A recent academic article with an Ontario focus offers new insights into the links between workplace-related injuries and opioid harms, with certain occupations including construction found to be at particularly high risk.
The study from the Institute for Work and Health (IWH) and the Occupational Cancer Research Centre, published in April in the Canadian Journal of Public Health, documented that injured workers experienced higher risks of both opioid-related poisonings and mental and behavioural disorders compared to the general Ontario population.
“Most occupational and industry groups were found to have increased risks of opioid-related harms, although certain occupations appear to be at particularly high risk, namely construction, materials handling, processing (mineral, metal, chemical), and machining and related occupations,” the report concluded.
As a result of their research, the authors say, strategies aimed at primary prevention of occupational injuries and secondary treatment of work disability and long-term opioid use are warranted.
‘Judicious prescribing’ suggested
Suggested injury-avoidance strategies included improving ergonomics, reducing physical and psychosocial hazards in the workplace and educating workers on injury risk factors.
Efforts to minimize harmful opioid use could include “judicious prescribing, access to effective non-opioid treatments for pain, mental health supports, availability of sick leave, work accommodations (and) educating workers on risks of opioid use,” the paper stated.
“Supportive workplace policies may also help encourage disclosure if workers develop an opioid use disorder.”
In total, 11,674 emergency department visits and 4,500 hospitalizations for opioid-related poisonings were observed from 2006 to 2020.
Two of the authors of the paper, Nancy Carnide and Jeavana Sritharan, suggested the study fills a gap in the literature and offers valuable Canadian context to the body of research on the topic.
“One of the main hypotheses around what places workers at risk of opioid-related harms is that it’s tied to work-related injury, but data to support that is emerging,” said Carnide, a researcher with the IWH in Toronto.
“There’s been a few studies in the U.S. that have looked at how work injury may play a role in opioid-related harms but again, there’s only been a handful of studies.”
The study, titled Occupational Patterns of Opioid-Related Harms Comparing a Cohort of Formerly Injured Workers to the General Population in Ontario, Canada, looked at long-term data from the Occupational Disease Surveillance System (ODSS).
Carnide commented science is “slow” whereas the needs of workplaces are immediate and growing. Programs are being put into place while researchers are taking one step at a time and building a foundation of evidence.
Stepping stone anticipated
“We’re hoping this is a stepping stone that would increase the awareness and the other research that needs to be done in this area,” said Sritharan, a researcher with the Occupational Cancer Research Centre based in Toronto.
An upcoming report will release findings specific to the construction sector but it is clear from the results published in April that workers in that sector are among those at highest risk of opioid harms.
Almost all occupational groups in the ODSS demonstrated elevated risks for opioid-related poisonings compared to the general population, with the highest risks observed among workers in construction trades, materials handling and processing, in that order.
Similar to poisonings, almost all occupational groups demonstrated high risks for opioid-related mental and behavioural disorders.
Occupations with the highest risks included materials handling followed by the construction trades.
The most common diagnoses for mental and behavioural disorders identified in the ODSS worker cohort were withdrawal state, dependence syndrome and harmful use.
Carnide said the study was not designed to look at the specific factors within each of the occupational groups causing risk. Those issues will be studied further in the future, she said, as will a differentiation of risks between trades.
But even high-level research can be filtered down to workplaces to raise awareness, Sritharan said. The current report will be digested into a plain-language summary and infographics for the public to study, she said.
“Hopefully, this will spark some conversations and maybe influence how they’re dealing with it in the workplace,” Sritharan said.
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