{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T01:15:58Z","timestamp":1780103758011,"version":"3.54.0"},"reference-count":22,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:00:00Z","timestamp":1693353600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000125","name":"National Institute for Occupational Safety and Health","doi-asserted-by":"publisher","award":["Kentucky Occupational Safety and Health program 5"],"award-info":[{"award-number":["Kentucky Occupational Safety and Health program 5"]}],"id":[{"id":"10.13039\/100000125","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000125","name":"National Institute for Occupational Safety and Health","doi-asserted-by":"publisher","award":["NCIPC\/Overdose Data to Action\/NU17CE924971-03-03"],"award-info":[{"award-number":["NCIPC\/Overdose Data to Action\/NU17CE924971-03-03"]}],"id":[{"id":"10.13039\/100000125","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Department of Health and Human Services","award":["6 NU17CE924971"],"award-info":[{"award-number":["6 NU17CE924971"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Inj Prev"],"accepted":{"date-parts":[[2023,8,2]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Variation among industries in the association between COVID-19-related closing or reopening orders and drug overdose deaths is unknown. The objectives of this study were to compare drug overdose decedent demographics, annual drug overdose fatality rates and monthly drug overdose fatality rates by specific industry within the service-related industry sector, and to perform an interrupted time series analysis comparing weekly drug overdose mortality counts in service-related and non-service-related industries, examining the COVID-19 pre-pandemic and pandemic phases by Kentucky closing and reopening orders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Kentucky drug overdose death certificate and toxicology testing data for years 2018\u20132021 were analysed using \u03a7<jats:sup>2<\/jats:sup> and interrupted time series methods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Before the pandemic, annual drug overdose fatality rates in service-related industries were higher than in non-service-related industries. However, these trends reversed during the pandemic. Both service-related and non-service-related industry groups experienced increased fatal drug overdoses at change points associated with the gubernatorial business closure orders, although the magnitude of the increase differed between the two groups. Young, female and black workers in service-related industries had higher frequencies of drug overdose deaths compared with decedents in the non-service-related industries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Spikes in drug overdose mortality in both service-related and non-service-related industries during the pandemic highlight the need to consider and include industries and occupations, as well as worker populations vulnerable to infectious diseases, as integral stakeholder groups when developing and implementing drug overdose prevention interventions, and implementing infectious disease surveillance systems.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/ip-2023-044894","type":"journal-article","created":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T13:20:14Z","timestamp":1693401614000},"page":"511-518","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Interrupted time series analysis of drug overdose fatalities in service-related industries versus non-service-related industries during the COVID-19 pandemic, 2018\u20132021"],"prefix":"10.1136","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5948-3313","authenticated-orcid":false,"given":"Terry L","family":"Bunn","sequence":"first","affiliation":[{"name":"Kentucky Injury Prevention and Research Center, University of Kentucky, Lexington, Kentucky, USA"},{"name":"Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8687-4478","authenticated-orcid":false,"given":"Julia F","family":"Costich","sequence":"additional","affiliation":[{"name":"Kentucky Injury Prevention and Research Center, University of Kentucky, Lexington, Kentucky, USA"},{"name":"Department of Health Management and Policy, University of Kentucky College of Public Health, Lexington, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mira","family":"Mirzaian","sequence":"additional","affiliation":[{"name":"Kentucky Injury Prevention and Research Center, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara K","family":"Daniels","sequence":"additional","affiliation":[{"name":"Kentucky Injury Prevention and Research Center, University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dandan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Kentucky College of Public Health, Lexington, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Quesinberry","sequence":"additional","affiliation":[{"name":"Kentucky Injury Prevention and Research Center, University of Kentucky, Lexington, Kentucky, USA"},{"name":"Department of Health Management and Policy, University of Kentucky College of Public Health, Lexington, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"key":"2025092504550777000_29.6.511.1","doi-asserted-by":"crossref","first-page":"108977","DOI":"10.1016\/j.drugalcdep.2021.108977","article-title":"The impact of the National stay-at-home order on emergency department visits for suspected opioid overdose during the first wave of the COVID-19 pandemic","volume":"228","author":"Root","year":"2021","journal-title":"Drug Alcohol Depend"},{"key":"2025092504550777000_29.6.511.2","doi-asserted-by":"crossref","first-page":"57","DOI":"10.7326\/M20-1141","article-title":"An epidemic in the midst of a pandemic: opioid use disorder and COVID-19","volume":"173","author":"Alexander","year":"2020","journal-title":"Ann Intern Med"},{"key":"2025092504550777000_29.6.511.3","doi-asserted-by":"publisher","DOI":"10.7326\/M20-1210"},{"key":"2025092504550777000_29.6.511.4","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1097\/EDE.0000000000001199","article-title":"The relative economy and drug overdose deaths","volume":"31","author":"Rudolph","year":"2020","journal-title":"Epidemiology"},{"key":"2025092504550777000_29.6.511.5","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1001\/jamainternmed.2019.5686","article-title":"Association between automotive assembly plant closures and opioid overdose mortality in the United States: a difference-in-differences analysis","volume":"180","author":"Venkataramani","year":"2020","journal-title":"JAMA Intern Med"},{"key":"2025092504550777000_29.6.511.6","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph19095351","article-title":"Economic challenges and behavioral and mental health risks for overdose during the COVID-19 pandemic among people who inject drugs","volume":"19","author":"Williams","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2025092504550777000_29.6.511.7","doi-asserted-by":"crossref","first-page":"342","DOI":"10.24095\/hpcdp.40.11\/12.03","article-title":"Substance use and related harms in the context of COVID-19: a conceptual model","volume":"40","author":"Enns","year":"2020","journal-title":"Health Promot Chronic Dis Prev Can"},{"key":"2025092504550777000_29.6.511.8","doi-asserted-by":"crossref","first-page":"106231","DOI":"10.1016\/j.ypmed.2020.106231","article-title":"Mental distress during the COVID-19 pandemic among US adults without a pre-existing mental health condition: findings from American trend panel survey","volume":"139","author":"Holingue","year":"2020","journal-title":"Prev Med"},{"key":"2025092504550777000_29.6.511.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113345"},{"key":"2025092504550777000_29.6.511.10","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1093\/aje\/kwac053","article-title":"Invited commentary: toward a better understanding of disparities in overdose mortality","volume":"191","author":"Abdalla","year":"2022","journal-title":"Am J Epidemiol"},{"key":"2025092504550777000_29.6.511.11","doi-asserted-by":"crossref","first-page":"e52","DOI":"10.1097\/ADM.0000000000000834","article-title":"Social determinants of mortality of COVID-19 and opioid overdose in American rural and urban counties","volume":"16","author":"Zhu","year":"2022","journal-title":"J Addict Med"},{"key":"2025092504550777000_29.6.511.12","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1002\/ajim.23029","article-title":"Opioid-related overdose deaths by industry and occupation-Massachusetts, 2011-2015","volume":"62","author":"Hawkins","year":"2019","journal-title":"Am J Ind Med"},{"key":"2025092504550777000_29.6.511.13","unstructured":"American Public Health Association . A public health approach to protecting workers from opioid use disorder and overdose related to occupational exposure, injury, and stress. 2020. Available: https:\/\/www.apha.org\/policies-and-advocacy\/public-health-policy-statements\/policy-database\/2021\/01\/13\/protecting-workers-from-opioid-use-disorder [Accessed 12 May 2021]."},{"key":"2025092504550777000_29.6.511.14","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1080\/00952990.2021.2003809","article-title":"Buprenorphine in safety-sensitive positions","volume":"48","author":"Hazle","year":"2022","journal-title":"Am J Drug Alcohol Abuse"},{"key":"2025092504550777000_29.6.511.15","doi-asserted-by":"crossref","DOI":"10.15585\/mmwr.mm7129a5","article-title":"Quickstats: age-adjusted drug overdose death rates* among workers aged 16-64 years in usual occupation\u2020 groups with the highest drug overdose death rates - national vital statistics system, United States,\u00a7 2020","volume":"71","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025092504550777000_29.6.511.16","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-022-13487-0","article-title":"A database of US state policies to mitigate COVID-19 and its economic consequences","volume":"22","author":"Skinner","year":"2022","journal-title":"BMC Public Health"},{"key":"2025092504550777000_29.6.511.17","unstructured":"Centers for Disease Control and Prevention . Cause-of-death classification and definition of drug deaths. 2022. Available: https:\/\/www.cdc.gov\/nchs\/nvss\/vsrr\/drug-overdose-data.htm#COD_classification_definition_drug_deaths"},{"key":"2025092504550777000_29.6.511.18","doi-asserted-by":"crossref","unstructured":"Robinson C , Schumacher P , Sweeney HM , et al . Guidelines for reporting occupation and industry on death certificates. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication no.2012-149, 2021. doi:10.26616\/NIOSHPUB2012149revised012021","DOI":"10.26616\/NIOSHPUB2012149revised012021"},{"key":"2025092504550777000_29.6.511.19","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev-2016-042308"},{"key":"2025092504550777000_29.6.511.20","unstructured":"SAS Institute, Inc . SAS\u00ae enterprise guide: version 8.2 for windows. Cary (NC): SAS Institute, Inc, 2022."},{"key":"2025092504550777000_29.6.511.21","doi-asserted-by":"crossref","DOI":"10.1186\/s40621-018-0165-8","article-title":"Interrupted time series design to evaluate the effect of the ICD-9-CM to ICD-10-CM coding transition on injury hospitalization trend","volume":"5","author":"Slavova","year":"2018","journal-title":"Inj Epidemiol"},{"key":"2025092504550777000_29.6.511.22","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2710.2002.00430.x"}],"container-title":["Injury Prevention"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/ip-2023-044894","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T11:55:18Z","timestamp":1758801318000},"score":1,"resource":{"primary":{"URL":"https:\/\/injuryprevention.bmj.com\/lookup\/doi\/10.1136\/ip-2023-044894"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,30]]},"references-count":22,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,11,27]]},"published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1136\/ip-2023-044894"],"URL":"https:\/\/doi.org\/10.1136\/ip-2023-044894","relation":{},"ISSN":["1353-8047","1475-5785"],"issn-type":[{"value":"1353-8047","type":"print"},{"value":"1475-5785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,30]]}}}