Trends in Opioid‐Related Poisonings and Mental and Behavioral Disorders From 2006 to 2022 Among a Large Cohort of Injured Workers in Ontario, Canada

BACKGROUND: Work-related injuries may increase risk for opioid-related harms. Yet there remains a gap in our understanding of trends in opioid-related harms over time among injured workers. We estimated trends in hospital encounters for opioid-related harms among injured workers in Ontario, Canada from 2006 to 2022. METHODS: This study used linked workers' compensation (1983-2019) and hospitalization and emergency department (ED) (2006-2022) data from 1.7 million injured workers. Rates of opioid-related poisonings and mental and behavioral disorders were estimated for all workers, as well as by age, sex, and occupational group. Joinpoint regression was used to analyze trends and estimate average annual percent change (AAPC) in rates. RESULTS: Rates of harms significantly increased across all age groups and sexes, with the highest increases among male workers and those aged 35-44. There was also variation by occupation. For poisonings, some of the largest increases in ED visits and hospitalizations were among workers in machining (ED visits = AAPC 18.5%, 95% CI 0.0%-40.5%; hospitalizations = AAPC 8.1%, 95% CI 3.4%-13.0%), and in construction trades (ED visits = AAPC 15.0%, 95% CI 10.4%-19.7%; hospitalizations = AAPC 6.5%, 95% CI 4.2%-8.8%). For mental and behavioral disorders, ED visits and hospitalizations were highest among workers in clerical work (ED visits = AAPC 12.4%, 95% CI 0.1%-26.2%; hospitalizations = AAPC 12.1%, 95% CI 7.9%-16.5%) and in materials handling (ED visits = AAPC 11.6%, 95% CI 1.8%-22.3%, hospitalizations = AAPC 14.2%, 95% CI 8.4%-20.3%). CONCLUSION: Rates of opioid-related harms significantly increased over time among injured workers in Ontario, with substantial increases within certain occupational groups. Findings suggest injured workers should be a priority in ongoing surveillance and policy responses.