Occupational patterns of opioid-related harms comparing a cohort of formerly injured workers to the general population in Ontario, Canada

The role of work-related injuries as a risk factor for opioid-related harms has been hypothesized, but little data exist to support this relationship. The objective was to compare the incidence of opioid-related harms among a cohort of formerly injured workers to the general population in Ontario, Canada.

Workers’ compensation claimants (1983–2019) were linked to emergency department (ED) and hospitalization records (2006–2020). Incident rates of opioid-related poisonings and mental and behavioural disorders were estimated among 1.7 million workers and in the general population. Standardized incidence ratios (SIRs) and 95% confidence intervals (CI) were calculated, adjusting for age, sex, year, and region.

Compared to the general population, opioid-related poisonings among this group of formerly injured workers were elevated in both ED (SIR = 2.41, 95% CI = 2.37–2.45) and hospitalization records (SIR = 1.54, 95% CI = 1.50–1.59). Opioid-related mental and behavioural disorders were also elevated compared to the general population (ED visits: SIR = 1.86, 95% CI = 1.83–1.89; hospitalizations: SIR = 1.42, 95% CI = 1.38–1.47). Most occupations and industries had higher risks of harm compared to the general population, particularly construction, materials handling, processing (mineral, metal, chemical), and machining and related occupations. Teaching occupations displayed decreased risks of harm.

Findings support the hypothesis that work-related injuries have a role as a preventable risk factor for opioid-related harms. Strategies aimed at primary prevention of occupational injuries and secondary prevention of work disability and long-term opioid use are warranted.