491 Estimating the number of opiate overdoses related to occupational injuries in the united states, 2011–2015

Abstract

Introduction The incidence of fatal opiate overdose in the United States has drastically increased over the past two decades, resulting in significant attention from the public health and medical communities. Intervention efforts to reduce overdose mortality have primarily focused on regulating prescriptive practices and the dissemination of naloxone with less focus given to primary prevention. Preventing occupational injuries is one area where primary prevention is possible. In order to understand the potential impact of such prevention, this study sought to estimate the number of U.S. opiate overdose deaths from 2011 through 2015 attributable to occupational injuries. Methods The number of reported occupational injuries occurring in the United States was obtained from the U.S. Bureau of Labour Statistics’ Survey of Occupational Injuries and Illnesses from 2011 to 2015. A literature review was conducted to obtain estimates of the probability of being prescribed an opiate after any occupational injury, the probability of being prescribed an opiate after a low back injury, and the probability of overdose mortality following an opiate prescription. These estimates were then combined to obtain an estimate of how many opiate overdose deaths would be expected for the numbers of occupational injuries recorded in 2011–2015. Monte Carlo simulations were used to model the uncertainty in these estimates. Results It was estimated that 718 (95% Confidence Interval: 667 to 775) opiate overdose deaths attributable to all occupational injuries occurred from 2011 to 2015. This risk of mortality was estimated to be 30% higher for the sub-group with low back injuries. Conclusion The primary prevention of occupational injury holds great promise to reduce the devastating personal and economic impact of opiate overdoses. Further research is recommended to provide additional evidence highlighting the pathway from various types of occupational injury to opiate overdoses.