Researchers to Delve into Association Between Disability and Increased Risk of Death

Sarasota, FL (WorkersCompensation.com) – “Compared to the general population, mortality from accidental poisoning was significantly elevated among the overall cohort and lost-time claimants. Most deaths from accidental poisoning in the cohort were due to drug overdoses involving opioids,” says a new study. “Mortality from intentional self-harm was also significantly elevated among lost‐time claimants.”

The study, published in the American Journal of Industrial Medicine, provides further evidence that lost-time injuries can increase the risk of death. In the latest study, the affected workers were those with low back injuries in West Virginia.

Researchers analyzed claims for 14,219 workers from 1998 and 1999. Mortality among them compared with the West Virginia general population was assessed using standard life table techniques.

The findings build on previous research from New Mexico that showed an increased risk of suicide among workers out for more than one week. For that study the researchers out of Boston University looked at data for more than 100,000 workers injured between 1994 and 2000.

“One big question both studies have is could it be that people who are opioid dependent or are depressed are more likely to have injuries at work, and does that explain it,” said Les Boden,  a professor of Public health at Boston University and one of the lead researchers on the studies. Based on the studies, “I feel confident that work-related injury increases the risk of depression and opioid use and thereby eventually suicide and overdose deaths.”

Boden will participate on a panel delving into the studies’ findings and outlining best practices companies are taking to address the issue during the upcoming Workers Compensation Research Institute’s annual conference in Boston.

The reasons for the association between lost time and deaths are not entirely clear. “But there are some things that could be causes of the differences,” Boden said. “It could be that, with opioids, prescribing patterns are different for work-related causes which focus on getting [injured workers] back to work and if you can reduce the amount of pain, you can get them back. That’s one possibility.”

Additionally, opioid overdoses tend to be more concentrated on workers in certain industries, especially those with lower job security. “Workers worried about losing their jobs or not able to take off time for sick leave may end up using opioids to help them get back to work,” Boden said.

“On the depression side, if somebody is injured and unable to work, particularly for an extended period of time, that could lead to exacerbation of depression symptoms.”

More appropriate prescribing along with better access to mental health services might reduce the risk of death among injured workers who are out of work for long periods of time.  

"IIn summary, we report an increase in overall mortality and deaths from cancer, heart disease, intentional self-harm and opioid overdoses associated with disability from work‐related low back strains. These results add to a growing body of literature pointing to the status of disability itself as the primary cause of both an overall decline in health and an increased risk of death from opioid overdose,” the second study concluded. “If confirmed, these results reinforce the need to see disability from work as an urgent and growing public health problem and the importance of prioritizing return to work efforts through aggressive and comprehensive rehabilitation efforts. Since opioids have been found to be ineffective in treating patients with chronic low back pain, our findings add to the reasons why these therapies are contraindicated in this setting.”

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