Abstract
Toxicology testing of fatally injured workers is not routinely conducted. We completed a case-series study of 2005–2009 occupational fatalities captured by Iowa’s Fatality Assessment and Control Evaluation (FACE) Program. The goals of our research were to: (1) measure the proportion of FACE cases that undergo toxicology testing, and describe the factors associated with being tested, and (2) measure the rate of positive toxicology tests, the substances identified and the demographics and occupations of victims who tested positive. Case documents and toxicology laboratory reports were reviewed. There were 427 occupational deaths from 2005 to 2009. Only 69% underwent toxicology testing. Younger workers had greater odds of being tested. Among occupational groups, workers in farming, fishing and forestry had half the odds of being tested compared to other occupational groups. Of the 280 cases with toxicology tests completed, 22% (n = 61) were found to have positive toxicology testing. Commonly identified drug classes included cannabinoids and alcohols. Based on the small number of positive tests, older victims (65+ years) tested positive more frequently than younger workers. Management, business, science, arts, service and sales/office workers had proportionately more positive toxicology tests (almost 30%) compared with other workers (18–22%). These results identify an area in need of further research efforts and a potential target for injury prevention strategies.
Highlights
Traumatic injury claims the lives of over 300,000 workers worldwide, about 4,500 of whom die in the United States each year [1,2]
A total of 21 victims were excluded because of insufficient human tissue available for testing (n = 2), substances were administered during medical treatment (n = 7), or toxicology testing was not completed within two days of the injury (n = 12) (Figure 1)
Certain types of victims were more likely to be tested than others: (1) those who died the same day of their traumatic injury and (2) workers who were less than 50 years of age
Summary
Traumatic injury claims the lives of over 300,000 workers worldwide, about 4,500 of whom die in the United States each year [1,2]. A wide range of personal and occupational factors are associated with the risk of suffering a fatal workplace injury. Occupational injury studies have focused largely on demographics and worker factors such as job shift or temporary status [3,4]. Among the most prominent yet relatively understudied personal risk factors for occupational injuries is the use of substances such as alcohol and other drugs. According to the 2002–2003 National Survey on Drug Use and Health, about 15% of the US working population reported using alcohol or suffering from hang-overs while on the job [5].
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