{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T16:06:42Z","timestamp":1771949202992,"version":"3.50.1"},"reference-count":38,"publisher":"Mattioli1885","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,24]]},"abstract":"<jats:p>Over the past two decades, fatal workplace accidents have accounted for between 300,000 and 400,000 deaths a year worldwide. The aim of this study was to investigate the general characteristics and the toxicological profile of work-related deaths. A descriptive retrospective study was carried out on occupational-related deaths occurred in the Lyon metropolitan area from 2000 to 2020 from the autopsy reports of the University Institute of Legal Medicine. A total of 476 cases of work-related deaths were identified, of which 91% were men. The median age was 48 years, 44% of the deaths were due to cardiac origin, 34% to mechanical accidents and 18% to suicide. 16 homicides were also recorded. The cause of death differed significantly between socio-professional categories: suicide was the main cause of death among managers &amp; intellectual occupations (50%), cardiovascular death among non-manual elementary workers (53%), manual elementary workers (49%) and craftsmen, shop keepers &amp; business owners (33%), and physical accidents among farmers (50%) and manual elementary workers (48%). The main cause of death varied by sector: physical accidents in construction (61%), cardiovascular events in transportation and storage (67%) and manufacturing (51%). 27% (n = 130) tested positive for at least one psychoactive substance, including 75 for alcohol, 43 for sedative anxiolytics and 33 for cannabis. These results may help occupational health professionals to design policies and campaigns to prevent deaths among the workers concerned. Specific studies to assess the proportion of fatal accidents attributable to the use of alcohol, cannabis or benzodiazepines could contribute to reducing work-related deaths.<\/jats:p>","DOI":"10.23749\/mdl.2026.17546","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T15:41:21Z","timestamp":1771947681000},"page":"17546","source":"Crossref","is-referenced-by-count":0,"title":["General and Toxicologic Aspects of Occupational Fatalities in the Metropolitan Area of Lyon From 2000 to 2020, a Retrospective Study"],"prefix":"10.23749","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9674-1070","authenticated-orcid":false,"given":"C\u00e9line","family":"Lamouroux","sequence":"first","affiliation":[{"name":"UMRESTTE UMR T 9405, University Claude Bernard Lyon 1, Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillaume","family":"Pouliquen","sequence":"first","affiliation":[{"name":"UMRESTTE UMR T 9405, University Claude Bernard Lyon 1, Lyon, France \/ CRPPE de Lyon (Regional Center for Occupational and Environmental Pathologies), Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre-B\u00e9nite, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1419-9914","authenticated-orcid":false,"given":"Emmanuel","family":"Fort","sequence":"first","affiliation":[{"name":"UMRESTTE UMR T 9405, University Claude Bernard Lyon 1, Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Epain","sequence":"first","affiliation":[{"name":"Service of Legal Medicine, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France \/ University Lyon, Claude-Bernard Lyon 1 University, Lyon-Est Medical School, Lyon-Sud Medical School, Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florent","family":"Marfaing","sequence":"first","affiliation":[{"name":"UMRESTTE UMR T 9405, University Claude Bernard Lyon 1, Lyon, France \/ CRPPE de Lyon (Regional Center for Occupational and Environmental Pathologies), Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre-B\u00e9nite, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8805-6225","authenticated-orcid":false,"given":"Barbara","family":"Charbotel","sequence":"first","affiliation":[{"name":"UMRESTTE, UMR T9405 UCBL1 Lyon, France ; CRPPE de Lyon, HCL, Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurent","family":"Fanton","sequence":"first","affiliation":[{"name":"Service of Legal Medicine, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France \/ University Lyon, Claude-Bernard Lyon 1 University, Lyon-Est Medical School, Lyon-Sud Medical School, Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"27750","reference":[{"key":"10.23749\/mdl.2026.17546_ref1","doi-asserted-by":"crossref","unstructured":"1. Herbert R, Landrigan P. Work-related death: a continuing epidemic. Am J Public Health [Internet]. 2000 Apr 1 [cited 2024 Aug 13];90(4):541\u20135. Available from: https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.90.4.541","DOI":"10.2105\/AJPH.90.4.541"},{"key":"10.23749\/mdl.2026.17546_ref2","doi-asserted-by":"crossref","unstructured":"2. Takala J, H\u00e4m\u00e4l\u00e4inen P, Saarela KL, Yun LY, Manickam K, Jin TW, et al. Global Estimates of the Burden of Injury and Illness at Work in 2012. J Occup Environ Hyg [Internet]. 2014 May 4 [cited 2024 Aug 13];11(5):326\u201337. Available from: http:\/\/www.tandfonline.com\/doi\/abs\/10.1080\/15459624.2013.863131","DOI":"10.1080\/15459624.2013.863131"},{"key":"10.23749\/mdl.2026.17546_ref3","unstructured":"3. WHO\/ILO joint estimates of the work-related burden of disease and injury, 2000-2016: global monitoring report: Geneva: World Health Organization and the International Labour Organization, 2021. Available from: https:\/\/www.who.int\/publications\/i\/item\/9789240034945"},{"key":"10.23749\/mdl.2026.17546_ref4","unstructured":"4. Statistics | Eurostat [Internet]. Available from: https:\/\/ec.europa.eu\/eurostat\/databrowser\/view\/sdg_08_60\/default\/table?lang=fr"},{"key":"10.23749\/mdl.2026.17546_ref5","unstructured":"5. CARSAT Rh\u00f4ne Alpes, Assurance Maladie Risques Professionnels. Statistiques Rh\u00f4ne-Alpes 2020 - Acci-dents du travail, Maladies Professionnelles, Accidents de Trajet. 2021 Dec p. 12. Report No.: SP 1137."},{"key":"10.23749\/mdl.2026.17546_ref6","unstructured":"6. Risque accident du travail : Statistiques sur la sinistralit\u00e9 de l\u2019ann\u00e9e 2019 suivant la nomenclature d\u2019activit\u00e9s fran\u00e7aise (NAF) [Internet]. CPAM Direction des risques professionnels; 2020 Sep p. 59. Report No.: 166. Available from: https:\/\/www.ameli.fr\/sites\/default\/files\/2019_at-indicateurs-selon-code-naf.pdf"},{"key":"10.23749\/mdl.2026.17546_ref7","unstructured":"7. Conseil d\u2019orientation des conditions de travail. Les conditions de travail en 2020 [Internet]. Direction g\u00e9-n\u00e9rale du travail - Minist\u00e8re du Travail; 2021. Available from: https:\/\/travail-emploi.gouv.fr\/IMG\/pdf\/bilan_des_conditions_de_travail_2019.pdf"},{"key":"10.23749\/mdl.2026.17546_ref8","unstructured":"8. MILDECA. Publication de la MILDECA 2021 : Les conduites addictives | Base documentaire | L\u2019espace scientifique | Cohorte Constances [Internet]. 2021. Available from: https:\/\/www.drogues.gouv.fr\/sites\/default\/files\/2022-09\/Les_conduites_addictives_de_la_population_active.pdf"},{"key":"10.23749\/mdl.2026.17546_ref9","doi-asserted-by":"crossref","unstructured":"9. Foster CA, Dissanaike SD. Prevalence and consequences of positive blood alcohol levels among patients injured at work. J Emerg Trauma Shock. 2014;7(4):268\u201373. DOI: 10.4103\/0974-2700.142748","DOI":"10.4103\/0974-2700.142748"},{"key":"10.23749\/mdl.2026.17546_ref10","doi-asserted-by":"crossref","unstructured":"10. Alpert HR, Slater ME, Yoon YH, Chen CM, Winstanley N, Esser MB. Alcohol Consumption and 15 Causes of Fatal Injuries: A Systematic Review and Meta-Analysis. Am J Prev Med [Internet]. 2022 May 15 [cited 2022 May 26]; DOI: 10.1016\/j.amepre.2022.03.025.","DOI":"10.1016\/j.amepre.2022.03.025"},{"key":"10.23749\/mdl.2026.17546_ref11","doi-asserted-by":"crossref","unstructured":"11. Khashaba E, El-Helaly M, El-Gilany AH, Motawei SM, Foda S. Risk factors for non-fatal occupational inju-ries among construction workers: A case-control study. Toxicol Ind Health. 2018 Feb;34(2):83\u201390. DOI: 10.1177\/0748233717733853","DOI":"10.1177\/0748233717733853"},{"key":"10.23749\/mdl.2026.17546_ref12","doi-asserted-by":"crossref","unstructured":"12. Normand J, Salyards S. An empirical evaluation of preemployment drug testing in the United States Postal Service: interim report of findings. [Internet]. 1989. Available from: NIDA Res Monogr, 91, 111-38. PMID: 2509921.","DOI":"10.1037\/e468982004-001"},{"key":"10.23749\/mdl.2026.17546_ref13","doi-asserted-by":"crossref","unstructured":"13. Ramirez M, Bedford R, Sullivan R, Anthony TR, Kraemer J, Faine B, et al. Toxicology testing in fatally in-jured workers: a review of five years of Iowa FACE cases. Int J Environ Res Public Health. 2013 Nov 14;10(11):6154\u201368. DOI: 10.3390\/ijerph10116154","DOI":"10.3390\/ijerph10116154"},{"key":"10.23749\/mdl.2026.17546_ref14","doi-asserted-by":"crossref","unstructured":"14. McNeilly B, Ibrahim JE, Bugeja L, Ozanne-Smith J. The prevalence of work-related deaths associated with alcohol and drugs in Victoria, Australia, 2001-6. Inj Prev J Int Soc Child Adolesc Inj Prev. 2010 Dec;16(6):423\u20138. DOI: 10.1136\/ip.2010.027052","DOI":"10.1136\/ip.2010.027052"},{"key":"10.23749\/mdl.2026.17546_ref15","unstructured":"15. Sant\u00e9 Publique France. Consommation d\u2019alcool en France : o\u00f9 en sont les Fran\u00e7ais ? [Internet]. 2020 Jan. Available from: https:\/\/www.santepubliquefrance.fr\/les-actualites\/2020\/consommation-d-alcool-en-france-ou-en-sont-les-francais"},{"key":"10.23749\/mdl.2026.17546_ref16","unstructured":"16. N\u00e9zet OL, Philippon A, Lahaie E, Andler R. Les niveaux d\u2019usage de cannabis en France en 2020. :6. https:\/\/www.santepubliquefrance.fr\/content\/download\/395591\/file\/Note%20Cannabis%20Baro%20SpF%202020.pdf"},{"key":"10.23749\/mdl.2026.17546_ref17","doi-asserted-by":"crossref","unstructured":"17. Turkkan A, Pala K. Trends in occupational injuries and fatality in Turkey. Int J Occup Saf Ergon JOSE. 2016 Dec;22(4):457\u201362. DOI: 10.1080\/10803548.2016.1153224","DOI":"10.1080\/10803548.2016.1153224"},{"key":"10.23749\/mdl.2026.17546_ref18","doi-asserted-by":"crossref","unstructured":"18. McGwin G, Valent F, Taylor AJ, Howard HJ, Davis GG, Brissie RM, et al. Epidemiology of fatal occupational injuries in Jefferson County, Alabama. South Med J. 2002 Nov;95(11):1300\u201311. PMID: 12539998","DOI":"10.1097\/00007611-200211000-00014"},{"key":"10.23749\/mdl.2026.17546_ref19","doi-asserted-by":"crossref","unstructured":"19. Maeda H, Fujita MQ, Zhu BL, Quan L, Kamikodai Y, Tsuda K, et al. Labor-related fatalities in forensic postmortem investigations during the past 6 years in the southern half of Osaka city and surrounding ar-eas. Leg Med Tokyo Jpn. 2003 Mar;5 Suppl 1:S325-327. DOI: 10.1016\/s1344-6223(02)00162-1","DOI":"10.1016\/S1344-6223(02)00162-1"},{"key":"10.23749\/mdl.2026.17546_ref20","doi-asserted-by":"crossref","unstructured":"20. Cohen MA, Clark RE, Silverstein B, Sjostrom T, Spielholz P. Work-related deaths in Washington State, 1998\u20132002. J Safety Res. 2006 Jan 1;37(3):307\u201319. DOI: 10.1016\/j.jsr.2006.02.007","DOI":"10.1016\/j.jsr.2006.02.007"},{"key":"10.23749\/mdl.2026.17546_ref21","doi-asserted-by":"crossref","unstructured":"21. Villanueva V, Garcia AM. Individual and occupational factors related to fatal occupational injuries: a case-control study. Accid Anal Prev. 2011 Jan;43(1):123\u20137.DOI: 10.1016\/j.aap.2010.08.001","DOI":"10.1016\/j.aap.2010.08.001"},{"key":"10.23749\/mdl.2026.17546_ref22","doi-asserted-by":"crossref","unstructured":"22. Al-Abdallat EM, Oqailan AMA, Al Ali R, Hudaib AA, Salameh GAM. Occupationnal fatalities in Jordan. J Fo-rensic Leg Med. 2015 Jan;29:25\u20139. DOI: 10.1016\/j.jflm.2014.11.001","DOI":"10.1016\/j.jflm.2014.11.001"},{"key":"10.23749\/mdl.2026.17546_ref23","doi-asserted-by":"crossref","unstructured":"23. Errico S, Drommi M, Calamano V, Barranco R, Molinari G, Ventura F. Fatal work-related injuries in the Genoa district (North-Western Italy): Forensic analysis of the 10-year period between 2011 and 2020. J Forensic Leg Med. 2022 Jan;85:102294. DOI: 10.1016\/j.jflm.2021.102294","DOI":"10.1016\/j.jflm.2021.102294"},{"key":"10.23749\/mdl.2026.17546_ref24","doi-asserted-by":"crossref","unstructured":"24. Lin YH, Chen CY, Luo JL. Gender and age distribution of occupational fatalities in Taiwan. Accid Anal Prev. 2008 Jul 1;40(4):1604\u201310. DOI: 10.1016\/j.aap.2008.04.008","DOI":"10.1016\/j.aap.2008.04.008"},{"key":"10.23749\/mdl.2026.17546_ref25","unstructured":"25. Henrotin JB, Boini S, H\u00e9delin G, B\u00e9jot Y, Giroud M, Abecassis P. Travail post\u00e9 et maladies c\u00e9r\u00e9bro- et car-diovasculaires : revue critique et synth\u00e8se des preuves \u00e9pid\u00e9miologiques - INRS. R\u00e9f En Sant\u00e9 Au Trav [Internet]. 2013 Jun;(n\u00b0 134). Available from: https:\/\/www.inrs.fr\/media.html?refINRS=TP%2016"},{"key":"10.23749\/mdl.2026.17546_ref26","doi-asserted-by":"crossref","unstructured":"26. Kivim\u00e4ki M, Kawachi I. Work Stress as a Risk Factor for Cardiovascular Disease. Curr Cardiol Rep. 2015 Sep;17(9):630. DOI: 10.1007\/s11886-015-0630-8","DOI":"10.1007\/s11886-015-0630-8"},{"key":"10.23749\/mdl.2026.17546_ref27","unstructured":"27. DREES, Sant\u00e9 Publique France. L\u2019\u00e9tat de sant\u00e9 de la population en France RAPPORT 2017 [Internet]. 2017. Available from: https:\/\/drees.solidarites-sante.gouv.fr\/sites\/default\/files\/2021-01\/Rapport-ESPF-2017.pdf"},{"key":"10.23749\/mdl.2026.17546_ref28","doi-asserted-by":"crossref","unstructured":"28. Rey-Merch\u00e1n MDC, G\u00f3mez-de-Gabriel JM, L\u00f3pez-Arquillos A, Choi SD. Analysis of Falls from Height Vari-ables in Occupational Accidents. Int J Environ Res Public Health. 2021 Dec 20;18(24):13417. DOI: 10.3390\/ijerph182413417","DOI":"10.3390\/ijerph182413417"},{"key":"10.23749\/mdl.2026.17546_ref29","doi-asserted-by":"crossref","unstructured":"29. New-Aaron M, Semin J, Duysen EG, Madsen M, Musil K, Rautiainen RH. Comparison of agricultural inju-ries reported in the media and census of fatal occupational injuries. J Agromedicine. 2019;24(3):279\u201387. DOI: 10.1080\/1059924X.2019.1593276","DOI":"10.1080\/1059924X.2019.1593276"},{"key":"10.23749\/mdl.2026.17546_ref30","doi-asserted-by":"crossref","unstructured":"30. Angioloni S, Jack C. Farm fatalities in Northern Ireland agriculture: What fifty years of data tell us. Econ Hum Biol. 2022 Mar 10;46:101122. DOI: 10.1016\/j.ehb.2022.101122","DOI":"10.1016\/j.ehb.2022.101122"},{"key":"10.23749\/mdl.2026.17546_ref31","unstructured":"31. Rapport annuel 2020 de l\u2019Assurance Maladie - Risques professionnels ; \u00c9l\u00e9ments statistiques et financiers [Internet]. Assurance Maladie - Risques Professionnels; 2021. Report No.: 2021. Available from: https:\/\/assurance-maladie.ameli.fr\/sites\/default\/files\/rapport_annuel_2020_de_lassurance_maladie_-_risques_professionnels_decembre_2021_0.pdf"},{"key":"10.23749\/mdl.2026.17546_ref32","doi-asserted-by":"crossref","unstructured":"32. Cohidon C, Geoffroy Perez B, Fouquet A, Le Naour C, Goldberg M, Imbernon E. Suicide et activit\u00e9 profes-sionnelle en France : premi\u00e8res exploitations de donn\u00e9es disponibles [Internet]. Sant\u00e9 Publique France - INVS; 2010. Available from: https:\/\/www.santepubliquefrance.fr\/maladies-et-traumatismes\/sante-mentale\/suicides\/suicide-et-activite-professionnelle-en-france-premieres-exploitations-de-donnees-disponibles","DOI":"10.1016\/j.respe.2010.01.001"},{"key":"10.23749\/mdl.2026.17546_ref33","doi-asserted-by":"crossref","unstructured":"33. Guseva Canu I, Bovio N, Wild P, Bopp M, Swiss National Cohort (SNC). Identification of so-cio-demographic, occupational, and societal factors for guiding suicide prevention: A cohort study of Swiss male workers (2000-2014). Suicide Life Threat Behav. 2021 Mar 16; DOI: 10.1111\/sltb.12746","DOI":"10.1111\/sltb.12746"},{"key":"10.23749\/mdl.2026.17546_ref34","doi-asserted-by":"crossref","unstructured":"34. Alexopoulos EC, Kavalidou K, Messolora F. Suicide Mortality Across Broad Occupational Groups in Greece: A Descriptive Study. Saf Health Work. 2016 Mar 1;7(1):1\u20135. DOI: 10.1016\/j.shaw.2015.09.004","DOI":"10.1016\/j.shaw.2015.09.004"},{"key":"10.23749\/mdl.2026.17546_ref35","doi-asserted-by":"crossref","unstructured":"35. Andersen K, Hawgood J, Klieve H, K\u00f5lves K, De Leo D. Suicide in Selected Occupations in Queensland: Ev-idence from the State Suicide Register. Aust N Z J Psychiatry. 2010 Mar 1;44(3):243\u20139. DOI: 10.3109\/00048670903487142","DOI":"10.3109\/00048670903487142"},{"key":"10.23749\/mdl.2026.17546_ref36","doi-asserted-by":"crossref","unstructured":"36. Sher L. Alcohol and suicide: neurobiological and clinical aspects. ScientificWorldJournal. 2006 Jun 21;6:700\u20136. DOI: 10.1100\/tsw.2006.146","DOI":"10.1100\/tsw.2006.146"},{"key":"10.23749\/mdl.2026.17546_ref37","doi-asserted-by":"crossref","unstructured":"37. Harshbarger D, Stout N, Curtin LR. Classifying Deaths as On the Job. J Occup Environ Med. 1995 Feb;37(2):124. DOI: 10.1097\/00043764-199502000-00002","DOI":"10.1097\/00043764-199502000-00002"},{"key":"10.23749\/mdl.2026.17546_ref38","unstructured":"38. Runyan CW, Loomis D, Butts J. Practices of county medical examiners in classifying deaths as on the job. J Occup Med Off Publ Ind Med Assoc. 1994 Jan;36(1):36\u201341. PMID: 8138846"}],"container-title":["La Medicina del Lavoro"],"original-title":[],"link":[{"URL":"https:\/\/mattioli1885journals.com\/index.php\/lamedicinadellavoro\/article\/download\/17546\/13120","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/mattioli1885journals.com\/index.php\/lamedicinadellavoro\/article\/download\/17546\/13120","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T15:41:54Z","timestamp":1771947714000},"score":1,"resource":{"primary":{"URL":"https:\/\/mattioli1885journals.com\/index.php\/lamedicinadellavoro\/article\/view\/17546"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,24]]},"references-count":38,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.23749\/mdl.2026.17546","relation":{"has-manifestation":[{"id-type":"other","id":"4-1025-17546-g13120","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"4-1025","asserted-by":"subject"}]},"ISSN":["2532-1080","0025-7818"],"issn-type":[{"value":"2532-1080","type":"electronic"},{"value":"0025-7818","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2,24]]},"article-number":"3"}}