O-144 Incidence of opioid-related harms by occupation in Ontario, Canada: findings from the occupational disease surveillance system

Introduction

The opioid crisis continues unabated in Canada, yet current health surveillance systems that monitor opioid-related harms have limited or no employment information. The limited opioid overdose fatality data available suggest certain occupational groups have been disproportionately affected among those with known employment, namely those in construction and trades occupations, but little is known beyond these data. The Occupational Disease Surveillance System (ODSS), designed to detect work-related disease in a large cohort of workers in Ontario (Canada), was recently expanded to identify opioid-related hospitalizations and emergency department visits. We sought to estimate associations between occupation and risk of opioid-related harms in the Ontario, Canada workforce.

Materials and Methods

The ODSS was established through linkage of Workplace Safety and Insurance Board accepted workers’ compensation lost-time claims data to hospitalization and emergency department data. Workers aged 18–65 were followed from 2006 to 2020 to identify incident opioid-related poisonings (p) and mental and behavioural disorders (mb). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for each of the opioid-related harms by occupation, adjusted for sex, age, and birth year.

Results

We identified 10,066 poisoning cases and 11,762 mental and behavioural disorder cases during follow-up among 1.7 million workers. Preliminary findings demonstrate consistent elevated risks for occupations in construction and trades (p: HR=1.57, 95% CI=1.48–1.67, mb: HR=1.59, 95% CI=1.51–1.68), forestry and logging (p: HR=1.45, 95% CI=1.09–1.94, mb: HR=1.70, 95% CI=1.34–2.16), materials handling and related (p: HR=1.32, 95% CI=1.22–1.43, mb: HR=1.22, 95% CI=1.13–1.31), processing (mineral, metal, chemical) (p: HR=1.27, 95% CI=1.14–1.42, mb: HR=1.26, 95% CI=1.14–1.39), among other occupations.

Conclusions

Results suggest opioid-related harms cluster among certain occupational groups in the Ontario workforce, some of which are consistent with fatality data. Identification of high-risk subgroups by occupation will help inform targeted prevention and harm reduction activities.