A new report in British Columbia shows that a disproportionate amount of people who died from illicit drug overdoses worked, or had previously worked, in one industry: construction.
Between 2011 and 2016, 2,362 people died from overdose in British Columbia. Among those who were employed (1,559 people), about one-fifth (327) worked in construction. An additional 13 percent worked in building maintenance, waste management and other support industries. (The biggest group, however—34 percent—of people who died from an illicit drug overdose in British Columbia were unemployed over this period.)
Recent studies in the US have similarly showed disproportionate fatal overdose rates among construction workers. A CDC analysis published in August found that construction workers were more likely to die of heroin-related and methadone-related overdoses than all other occupations combined.
Another report that month, from the Massachusetts Department of Public Health, showed that people working in construction are six times more likely to die from an opioid-related overdose than all other workers in the state.
Some of the cause may be what intuitively makes sense: Construction work is physically demanding, and often leads to serious injuries or chronic pain, which in turn leads to high rates of opioid prescription and access.
But another, less obvious factor may also contribute: Many jobs in the construction industry don’t provide paid sick leave.
“When you are in these jobs, people are working through pain. They need to keep their job, and cannot afford not to go to work and cannot afford to be in pain,” Vaira Harik, senior project manager at the Barnstable County Department of Human Services, who has studied overdose deaths in Cape Cod, told Tonic.
Arizona, Connecticut, California, Massachusetts, Oregon, Vermont, Maryland and New Jersey are the only states with statewide paid sick days laws.
Employers are not required to provide paid sick leave in other US states, or in British Columbia, regardless of the size of the business. And of course, even in places where legal paid sick leave is required, it doesn’t help those who work “off the books”—as one in six construction workers in California does, for example.
While union employers have gradually started to implement practices like stocking naloxone, it’s clear that systemic changes to the industry must occur to protect these vulnerable workers.