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Abstract
Introduction We aimed to describe the occupational pattern of opioid overdose deaths in Maryland between 2018 and 2022 and determine the occupations at higher risk of opioid overdose death.
Methods The sample included undetermined or unintentional opioid overdose deaths among those aged 16 years or older in Maryland, drawn from the State Unintentional Drug Overdose Reporting System. We calculated population-based incidence overdose rates by occupation, stratified by sex and race. We further calculated the incidence rate ratios (IRRs) comparing each occupation with all other groups combined and estimated the IRRs among males versus females and non-Hispanic whites versus other racial/ethnic groups.
Results The pooled sample included 11 455 opioid overdose decedents (72% male and 55% non-Hispanic whites) of whom 80% were employed. The three occupation groups with the highest incidence rates were ‘construction and extraction’, ‘transportation and material moving’ and ‘installation/maintenance and repair’ with 291, 137 and 133 deaths per 100 000 workers in these respective occupational groups. Incidence rates were significantly higher in males than females in all categories except those ‘Not in Labour Force’ (IRR=0.51, p<0.001). Non-Hispanic whites relative to other racial/ethnic groups had a lower incidence of opioid overdose death in ‘Military-Specific’ occupations (IRR=0.53, p=0.031).
Conclusion Opioid overdose deaths vary by type of occupation and certain occupations are at higher risk of overdose death. The findings highlight the need for priority setting in the implementation and expansion of existing strategies to target the workers most impacted by opioid overdose.
- Epidemiology
- Public health
- Toxicology
- Accidents
- Mortality
Data availability statement
Data may be obtained from a third party and are not publicly available. All data relevant to the study are included in the article or uploaded as supplementary information.
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Data availability statement
Data may be obtained from a third party and are not publicly available. All data relevant to the study are included in the article or uploaded as supplementary information.
Footnotes
Contributors MA-E conceived, and designed the study, performed the data analyses, and drafted the manuscript with input from all authors. RS supervised the data analyses and contributed to the interpretation of the results and reporting. HB contributed to the interpretation of the results and reporting. ZEZ contributed to the interpretation of the results. CSM validated the study and contributed to both the interpretation of the results and the reporting. RMJ conceived, designed and validated the study, and contributed to the interpretation of the results. All authors reviewed and approved the final manuscript. MA-E, as the guarantor/principal investigator, takes responsibility for the overall content of the study, has access to the data and controlled the decision to publish.
Funding This research was supported by a grant from MDH to the Maryland Overdose Data Collaborative at Johns Hopkins Bloomberg School of Public Health (JHSPH) through a Cooperative Agreement number 6NU17CE924961 and a research and training award from the Johns Hopkins Bloomberg School of Public Health, Psychosocial, Organizational, and Environmental Center in Mental Health-Total Worker Health (POE-TWH), through a grant number 90097970.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
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