The number of people who die or who are being hospitalized due to opioids continues to rise, prompting the Institute for Work & Health (IWH) and the Occupational Cancer Research Centre (OCRC) to launch a research project monitoring opioid-related adverse health events in order to identify the worker groups most at risk.
The Opioid-Related Harms among Ontario Workers project, a four-year collaboration, aims to raise awareness about the risk of opioid-related harms occurring among Ontario workers and expand efforts to address the crisis.
Nancy Carnide, an associate scientist at the IWH, and Paul Demers, director of the OCRC, are the co-leads on the project.
The main objective is to establish a surveillance program to examine and monitor opioid-related events and identify worker groups at the greatest risk.
“When we look at the surveillance systems here in Canada that track opioid related harms among the population they typically don’t have any information on employment,” said Carnide.
Overdose fatality information from a few jurisdictions, including Ontario, shows these deaths are more common among people who work in the construction, transportation and manufacturing sectors.
“They were able to get some information from coroner records around whether the person was employed at the time, in many cases though the employment information was not available,” Carnide said. “When it was available, what we were seeing is that certain occupational groups were being disproportionately affected, construction workers being one of them.”
“A lot of people involved in opioids recognize this as a gap, understanding the relationship between opioid use and work and then the risks of harm that come from that,” added Demers.
The project is looking to adapt and expand an existing system called the Occupational Disease Surveillance System (ODSS) which contains occupational data on 1.7 million Ontario workers linked to health information on hospitalizations and emergency department visits.
We can’t ignore the role that employment and job conditions could have in either initiating or perpetuating someone’s substance use disorder,
— Nancy Carnide
Institute for Work & Health
“What we’re doing is we have a very large data set of people who have filed workers compensation claims in the past, so we have their occupation and industry there, so we can identify for instance, people in construction, what trades they are in,” explained Demers.
“We are connecting that to all the health records of the province. So we don’t need people to self-report anything. Whenever there is a hospital visit or somebody goes to the emergency room we actually have that electronically.”
“What we are able to do is look at a history of employment as we’ve been able to identify in the ODSS and then follow forward to look at any sort of hospitalizations or emergency department visits that they have had for an opioid-related event,” Carnide added.
“We have the benefit of seeing that occupational history prior to the event occurring, we can’t get that necessarily in the overdose fatality data.”
Sometimes the coroner’s report doesn’t specify the occupation of the victim, Demers noted.
“If, for example, they don’t happen to collapse at work it might not be part of the coroner’s report,” he said.
“There are a lot of things that can be missed in that, so we are trying to cast this very broad net where we don’t start with a person dies from opioids and then trying to investigate backwards, but instead trying to link these big sets of data together to get that kind of picture that really might help us better understand this.”
The goals of the project are to monitor and describe rates of opioid-related hospitalizations and emergency department visits among workers in the ODSS since 2006; compare rates of opioid-related harms among workers in the ODSS to those in the general population of Ontario; and identify the characteristics of workers in the ODSS (e.g., occupation, industry, nature of claim) associated with higher rates of opioid-related harms.
The team is hoping the findings will lead to change.
“We can’t ignore the role that employment and job conditions could have in either initiating or perpetuating someone’s substance use disorder,” said Carnide.
“What I think we’ll also be able to do is…highlight higher risk subgroups of the working population so that government, policy-makers can start to create programs, policies…and target those to the groups that are most affected and are most likely to benefit.”
The project is being funded by the Public Health Agency of Canada. Carnide and Demers said the project could lead to further research on the opioid-related harms and the causes in the future.
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