Ergonomic workplace injuries as predictors of opioid-related outcomes in New York

Ergonomic injuries are a common and preventable type of workplace injury that may result in persistent pain and opioid use or misuse, and previous studies have linked occupational injuries to subsequent opioid misuse. Despite a decrease in opioid prescriptions, opioid-related overdose deaths in New York State (NYS) continue to increase, requiring further exploration of contributing factors. This study aimed to investigate the relationship between ergonomic workplace injury rates and opioid-related outcomes in NYS.  METHODS: County-level rates of NYS Workers' Compensation Claims (WCC) from 2015-2021 were analyzed, focusing on sprain, strain, and tear injuries. These injury claim rates were compared with county-level opioid-related data from the NYS Opioid Data Dashboard. A linear mixed-effects model, with year fixed effects and county-level clustering, was used to estimate the association between opioid prescription rates, WCC rates, and opioid-related mortality rates. The association between prescribing and mortality outcomes was modified by WCC rates was also examined.

There was a greater overlap between high WCC rates and high opioid indicator rates observed in non-metro counties over metro counties. Health Care and Social Assistance, Public Administration, Retail Trade, and Educational Services were the most represented industries in ergonomic WCCs across the state. There was evidence of effect modification by WCC injury rates on the association between opioid prescription and overdose mortality rates, for opioids (B=-3.03, 95% CI: -4.58, -1.48) and opioid pain relievers (B=-3.75, 95% CI: -5.34, -2.17), showing that the association between opioid prescribing and mortality rates weakened among counties with higher WCC injury rates.

Despite progress in reducing opioid prescription rates in NYS, workplace ergonomic injuries resulting in strains, sprains, and tears may be contributing to overdose deaths, including from opioids. Workplace ergonomic safety campaigns may be an avenue for prevention of opioid-related overdoses in NYS.