Workers who do the the roughest jobs are no strangers to risk: Slipping off a scaffold, or getting bludgeoned by a collapsing crane are everyday worries. But they may not know that the deadliest occupational hazard could come in their doctor’s office—with a prescription that will one day become their death warrant.
A groundbreaking study in Massachusetts links dangerous workplaces to another crisis: The construction industry and related fields have a higher rate of opioid deaths than other industries. On the surface, the link between workplace injuries and opioid deaths seems obvious in only one aspect—they both disproportionately affect the working poor. The puzzle for policy-makers is the cause-and-effect relationship between tough jobs and drug dependency. Worker advocates say that at the intersection between work and health, two crises often mix fatally in the lives of struggling workers.
Administered through the Massachusetts Department of Public Health, the study traces the overlap between job quality and opioid-related death risk, and shows workers in construction and extraction jobs had “six times the average [opioid-related death] rate for all Massachusetts workers,” or about 150 deaths per 100,000 workers, compared to the average of 25. Of an estimated 5,580 opioid deaths in Massachusetts from 2011 to 2015, about 1,155 were in construction. Other high-risk, high-overdose job sectors include farming, fishing, and forestry work, with five times above-average fatality rates.
Further parsing the demographic profile of opioid deaths shows how gender, labor segregation, and job quality are interconnected factors that drive the drug crisis. For women, the top overdose-related jobs were in health-care support and food service—also sectors known for low pay, high stress, and erratic work schedules.
Not surprisingly, the highest death rates were among those earning the least (under $30,000 annually), and with poor access to health care. Workers without paid sick leave and lacking job security (as measured by workers’ general worries about losing employment) were also more vulnerable to overdose death. These circumstances “increase the need to work while in pain and…increase reliance on pain medication.” Job instability is also a common feature of on-call or contract-based jobs—all prevalent in construction, restaurant and hospitality, and frontline health-care jobs. Meanwhile, public-health advocates criticize the state Workers Compensation system, which is supposed to cover workplace-related injuries, as insufficient and inaccessible for many workers.