Opioids are killing construction workers more than any other Canadians

Canada’s opioid overdoses are on the rise and it’s an issue that is trending upward within the country’s construction sector. One region where massive spikes in opioid-related deaths in the sector are taking place is within the country’s most populated province.

According to the recently released report, “Lives Lost to Opioid Toxicity among Ontarians Who Worked in the Construction Industry,” the numbers have been climbing fast. The report, created on behalf of The Ontario Drug Policy Network, The Office of the Chief Coroner for Ontario/
Ontario Forensic Pathology Service and Public Health Ontario, stated that Ontario reported 2,460 opioid toxicity deaths in 2020, a staggering 60-percent increase from 2019. It also states that Ontario’s construction sector is significantly over-represented in the number of opioid toxicity deaths since the beginning of the COVID-19 coronavirus pandemic in March 2020.

While the industry represented approximately 3.6 percent of the province’s population and 7.2 percent of people employed in Ontario in 2021, 33 percent of those who were employed at the time of their deaths due to opioid toxicity worked in the construction sector.

The report points to the rigors of the type of work being performed as a contributing factor:
The physical demands of construction work may explain why construction workers are prone to injuries and chronic pain, which may contribute to opioid use. In addition, the mental challenges associated with long hours and precarious, competitive and stressful work environments may also contribute to opioid use among people working in the construction industry. The precarious or occasional nature of some construction work may also make the construction industry a more accessible field of employment for people who use substances, compared to other sectors. Furthermore, the high proportion of men, particularly in younger age groups, may explain the clustering of opioid-related harm in the construction industry, as these are demographic groups that tend to be most affected by opioid toxicity death.

“Construction workers and anyone working jobs with very high physical demands, that’s where you’re going to see more injuries,” says Jan Chappel, senior technical specialist for occupational health and safety at the Canadian Centre for Occupational Health and Safety.

When breaking down the age distributions of construction workers in the sector that died of opioid toxicity in Ontario between 2018 to 2020, the report states that 60.1 percent were between the ages of 25 to 44, while 31.4 percent fell between the ages of 45 to 64, 6.6. percent were 25 years of age of younger, and 1.9 percent were 65 years of age or older.

During that same time period, 98.4 percent of the people employed in the sector that died of opioid toxicity were male.

When it came to the origin of the opioids directly contributing to opioid toxicity deaths in construction worked between 2018 to 2020, 79.2 percent were non-pharmaceutical opioids (overwhelmingly fentanyl and fentanyl analogues). Solely pharmaceutical opioids contributed
to nine percent of opioid toxicity deaths of construction workers, while a combination of pharmaceutical and non-pharmaceutical opioids accounted for 11.7 percent of opioid toxicity deaths of construction workers.

The rising opioid issues in Ontario’s construction sector are on a similar trend to British Columbia, where it was reported that 20 percent of opioid toxicity deaths that took place in 2021 were employees within the construction sector.

In 2021, according to a B.C. Coroners Service report, B.C. experienced 2,265 illicit drug toxicity deaths (up from 1,747 in 2020 and 984 in 2019). From 2019 to 2022, the percentage share of drugs involved in illicit drug toxicity deaths were:

• Illicit fentanyl and analogues: 85.6
• Cocaine: 45
• Methamphetamine/amphetamine: 41.9
• Other opioids: 22.8
• Ethyl alchohol: 26
• Benzodiazepines: 13.9
• Other stimulants: 2.9

While the number of opioid toxicity deaths in B.C. have spiked since the beginning off the pandemic, the construction industry was over-represented well before COVID-19 came to Canada.

According to government of British Columbia Coroners Services report, “Illicit Drug Overdose Deaths in BC: Findings of Coroners’ Investigations,” published on Sept. 27, 2018, 55 percent of those who died of an overdose in B.C. between 2016 and 2017 (and were employed at their time of death) were working in the trades and transport industries. This is another massive over-representation of those employed in the trades and transport industries, considering it was reported that those industries made up 15 percent of people employed in the B.C. 2016 Census.

Across Canada
In addition to all of the tragic deaths that opioid use is responsible for across Canada, it is responsible for billions of dollars in losses. The Ontario-based report stated that in 2017 it was estimated that across all sectors there was $4.2 billion in lost productivity due to opioid use in Canada. This number was reached due to “100,000 productive years of life lost due to premature opioid toxicity deaths.” One can certainly argue that those losses have only skyrocketed since that time.

According to the government of Canada report, “Opioid-and Stimulant-related Harms in Canada (June 2022),” a total of 29,052 people have died from apparent opioid toxicity deaths between January 2016 and December 2021. Of those deaths, 88 percent took place in Ontario, B.C. or Alberta.

The report notes that elevated rates have been observed in other areas of the country, including Yukon and Saskatchewan (Manitoba’s data was not available at the time of the report). Fentanyl was involved in 86 percent of Canada’s accidental opioid toxicity deaths in 2021 (81 percent of those were non-pharmaceutical).

Managing employee addiction
For employers who suspect an employee may have a “drug problem,” Chappel suggests focusing on assessing the employee’s behaviours on the job and drop the word “problem.”

“Employers should be assessing if that individual can do their tasks safely at that time, on that day, at that moment,” she says. “We hesitate to use the word ‘problem’ when you’re talking about addiction. You really can’t diagnose that unless you’re a medical professional or a counsellor, so what we encourage employers to do is focus on what they’re seeing, and if that behaviour is a safety concern.”

Chappel encourages employers to evaluate their employees as they go about their day-to-day tasks.

“Does the person have the ability to perform that job or that task safely? Can they drive the machine? Can they operate the machine? Can they use a sharp object? Are they having trouble
making decisions and judgments that affect safety? And then, use that assessment to ask if that person is able to conduct that job safely?” Chappel says.

Chappel encourages employers to develop programs and policies so that every instance of impairment is addressed similarly and in a clear manner.

“Employers may offer employee-assistance programs, if they can,” Chappel says, adding that there are many other organizations that have resources available for employers and employees.

One free downloadable toolkit available is “Substance Use and the Workplace: Supporting Employers and Employees in the Trades,” which is available on the website for the Canadian Centre on Substance Use and Addiction.

The toolkit was designed for supervisors, managers, human resources professionals, unions, associations and related organizations, while also containing ready-to-use resources for employees. It includes resources for employers and workers to help prevent substance use harms; educate about substances and their effects; address employee substance use; find services and supports, and access related information about key reports and organizations.

For any questions related to the toolkit, the CCSA can be contacted at workplace@ccsa.ca.