pandemic measures were introduced on March 16, 2020. Chi-square tests were used to compare between cohorts and geographies to determine significant differences for each variable, and for dichotomized levels within variables. P-values < 0.05 were considered statistically significant a priori.
In Northern ON, the number of opioid-related deaths approximately doubled from the pre-pandemic cohort (n = 185) to the early pandemic cohort (n = 365). Compared to the rest of ON, higher proportions of deaths occurred in Northern ON among individuals who lived and died in private residences, among women (although the majority of decedents were male) and among individuals employed in mining, quarrying, and oil and gas industries. Compared to the pre-pandemic year, in Northern ON, higher proportions of opioid-related deaths involved fentanyl and stimulants as direct contributors, and the majority involved evidence of inhaled drugs.
Differences between the circumstances of death in Northern ON and in the rest of ON suggest opportunities to tailor interventions.
在实施大流行措施的第一年，安大略省（ON）34个公共卫生单位（PHU）的阿片类药物相关死亡人数增加了60%。安大略省北部所有7个公共卫生单位的死亡率均高于该省平均水平。本研究描述并比较了在实施大流行措施前后，安大略省北部与安大略省其他地区阿片类药物相关死亡的影响因素。
首席验尸官办公室/安大略法医病理服务局提供了安大略省北部和该省其他地区的汇总数据。根据2020年3月16日实施大流行措施前后一年的死亡日期，对阿片类药物相关死亡进行队列分析。采用卡方检验比较不同队列和地区之间的差异，以确定每个变量以及变量内二分水平的显著差异。P值<0.05被认为具有统计学意义。
在安大略省北部，阿片类药物相关死亡人数从大流行前队列（n = 185）到早期大流行队列（n = 365）几乎翻了一番。与安大略省其他地区相比，安大略省北部在私人住宅中生活和死亡的个人、女性（尽管大多数死者为男性）以及从事采矿、采石和石油天然气行业的个人中，死亡比例更高。与大流行前一年相比，在安大略省北部，更高比例的阿片类药物相关死亡涉及芬太尼和兴奋剂作为直接促成因素，且大多数涉及吸入药物的证据。
安大略省北部与安大略省其他地区死亡情况的差异表明有机会调整干预措施。
