Massachusetts workers employed in construction and extraction have the highest rates of opioid overdose deaths, according to a CDC-funded study by the Massachusetts Department of Public Health.

The study found that workers in the state died of opioid-related causes at vastly different rates depending upon their job.

To understand those differences, investigators looked at 4,302 publicly available death certificates filed in Massachusetts from 2011 through 2015. They also used data from four national surveys to explore occupational factors that may contribute to differences in rates of opioid-related deaths among workers in different occupations and industries.

97% of opioid deaths among construction workers

More than 24% of opioid-related deaths occurred among construction and extraction workers during the years studied, with 1,096 opioid-related deaths in this group alone. This number translates to a rate of 150.6 deaths per every 100,000 workers—6 times greater than the 25.1 average rate for all Massachusetts workers. By job type, nearly all—97%—of these opioid-related deaths were among construction workers.

After construction and extraction, the agriculture, forestry, and fishing occupations had the second highest rate of death from opioids. Although the number (61) of opioid-related deaths was fewer than in construction, the rate was 143.9, which was more than 5 times the average rate for all Massachusetts workers. Among those who died in agriculture, forestry, and fishing, 74% had worked in fishing occupations.

Other above-average job types

Similarly, several other occupations had much higher than average rates of opioid-related deaths:

  • Material moving (59.1)
  • Installation, maintenance, and repair (54.0)
  • Transportation (42.6)
  • Production (42.1)
  • Food preparation and serving (39.5)
  • Building and grounds cleaning and maintenance (38.3)
  • Healthcare support (31.8)

The study also found differences by gender. Overall, most of the opioid-related deaths were among males, which is similar to findings for all opioid-related overdose deaths in Massachusetts. The rate was highest among male workers in agriculture, forestry, and fishing (205.9), followed by male workers in construction and extraction (152.3) and in material moving (71.9), as compared with the average rate for Massachusetts male workers (38.2). Among females, healthcare support (30.1) and food preparation and serving (28.9) were the two occupations with much higher rates than the Massachusetts average for female workers (11.6).

Work-related injuries, less paid sick leave are factors

The rate of opioid-related overdose deaths was higher among workers employed in industries and occupations that have high rates of work-related injuries and illness based on data from the Bureau of Labor Statistic Survey of Occupational Injuries and Illnesses. This finding is consistent with previous research documenting common use of prescribed opioids for management of pain following work-related injury. The rate of fatal opioid overdose was also higher among workers employed in occupations with lower availability of paid sick leave (data from the Bureau of Labor Statistics Employee Benefits Survey) and high job insecurity, or the worry of becoming unemployed (data from the National Health Interview Survey).

Although more research is needed to understand how injury, job insecurity, paid sick leave, and other work factors may contribute to opioid overdose deaths, this study’s findings highlight the critical need for immediate interventions. For example, educational programs and policies targeted toward occupations with a high rate of fatal opioid overdose should aim to decrease workplace hazards that could cause injury resulting in opioid prescriptions. Other critical steps include post-injury pain management with safer practices for prescribing opioids, overdose prevention education, and effective treatment for opioid use disorders among workers.

More information is available: