Suicide and drug‐related mortality following occupational injury

Abstract

Background Drug overdoses and suicides have been rising since 2000 and are major contributors to a 3‐year decline in US life expectancy. Studies suggest that injured workers have elevated rates of depression and opioid use, but no studies have measured excess mortality related to these risks. Materials and methods We linked New Mexico workers' compensation data for 100 806 workers injured in 1994 through 2000 with Social Security Administration earnings and mortality data through 2013 and National Death Index cause of death data. We then estimated the association between receiving lost‐time workers' compensation benefits and mortality hazard ratios (HRs) and 95% confidence intervals (CIs) based on Fine and Gray cause‐specific subdistribution hazards for common causes of death and for drug‐related, suicide, and alcohol‐related mortality. Results There was almost a 3‐fold increase in combined drug‐related and suicide mortality hazard among women (HR = 2.63, 95% CI = 1.91‐3.64) and a substantial increase among men (HR = 1.42, 95% CI = 1.13‐1.79). Circulatory disease mortality hazard was elevated for men (HR = 1.25, 95% CI = 1.05‐1.50). Conclusion Workplace injuries severe enough to require more than a week off work may impair workers' long‐term health and well‐being. Drug‐related deaths and suicides may be important contributors to the long‐term excess mortality of injured workers. Improved workplace conditions, improved pain treatment, better treatment of substance use disorders, and treatment of postinjury depression may substantially reduce mortality consequent to workplace injuries.

Increased overall and cause‐specific mortality associated with disability among workers’ compensation claimants with low back injuries

“…We also found an association between work‐related disability and fatal drug overdoses involving opioids. Applebaum et al recently reported the results of a follow‐up study from the New Mexico workers’ compensation cohort which found an HR of 2.63 (95% CI = 1.91‐3.64) for combined drug‐related and suicide mortality among women and an HR of 1.42 (95% CI = 1.13‐1.79) among men comparing lost‐time to no lost‐time injuries. Circulatory disease mortality was also elevated for men with an HR = 1.25 (95% CI = 1.05‐1.50) .…”

“…Applebaum et al recently reported the results of a follow‐up study from the New Mexico workers’ compensation cohort which found an HR of 2.63 (95% CI = 1.91‐3.64) for combined drug‐related and suicide mortality among women and an HR of 1.42 (95% CI = 1.13‐1.79) among men comparing lost‐time to no lost‐time injuries. Circulatory disease mortality was also elevated for men with an HR = 1.25 (95% CI = 1.05‐1.50) . In contrast, we did not observe significantly different HRs between women and men, either by lost‐time injury or other measures of disability (Table S3).…”

Promoting Opioid Awareness Through a Union-Based Peer Training Model

“…4 Numerous work factors such as job strain, employment in construction and extraction occupations, unemployment and economic conditions, lack of sick days, heavy lifting, seasonal work, and workers’ compensation claims have been linked to opioid use disorder and opioid-related overdose deaths of workers. 3,5–9 For example, Choi reported prevalence ratios for opioid use disorder of 2.0 for psychosocial job strain and 2.2 for frequent heavy lifting. 5 Although further epidemiologic research is being conducted to examine the mechanisms of these associations, public health prevention efforts should be targeted toward working populations who face such risk factors, as part of a comprehensive response to the crisis.…”

Clinical correlates of workplace injury occurrence and recurrence in adults

“…It is recognized that re-occurrence of incidents with a similar cause and circumstance in the workplace environment is a public health concern with unacceptable high incidence in the U.S. and worldwide [20]. Both pre-injury and post-injury correlates include social (disparity) determinants as race, and clinical conditions such as mental health disorders and drug dependence (which can be ascertained by prior ICD diagnoses) [21,22]. The Cox regression highlighted a number of conditions that affect the risk of WPI recurrence ( Table 6 ).…”