Risk of opioid-related harms by occupation within a large cohort of formerly injured workers in Ontario, Canada: findings from the Occupational Disease Surveillance System.

IF 3.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Occupational and Environmental Medicine Pub Date : 2024-10-23 DOI:10.1136/oemed-2024-109458

Nancy Carnide, Jeavana Sritharan, Chaojie Song, Fateme Kooshki, Paul A Demers

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引用次数: 0

Abstract

Objective: Working-age individuals have been disproportionately affected by the opioid crisis, prompting interest in the potential role of occupation as a contributor. This study aimed to estimate the risk of opioid-related poisonings and mental and behavioural disorders by occupation and industry within a cohort of 1.7 million formerly injured workers.

Methods: Workers were identified in the Occupational Disease Surveillance System, a system linking workers' compensation data (1983-2019) to emergency department and hospitalisation records (2006-2020) in Ontario, Canada. Cox proportional hazards models were used to estimate HRs and 95% CIs for hospital encounters for opioid-related poisonings and mental and behavioural disorders by occupation and industry compared with all other workers, adjusted for age, sex and birth year.

Results: In total, 13 702 opioid-related poisoning (p) events (n=10 064 workers) and 19 629 opioid-related mental and behavioural (mb) disorder events (n=11 755 workers) were observed. Elevated risks were identified among workers in forestry and logging (HR_p=1.45, 95% CI 1.09 to 1.94; HR_mb=1.70, 95% CI 1.34 to 2.16); processing (minerals, metals, clay, chemical) (HR_p=1.27, 95% CI 1.14 to 1.42; HR_mb=1.26, 95% CI 1.14 to 1.39); processing (food, wood, textile) (HR_p=1.12, 95% CI 1.01 to 1.24; HR_mb=1.19, 95% CI 1.09 to 1.31); machining (HR_p=1.13, 95% CI 1.04 to 1.21; HR_mb=1.17, 95% CI 1.09 to 1.25); construction trades (HR_p=1.57, 95% CI 1.48 to 1.67; HR_mb=1.59, 95% CI 1.51 to 1.68); materials handling (HR_p=1.32, 95% CI 1.22 to 1.43; HR_mb=1.22, 95% CI 1.13 to 1.31); mining and quarrying (HR_mb=1.68, 95% CI 1.34 to 2.11); and transport equipment operating occupations (HR_p=1.18, 95% CI 1.09 to 1.27). Elevated risks were observed among select workers in service, sales, clerical and health. Findings by industry were similar.

Conclusions: Results provide additional evidence that opioid-related harms cluster among certain occupational groups. Findings can be used to strategically target prevention and harm reduction activities in the workplace.

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加拿大安大略省以前受过伤害的大型工人队列中阿片类药物相关伤害的职业风险：职业病监测系统的研究结果。

目的：工作年龄段的人受阿片类药物危机的影响尤为严重，这促使人们关注职业作为诱因的潜在作用。本研究旨在估算170万曾受过伤的工人群体中与阿片类药物有关的中毒以及精神和行为障碍的风险，并按职业和行业进行分类：该系统将加拿大安大略省的工人赔偿数据（1983-2019 年）与急诊科和住院记录（2006-2020 年）联系起来。使用考克斯比例危险模型估算了与所有其他工人相比，不同职业和行业的阿片类药物相关中毒以及精神和行为障碍住院治疗的 HRs 和 95% CIs，并对年龄、性别和出生年份进行了调整：总共观察到 13 702 起与阿片类药物有关的中毒（p）事件（人数=10 064 名工人）和 19 629 起与阿片类药物有关的精神和行为障碍（mb）事件（人数=11 755 名工人）。在林业和伐木业（HRp=1.45，95% CI 1.09 至 1.94；HRmb=1.70，95% CI 1.34 至 2.16）、加工业（矿物、金属、粘土、化工）（HRp=1.27，95% CI 1.14 至 1.42；HRmb=1.26，95% CI 1.14 至 1.39）；加工（食品、木材、纺织品）（HRp=1.12，95% CI 1.01 至 1.24；HRmb=1.19，95% CI 1.09 至 1.31）；机械加工（HRp=1.13，95% CI 1.04 至 1.21；HRmb=1.17，95% CI 1.09 至 1.25）；建筑行业（HRp=1.57，95% CI 1.48 至 1.67；HRmb=1.59，95% CI 1.51 至 1.68）；材料处理（HRp=1.32，95% CI 1.22至1.43；HRmb=1.22，95% CI 1.13至1.31）；采矿和采石业（HRmb=1.68，95% CI 1.34至2.11）；以及运输设备操作职业（HRp=1.18，95% CI 1.09至1.27）。在服务、销售、文秘和保健等特定行业的工人中，观察到了更高的风险。各行业的调查结果相似：研究结果提供了更多证据，表明与阿片类药物相关的危害集中在某些职业群体中。研究结果可用于在工作场所有针对性地开展预防和减少伤害活动。

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来源期刊

Occupational and Environmental Medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

8.30

自引率

2.00%

发文量

审稿时长

2 months

期刊介绍： Occupational and Environmental Medicine is an international peer reviewed journal covering current developments in occupational and environmental health worldwide. Occupational and Environmental Medicine publishes high-quality research relating to the full range of chemical, physical, ergonomic, biological and psychosocial hazards in the workplace and to environmental contaminants and their health effects. The journal welcomes research aimed at improving the evidence-based practice of occupational and environmental research; including the development and application of novel biological and statistical techniques in addition to evaluation of interventions in controlling occupational and environmental risks.