{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T10:31:15Z","timestamp":1740133875502,"version":"3.37.3"},"reference-count":40,"publisher":"BMJ","issue":"9","funder":[{"DOI":"10.13039\/100008309","name":"Johns Hopkins Bloomberg School of Public Health","doi-asserted-by":"publisher","award":["90097970"],"award-info":[{"award-number":["90097970"]}],"id":[{"id":"10.13039\/100008309","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100024327","name":"Maryland Department of Health","doi-asserted-by":"publisher","award":["6NU17CE924961"],"award-info":[{"award-number":["6NU17CE924961"]}],"id":[{"id":"10.13039\/100024327","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2024,9,4]]},"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The pooled sample included 11\u2009455 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 \u2018construction and extraction\u2019, \u2018transportation and material moving\u2019 and \u2018installation\/maintenance and repair\u2019 with 291, 137 and 133 deaths per 100\u2009000 workers in these respective occupational groups. Incidence rates were significantly higher in males than females in all categories except those \u2018Not in Labour Force\u2019 (IRR=0.51, p&lt;0.001). Non-Hispanic whites relative to other racial\/ethnic groups had a lower incidence of opioid overdose death in \u2018Military-Specific\u2019 occupations (IRR=0.53, p=0.031).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1136\/oemed-2024-109536","type":"journal-article","created":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T23:15:15Z","timestamp":1727392515000},"page":"462-470","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Maryland opioid overdose deaths from 2018 to 2022: occupational patterns and their sociodemographic variations"],"prefix":"10.1136","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3888-3254","authenticated-orcid":false,"given":"Masoumeh","family":"Amin-Esmaeili","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryoko","family":"Susukida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Himani","family":"Byregowda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiqing E","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clifford S","family":"Mitchell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renee M","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,9,26]]},"reference":[{"key":"2024100812502032000_81.9.462.1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302843"},{"key":"2024100812502032000_81.9.462.2","doi-asserted-by":"publisher","DOI":"10.1097\/yco.0000000000000712"},{"key":"2024100812502032000_81.9.462.3","unstructured":"Centers for Disease Control and Prevention . SUDORS dashboard: fatal overdose data. Available: https:\/\/www.cdc.gov\/drugoverdose\/fatal\/dashboard [Accessed 19 Apr 2023]."},{"key":"2024100812502032000_81.9.462.4","unstructured":"Substance Abuse and Mental Health Services Administration . Key substance use and mental health indicators in the United States: results from the 2019 National Survey on Drug Use and Health (HHS Publication no.PEP20-07-01-001, NSDUH Series H-55). Rockville, MD Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2020. Available: https:\/\/www.samhsa.gov\/data\/"},{"key":"2024100812502032000_81.9.462.5","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA) . National survey on drug use and health: 2019 NSDUH detailed tables. Available: https:\/\/www.samhsa.gov\/data\/report\/2019-nsduh-detailed-tables [Accessed 26 Oct 2021]."},{"key":"2024100812502032000_81.9.462.6","unstructured":"Centers for Disease Control and Prevention . 2019 annual surveillance report of drug-related risks and outcomes \u2014 United States surveillance special report [Centers for Disease Control and Prevention, U.S. Department of Health and Human Services]. Available: https:\/\/www.cdc.gov\/drugoverdose\/pdf\/pubs\/2019-cdc-drug-surveillance-report.pdf [Accessed 24 Oct 2021]."},{"key":"2024100812502032000_81.9.462.7","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":"2024100812502032000_81.9.462.8","doi-asserted-by":"crossref","first-page":"2210","DOI":"10.1007\/s11606-020-05684-7","article-title":"Occupational Patterns of Opioid-Related Overdose Deaths Among Arizona Medicaid Enrollees, 2008-2017","volume":"35","author":"Chalasani","year":"2020","journal-title":"J Gen Intern Med"},{"key":"2024100812502032000_81.9.462.9","doi-asserted-by":"crossref","first-page":"925","DOI":"10.15585\/mmwr.mm6733a3","article-title":"Occupational Patterns in Unintentional and Undetermined Drug-Involved and Opioid-Involved Overdose Deaths \u2014 United States, 2007\u20132012","volume":"67","author":"Harduar Morano","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2024100812502032000_81.9.462.10","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.2105\/AJPH.2020.305716","article-title":"Work Environment Factors and Prevention of Opioid-Related Deaths","volume":"110","author":"Shaw","year":"2020","journal-title":"Am J Public Health"},{"key":"2024100812502032000_81.9.462.11","first-page":"1","article-title":"Drug overdose mortality by usual occupation and industry: 46 US States and New York City, 2020. National Vital Statistics Reports: From the Centers for Disease Control and Prevention, National Center for Health Statistics","volume":"72","author":"Billock","year":"2023","journal-title":"NVSS"},{"key":"2024100812502032000_81.9.462.12","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev-2018-043104"},{"key":"2024100812502032000_81.9.462.13","doi-asserted-by":"crossref","first-page":"107640","DOI":"10.1016\/j.drugalcdep.2019.107640","article-title":"Construction trade and extraction workers: A population at high risk for drug use in the United States, 2005-2014","volume":"205","author":"Ompad","year":"2019","journal-title":"Drug Alcohol Depend"},{"key":"2024100812502032000_81.9.462.14","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1177\/10482911211048438","article-title":"Introduction to the Special Issue: Opioids and the Workplace - Risk Factors and Solutions","volume":"31","author":"Rosen","year":"2021","journal-title":"New Solut"},{"key":"2024100812502032000_81.9.462.15","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2020-106535"},{"key":"2024100812502032000_81.9.462.16","unstructured":"Centers for Disease Control and Prevention . Enhanced state opioid overdose surveillance. Available: https:\/\/www.cdc.gov\/drugoverdose\/foa\/state-opioid-mm.html [Accessed 25 Oct 2021]."},{"key":"2024100812502032000_81.9.462.17","unstructured":"Maryland Opioid Operational Command Center (OOCC) . Before it\u2019s too late, 2020 annual report. Available: https:\/\/beforeitstoolate.maryland.gov\/resources-2 [Accessed 25 Oct 2021]."},{"key":"2024100812502032000_81.9.462.18","unstructured":"Centers for Disease Control and Prevention . State Unintentional Drug Overdose System (SUDORS) coding manual revised 2022 [National Center for Injury Prevention and Control, Centers for Disease Control and Prevention]. n.d. Available: https:\/\/www.cdc.gov\/overdose-prevention\/media\/pdfs\/SUDORS_Coding_Manual_OD2A_v6.3.pdf"},{"key":"2024100812502032000_81.9.462.19","unstructured":"The National Institute for Occupational Safety and Health (NIOSH) . NIOSH Industry and Occupation Computerized Coding System (NIOCCS). Available: https:\/\/csams.cdc.gov\/nioccs\/Default.aspx [Accessed 08 Mar 2023]."},{"key":"2024100812502032000_81.9.462.20","unstructured":"U.S. Bureau of Labor Statistics . Standard occupational classification manual. Available: https:\/\/www.bls.gov\/soc\/2018\/home.htm [Accessed 15 Aug 2024]."},{"key":"2024100812502032000_81.9.462.21","doi-asserted-by":"publisher","DOI":"10.1007\/s10597-015-9889-x"},{"key":"2024100812502032000_81.9.462.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2003.09.023"},{"key":"2024100812502032000_81.9.462.23","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1111\/imj.15124","article-title":"Workplace stress, common mental disorder and suicidal ideation in junior doctors","volume":"51","author":"Petrie","year":"2021","journal-title":"Intern Med J"},{"key":"2024100812502032000_81.9.462.24","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1002\/ajim.23243","article-title":"Effects of work stress, sleep, and shift work on suicidal ideation among female workers in an electronics company","volume":"64","author":"Son","year":"2021","journal-title":"Am J Ind Med"},{"key":"2024100812502032000_81.9.462.25","doi-asserted-by":"crossref","DOI":"10.1002\/1348-9585.12219","article-title":"Health outcomes of psychosocial stress within firefighters: A systematic review of the research landscape","volume":"63","author":"Igboanugo","year":"2021","journal-title":"J Occup Health"},{"key":"2024100812502032000_81.9.462.26","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1093\/annweh\/wxab017","article-title":"The Contribution of Occupation-Specific Factors to the Deaths of Despair, Massachusetts, 2005-2015","volume":"65","author":"Hawkins","year":"2021","journal-title":"Ann Work Expo Health"},{"key":"2024100812502032000_81.9.462.27","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1177\/2165079920909136","article-title":"Health Risk Factors Among Miners, Oil and Gas Extraction Workers, Other Manual Labor Workers, and Nonmanual Labor Workers, BRFSS 2013-2017, 32 States","volume":"68","author":"Yeoman","year":"2020","journal-title":"Workplace Health Saf"},{"key":"2024100812502032000_81.9.462.28","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1002\/ajim.23021","article-title":"Suicide and drug-related mortality following occupational injury","volume":"62","author":"Applebaum","year":"2019","journal-title":"Am J Ind Med"},{"key":"2024100812502032000_81.9.462.29","doi-asserted-by":"publisher","DOI":"10.2224\/sbp.2003.31.4.395"},{"key":"2024100812502032000_81.9.462.30","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1002\/ajim.23158","article-title":"Prescription opioid use and associated factors among US construction workers","volume":"63","author":"Dong","year":"2020","journal-title":"Am J Ind Med"},{"key":"2024100812502032000_81.9.462.31","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1002\/ajim.23078","article-title":"Influence of work organization and work environment on missed work, productivity, and use of pain medications among construction apprentices","volume":"63","author":"Evanoff","year":"2020","journal-title":"Am J Ind Med"},{"key":"2024100812502032000_81.9.462.32","first-page":"221","article-title":"Performance-Based Rewards and Work Stress","volume":"31","author":"Ganster","year":"2011","journal-title":"J Organ Behav Manage"},{"key":"2024100812502032000_81.9.462.33","doi-asserted-by":"crossref","first-page":"S77","DOI":"10.2105\/AJPH.2021.306510","article-title":"Pain and Prescription Opioid Use Among US Construction Workers: Findings From the 2011\u20122018 Medical Expenditure Panel Survey","volume":"112","author":"Dong","year":"2022","journal-title":"Am J Public Health"},{"key":"2024100812502032000_81.9.462.34","unstructured":"Dong XS , Brooks RD , Cain CT . Overdose fatalities at worksites and opioid use in the construction industry [The Center for Construction Research and Training-CPWR Quarterly Data Report]. Available: https:\/\/stacks.cdc.gov\/view\/cdc\/85344 [Accessed 19 Aug 2024]."},{"key":"2024100812502032000_81.9.462.35","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1177\/10482911211023476","article-title":"Commercial Fishing as an Occupational Determinant of Opioid Overdoses and Deaths of Despair in Two Massachusetts Fishing Ports, 2000-2014","volume":"31","author":"Fulmer","year":"2021","journal-title":"New Solut"},{"key":"2024100812502032000_81.9.462.36","unstructured":"Larson SL , Eyerman J , Foster MS , et al . Worker substance use and workplace policies and programs (DHHS publication No. SMA 07-4273, analytic series A-29). Rockville, MD Substance Abuse and Mental Health Services Administration, Office of Applied Studies; 2007."},{"key":"2024100812502032000_81.9.462.37","doi-asserted-by":"crossref","first-page":"59","DOI":"10.15270\/50-1-16","article-title":"SUBSTANCE ABUSE, DEPENDENCE AND THE WORKPLACE: A LITERATURE OVERVIEW","volume":"50","author":"Smook","year":"2014","journal-title":"SWORK"},{"key":"2024100812502032000_81.9.462.38","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1002\/ajim.23123","article-title":"Demographic considerations in analyzing decedents by usual occupation","volume":"63","author":"Peterson","year":"2020","journal-title":"Am J Ind Med"},{"key":"2024100812502032000_81.9.462.39","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0b013e318297321d"},{"key":"2024100812502032000_81.9.462.40","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.4700140203"}],"container-title":["Occupational and Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/oemed-2024-109536","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T19:51:19Z","timestamp":1728417079000},"score":1,"resource":{"primary":{"URL":"https:\/\/oem.bmj.com\/lookup\/doi\/10.1136\/oemed-2024-109536"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":40,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,10,8]]},"published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1136\/oemed-2024-109536"],"URL":"https:\/\/doi.org\/10.1136\/oemed-2024-109536","relation":{},"ISSN":["1351-0711","1470-7926"],"issn-type":[{"type":"print","value":"1351-0711"},{"type":"electronic","value":"1470-7926"}],"subject":[],"published":{"date-parts":[[2024,9]]}}}