{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:12:43Z","timestamp":1789477963883,"version":"build-2803163510"},"reference-count":40,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T00:00:00Z","timestamp":1729123200000},"content-version":"unspecified","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Ontario Ministry of Labour, Immigration, Training and Skills Development","award":["14-R-029"],"award-info":[{"award-number":["14-R-029"]}]},{"DOI":"10.13039\/100011094","name":"Public Health Agency of Canada","doi-asserted-by":"publisher","award":["1516-HQ-000066"],"award-info":[{"award-number":["1516-HQ-000066"]}],"id":[{"id":"10.13039\/100011094","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011094","name":"Public Health Agency of Canada","doi-asserted-by":"publisher","award":["2021-HQ-000092"],"award-info":[{"award-number":["2021-HQ-000092"]}],"id":[{"id":"10.13039\/100011094","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2024,7,23]]},"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Working-age individuals have been disproportionately affected by the opioid crisis, prompting interest in the potential role of occupation as a contributor. This study aimed to estimate the risk of opioid-related poisonings and mental and behavioural disorders by occupation and industry within a cohort of 1.7 million formerly injured workers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Workers were identified in the Occupational Disease Surveillance System, a system linking workers\u2019 compensation data (1983\u20132019) to emergency department and hospitalisation records (2006\u20132020) in Ontario, Canada. Cox proportional hazards models were used to estimate HRs and 95% CIs for hospital encounters for opioid-related poisonings and mental and behavioural disorders by occupation and industry compared with all other workers, adjusted for age, sex and birth year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 13 702 opioid-related poisoning (p) events (n=10 064 workers) and 19 629 opioid-related mental and behavioural (mb) disorder events (n=11 755 workers) were observed. Elevated risks were identified among workers in forestry and logging (HR\n                      <jats:sub>p<\/jats:sub>\n                      =1.45, 95% CI 1.09 to 1.94; HR\n                      <jats:sub>mb<\/jats:sub>\n                      =1.70, 95% CI 1.34 to 2.16); processing (minerals, metals, clay, chemical) (HR\n                      <jats:sub>p<\/jats:sub>\n                      =1.27, 95% CI 1.14 to 1.42; HR\n                      <jats:sub>mb<\/jats:sub>\n                      =1.26, 95% CI 1.14 to 1.39); processing (food, wood, textile) (HR\n                      <jats:sub>p<\/jats:sub>\n                      =1.12, 95% CI 1.01 to 1.24; HR\n                      <jats:sub>mb<\/jats:sub>\n                      =1.19, 95% CI 1.09 to 1.31); machining (HR\n                      <jats:sub>p<\/jats:sub>\n                      =1.13, 95% CI 1.04 to 1.21; HR\n                      <jats:sub>mb<\/jats:sub>\n                      =1.17, 95% CI 1.09 to 1.25); construction trades (HR\n                      <jats:sub>p<\/jats:sub>\n                      =1.57, 95% CI 1.48 to 1.67; HR\n                      <jats:sub>mb<\/jats:sub>\n                      =1.59, 95% CI 1.51 to 1.68); materials handling (HR\n                      <jats:sub>p<\/jats:sub>\n                      =1.32, 95% CI 1.22 to 1.43; HR\n                      <jats:sub>mb<\/jats:sub>\n                      =1.22, 95% CI 1.13 to 1.31); mining and quarrying (HR\n                      <jats:sub>mb<\/jats:sub>\n                      =1.68, 95% CI 1.34 to 2.11); and transport equipment operating occupations (HR\n                      <jats:sub>p<\/jats:sub>\n                      =1.18, 95% CI 1.09 to 1.27). Elevated risks were observed among select workers in service, sales, clerical and health. Findings by industry were similar.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Results provide additional evidence that opioid-related harms cluster among certain occupational groups. Findings can be used to strategically target prevention and harm reduction activities in the workplace.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/oemed-2024-109458","type":"journal-article","created":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T10:10:17Z","timestamp":1729159817000},"page":"507-514","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Risk of opioid-related harms by occupation within a large cohort of formerly injured workers in Ontario, Canada: findings from the Occupational Disease Surveillance System"],"prefix":"10.1136","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7892-5626","authenticated-orcid":false,"given":"Nancy","family":"Carnide","sequence":"first","affiliation":[{"name":"Institute for Work & Health, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8228-1632","authenticated-orcid":false,"given":"Jeavana","family":"Sritharan","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2693-1095","authenticated-orcid":false,"given":"Chaojie","family":"Song","sequence":"additional","affiliation":[{"name":"Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4670-7660","authenticated-orcid":false,"given":"Fateme","family":"Kooshki","sequence":"additional","affiliation":[{"name":"Institute for Work & Health, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2163-2352","authenticated-orcid":false,"given":"Paul A","family":"Demers","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,10,17]]},"reference":[{"key":"2026051808500763000_81.10.507.1","unstructured":"Centers for Disease Control and Prevention and National Center for Health Statistics . National Vital Statistics System, Mortality. CDC WONDER; 2024. Available: https:\/\/wonder.cdc.gov\/ [Accessed 29 May 2024]."},{"key":"2026051808500763000_81.10.507.2","unstructured":"Federal Provincial and Territorial Special Advisory Committee on the Epidemic of Opioid Overdoses . Opioid- and Stimulant-related Harms in Canada. Ottawa,ON: Public Health Agency of Canada; 2023. Available: https:\/\/health-infobase.canada.ca\/substance-related-harms\/opioids-stimulants [Accessed 29 May 2024]."},{"key":"2026051808500763000_81.10.507.3","unstructured":"Statistics Canada . Deaths, 2022. Ottawa, ON: Statistics Canada; 2023. Available: https:\/\/www150.statcan.gc.ca\/n1\/daily-quotidien\/231127\/dq231127b-eng.htm [Accessed 17 Dec 2023]."},{"key":"2026051808500763000_81.10.507.4","doi-asserted-by":"crossref","unstructured":"Arias E , Tejada-Vera B , Kochanek KD , et al . Provisional life expectancy estimates for 2021. Vital Statistics Rapid Release; No 23. Hyattsville, MD: National Center for Health Statistics; 2022. doi:10.15620\/cdc:118999","DOI":"10.15620\/cdc:118999"},{"key":"2026051808500763000_81.10.507.5","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-05684-7"},{"key":"2026051808500763000_81.10.507.6","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.23029"},{"key":"2026051808500763000_81.10.507.7","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6733a3"},{"key":"2026051808500763000_81.10.507.8","first-page":"46","article-title":"Accidental or undetermined opioid-involved drug overdose deaths in Rhode Island and usual occupation - higher rates observed in natural resources, construction, and maintenance occupations","volume":"102","author":"Scagos","year":"2019","journal-title":"R I Med J"},{"key":"2026051808500763000_81.10.507.9","first-page":"1","article-title":"Drug overdose mortality by usual occupation and industry: 46 U.S States and New York City, 2020","volume":"72","author":"Billock","year":"2023","journal-title":"Natl Vital Stat Rep"},{"key":"2026051808500763000_81.10.507.10","first-page":"3","article-title":"Exploring the intersectionality of characteristics among those who experienced opioid overdoses: a cluster analysis","volume":"34","author":"Chu","year":"2023","journal-title":"Health Rep"},{"key":"2026051808500763000_81.10.507.11","unstructured":"Gomes T , Iacono A , Kolla G , et al . Lives lost to opioid toxicity among Ontarians who worked in construction. Toronto, ON: Ontario Drug Policy Research Network; 2022. Available: https:\/\/odprn.ca\/wp-content\/uploads\/2022\/07\/Opioid-Toxicity-in-the-Construction-Industry-Report-Final.pdf [Accessed 17 Dec 2023]."},{"key":"2026051808500763000_81.10.507.12","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.23241"},{"key":"2026051808500763000_81.10.507.13","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2021-108146"},{"key":"2026051808500763000_81.10.507.14","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2017-104926"},{"key":"2026051808500763000_81.10.507.15","doi-asserted-by":"crossref","unstructured":"Carnide N , Feng G , Song C , et al . Occupational patterns of opioid-related harms comparing a cohort of formerly injured workers to the general population in Ontario, Canada. Can J Public Health 2024. doi:10.17269\/s41997-024-00882-w","DOI":"10.17269\/s41997-024-00882-w"},{"key":"2026051808500763000_81.10.507.16","unstructured":"Government of Canada . Occupational Classification Manual, Census of Canada, 1971, based on Canadian Classification and Dictionary of Occupations. Ottawa, ON: Dominion Bureau of Statistics; 1971. Available: https:\/\/publications.gc.ca\/site\/eng\/9.847964\/publication.html [Accessed 14 Dec 2023]."},{"key":"2026051808500763000_81.10.507.17","unstructured":"Government of Canada . Standard Industrial Classification Manual. Ottawa, ON: Dominion Bureau of Statistics; 1970. Available: https:\/\/publications.gc.ca\/site\/eng\/9.835816\/publication.html [Accessed 14 Dec 2023]."},{"key":"2026051808500763000_81.10.507.18","unstructured":"Government of Canada . Standard Industrial Classification. Ottawa, ON: Statistics Canada; 1980. Available: https:\/\/publications.gc.ca\/site\/eng\/9.836825\/publication.html [Accessed 14 Dec 2023]."},{"key":"2026051808500763000_81.10.507.19","unstructured":"Special Advisory Committee on the Epidemic of Opioid Overdoses . Understanding a broader range of opioid-related hospitalizations in Canada. Ottawa, ON: Public Health Agency of Canada; 2020. Available: https:\/\/www.canada.ca\/en\/health-canada\/services\/opioids\/data-surveillance-research\/understanding-broader-range-opioid-related-hospitalizations.html [Accessed 28 Mar 2023]."},{"key":"2026051808500763000_81.10.507.20","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2020.305716"},{"key":"2026051808500763000_81.10.507.21","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.23483"},{"key":"2026051808500763000_81.10.507.22","doi-asserted-by":"publisher","DOI":"10.1093\/annweh\/wxab017"},{"key":"2026051808500763000_81.10.507.23","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0000000000002709"},{"key":"2026051808500763000_81.10.507.24","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2019.7222","article-title":"Prevalence and risk factors associated with long-term opioid use after injury among previously opioid-free workers","volume":"2","author":"Durand","year":"2019","journal-title":"JAMA Netw Open"},{"key":"2026051808500763000_81.10.507.25","doi-asserted-by":"publisher","DOI":"10.1177\/0020731419881336"},{"key":"2026051808500763000_81.10.507.26","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/1475-6773.13564","article-title":"Changes in early high\u2010risk opioid prescribing practices after policy interventions in Washington State","volume":"56","author":"Sears","year":"2021","journal-title":"Health Serv Res"},{"key":"2026051808500763000_81.10.507.27","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0000000000001187"},{"key":"2026051808500763000_81.10.507.28","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0272385","article-title":"Opioid prescriptions for individuals receiving workers\u2019 compensation in Michigan","volume":"17","author":"Rosenman","year":"2022","journal-title":"PLoS One"},{"key":"2026051808500763000_81.10.507.29","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssci.2015.07.029"},{"key":"2026051808500763000_81.10.507.30","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2020-106535"},{"key":"2026051808500763000_81.10.507.31","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.23083"},{"key":"2026051808500763000_81.10.507.32","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.23021"},{"key":"2026051808500763000_81.10.507.33","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-019-01514-4"},{"key":"2026051808500763000_81.10.507.34","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182413334"},{"key":"2026051808500763000_81.10.507.35","doi-asserted-by":"publisher","DOI":"10.1177\/10482911211039880"},{"key":"2026051808500763000_81.10.507.36","unstructured":"The National Institute for Occupational Safety and Health (NIOSH) . Workplace supported recovery program. 2023. Available: https:\/\/www.cdc.gov\/niosh\/topics\/opioids\/wsrp\/default.html [Accessed 6 Jan 2024]."},{"key":"2026051808500763000_81.10.507.37","doi-asserted-by":"publisher","DOI":"10.1177\/10482911211037905"},{"key":"2026051808500763000_81.10.507.38","doi-asserted-by":"publisher","DOI":"10.1177\/10482911211010343"},{"key":"2026051808500763000_81.10.507.39","doi-asserted-by":"publisher","DOI":"10.1177\/1048291120982597"},{"key":"2026051808500763000_81.10.507.40","unstructured":"Bureau of Labor Statistics, US Department of Labor . Unintentional overdoses rose for the ninth consecutive year in 2021. 2023. Available: https:\/\/www.bls.gov\/opub\/ted\/2023\/unintentional-overdoses-rose-for-the-ninth-consecutive-year-in-2021.htm [Accessed 22 Dec 2023]."}],"container-title":["Occupational and Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/oemed-2024-109458","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T15:50:54Z","timestamp":1779119454000},"score":1,"resource":{"primary":{"URL":"https:\/\/oem.bmj.com\/lookup\/doi\/10.1136\/oemed-2024-109458"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":40,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,10,23]]},"published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1136\/oemed-2024-109458"],"URL":"https:\/\/doi.org\/10.1136\/oemed-2024-109458","relation":{},"ISSN":["1351-0711","1470-7926"],"issn-type":[{"value":"1351-0711","type":"print"},{"value":"1470-7926","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10]]}}}