Drug overdose deaths at work, 2011–2016

2019 ◽  
Vol 25 (6) ◽  
pp. 577-580 ◽  
Author(s):  
Hope M Tiesman ◽  
Srinivas Konda ◽  
Lauren Cimineri ◽  
Dawn N Castillo

Drug overdose fatalities have risen sharply and the impact on US workplaces has not been described. This paper describes US workplace overdose deaths between 2011 and 2016. Drug overdose deaths were identified from the Census of Fatal Occupational Injuries and fatality rates calculated using denominators from the Current Population Survey. Fatality rates were compared among demographic groups and industries. Negative binomial regression was used to analyse trends. Between 2011 and 2016, 760 workplace drug overdoses occurred for a fatality rate of 0.9 per 1 000 000 full-time equivalents (FTEs). Workplace overdose fatality rates significantly increased 24% annually. Workplace overdose fatality rates were highest in transportation and mining industries (3.0 and 2.6 per 1 000 000 FTEs, respectively). One-third of workplace overdose fatalities occurred in workplaces with fewer than 10 employees. Heroin was the single most frequent drug documented in workplace overdose deaths (17%). Workplace overdose deaths were low, but increased considerably over the six-year period. Workplaces are impacted by the national opioid overdose epidemic.

2020 ◽  
Vol 42 (7) ◽  
pp. 535-542
Author(s):  
Nicole Adams ◽  
Ellen Gundlach ◽  
Ching-Wei Cheng

Many legislative and regulatory changes have occurred at the state level in response to the opioid crisis in an attempt to decrease overdose deaths. We conducted a negative binomial, regression-based, interrupted time series analysis to evaluate the effects of policies on opioid overdose death counts for 2008–2017 in five Midwestern states: Illinois, Indiana, Kentucky, Michigan, and Ohio. Except for the Good Samaritan laws in Illinois, no single policy change was statistically significant in decreasing overdose deaths. Governmental involvement as a whole was significantly associated with an increase in overdose deaths in Indiana. Policies created to address opioid overdose mortality have had minimal impact in these five Midwestern states. Most of the legislation and regulation that have been created lack educational components for prescribers and community members, which may explain why these policies have not had the intended effect.


Author(s):  
Jonathan Rosen ◽  
Peter Harnett

This article was originally written for and published in the January 2021 issue of The Synergist, a monthly publication of the American Industrial Hygiene Association. The article addresses the convergence of the COVID-19 and opioid crises, the impact of the opioid crisis on the workplace and workers, and the role that industrial hygienists can play in developing workplace programs to prevent and respond to opioid misuse. While the article is specifically written for industrial hygienists, the review and recommendations will be useful to others who are developing workplace opioid prevention programs. Note that the data presented in this article were current as of January 2021. Centers for Disease Control and Prevention’s latest available data are for the twelve-month period ending October 2020 and include 88,990 total overdose deaths and 91,862 predicted, when reporting is completed. Source: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm (accessed on 15 June 2021).


2020 ◽  
Vol 41 (S1) ◽  
pp. s133-s133
Author(s):  
Mohammad Alrawashdeh ◽  
Chanu Rhee ◽  
Heather Hsu ◽  
Grace Lee

Background: The Hospital-Acquired Conditions Reduction Program (HACRP) and Hospital Value-Based Purchasing (HVBP) are federal value-based incentive programs that financially reward or penalize hospitals based on quality metrics. Hospital-onset C. difficile infection (HO-CDI) rates reported to the CDC NHSN became a target quality metric for both HACRP and HVBP in October 2016, but the impact of these programs on HO-CDI rates is unknown. Methods: We used an interrupted time-series design to examine the association between HACRP/HVBP implementation in October 2016 and quarterly rates of HO-CDI per 10,000 patient days among incentive-eligible acute-care hospitals conducting facility-wide HO-CDI NHSN surveillance between January 2013 and March 2019. Generalized estimating equations were used to fit negative binomial regression models to assess for immediate program impact (ie, level change) and changes in the slope of HO-CDI rates, controlling for each hospital’s predominant method for CDI testing (nucleic acid amplification including PCR (NAAT), enzyme immunoassay for toxin (EIA), or other testing method including cell cytotoxicity neutralization assay and toxigenic culture). Results: Of the 265 study hospitals studied, most were medium-sized (100–399 beds, 55%), not-for-profit (77%), teaching hospitals (70%), and were located in a metropolitan area (87%). Compared to EIA, rates of HO-CDI were higher when detected by NAAT (incidence rate ratio [IRR], 1.55; 95% CI, 1.41–1.70) or other testing methods (IRR, 1.47; 95% CI, 1.26–1.71). Controlling for CDI testing methods, HACRP/HVBP implementation was associated with an immediate 6% decline in HO-CDI rates (IRR, 0.94; 95% CI, 0.89–0.99) and a 4% decline in slope per year-quarter thereafter (IRR, 0.96; 95% CI, 0.95–0.97) (Fig. 1). Conclusions: HACRP/HVBP implementation was associated with both immediate and gradual improvements in HO-CDI rates, independent of CDI testing methods of differing sensitivity. Future research may evaluate the precise mechanisms underlying this improvement and if this impact is sustained in the long term.Funding: NoneDisclosures: None


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Layana Costa Alves ◽  
Mauro Niskier Sanchez ◽  
Thomas Hone ◽  
Luiz Felipe Pinto ◽  
Joilda Silva Nery ◽  
...  

Abstract Background Malaria causes 400 thousand deaths worldwide annually. In 2018, 25% (187,693) of the total malaria cases in the Americas were in Brazil, with nearly all (99%) Brazilian cases in the Amazon region. The Bolsa Família Programme (BFP) is a conditional cash transfer (CCT) programme launched in 2003 to reduce poverty and has led to improvements in health outcomes. CCT programmes may reduce the burden of malaria by alleviating poverty and by promoting access to healthcare, however this relationship is underexplored. This study investigated the association between BFP coverage and malaria incidence in Brazil. Methods A longitudinal panel study was conducted of 807 municipalities in the Brazilian Amazon between 2004 and 2015. Negative binomial regression models adjusted for demographic and socioeconomic covariates and time trends were employed with fixed effects specifications. Results A one percentage point increase in municipal BFP coverage was associated with a 0.3% decrease in the incidence of malaria (RR = 0.997; 95% CI = 0.994–0.998). The average municipal BFP coverage increased 24 percentage points over the period 2004–2015 corresponding to be a reduction of 7.2% in the malaria incidence. Conclusions Higher coverage of the BFP was associated with a reduction in the incidence of malaria. CCT programmes should be encouraged in endemic regions for malaria in order to mitigate the impact of disease and poverty itself in these settings.


2016 ◽  
Vol 10 (5-6) ◽  
pp. 172 ◽  
Author(s):  
Blayne Welk ◽  
Jennifer Winick-Ng ◽  
Andrew McClure ◽  
Chris Vinden ◽  
Sumit Dave ◽  
...  

Introduction: The ability of academic (teaching) hospitals to offer the same level of efficiency as non-teaching hospitals in a publicly funded healthcare system is unknown. Our objective was to compare the operative duration of general urology procedures between teaching and non-teaching hospitals. Methods: We used administrative data from the province of Ontario to conduct a retrospective cohort study of all adults who underwent a specified elective urology procedure (2002–2013). Primary outcome was duration of surgical procedure. Primary exposure was hospital type (academic or non-teaching). Negative binomial regression was used to adjust relative time estimates for age, comorbidity, obesity, anesthetic, and surgeon and hospital case volume.Results: 114 225 procedures were included (circumcision n=12 280; hydrocelectomy n=7221; open radical prostatectomy n=22 951; transurethral prostatectomy n=56 066; or mid-urethral sling n=15 707). These procedures were performed in an academic hospital in 14.8%, 13.3%, 28.6%, 17.1%, and 21.3% of cases, respectively. The mean operative duration across all procedures was higher in academic centres; the additional operative time ranged from 8.3 minutes (circumcision) to 29.2 minutes (radical prostatectomy). In adjusted analysis, patients treated in academic hospitals were still found to have procedures that were significantly longer (by 10‒21%). These results were similar in sensitivity analyses that accounted for the potential effect of more complex patients being referred to tertiary academic centres.Conclusions: Five common general urology operations take significantly longer to perform in academic hospitals. The reason for this may be due to the combined effect of teaching students and residents or due to inherent systematic inefficiencies within large academic hospitals.


2019 ◽  
Author(s):  
Nathan Seltzer

U.S. labor markets have experienced transformative change over the past half century. Spurred on by global economic change, robotization, and the decline of labor unions, state labor markets have shifted away from an occupational regime dominated by the production of goods to one characterized by the provision of services. Prior studies have proposed that deterioration of employment opportunities may be associated with the rise of substance use disorders and drug overdose deaths, yet no clear link between changes in labor market dynamics in the U.S. manufacturing sector and drug overdose deaths has been established. Using restricted-use vital registration records between 1999-2017 that comprise over 700,000 drug deaths, I test two questions. First, what is the association between manufacturing decline and drug and opioid overdose mortality rates? Second, how much of the increase in these drug-related outcomes can be accounted for by manufacturing decline? The findings provide strong evidence that restructuring of the U.S. labor market has played an important upstream role in the current drug crisis. Up to 77,000 overdose deaths for men and up to 40,000 overdose deaths for women are attributable to the decline of state-level manufacturing over this nearly two-decade period. These results persist in models that adjust for other social, economic, and policy trends changing at the same time, including the supply of prescription opioids. Critically, the findings signal the value of policy interventions that aim to reduce persistent economic precarity experienced by individuals and communities, especially the economic strain placed upon the middle class.


2022 ◽  
Vol 80 (1) ◽  
Author(s):  
Samuel Kwaku Essien ◽  
David Kopriva ◽  
A. Gary Linassi ◽  
Audrey Zucker-Levin

Abstract Background Most epidemiologic reports focus on lower extremity amputation (LEA) caused specifically by diabetes mellitus. However, narrowing scope disregards the impact of other causes and types of limb amputation (LA) diminishing the true incidence and societal burden. We explored the rates of LEA and upper extremity amputation (UEA) by level of amputation, sex and age over 14 years in Saskatchewan, Canada. Methods We calculated the differential impact of amputation type (LEA or UEA) and level (major or minor) of LA using retrospective linked hospital discharge data and demographic characteristics of all LA performed in Saskatchewan and resident population between 2006 and 2019. Rates were calculated from total yearly cases per yearly Saskatchewan resident population. Joinpoint regression was employed to quantify annual percentage change (APC) and average annual percent change (AAPC). Negative binomial regression was performed to determine if LA rates differed over time based on sex and age. Results Incidence of LEA (31.86 ± 2.85 per 100,000) predominated over UEA (5.84 ± 0.49 per 100,000) over the 14-year study period. The overall LEA rate did not change over the study period (AAPC -0.5 [95% CI − 3.8 to 3.0]) but fluctuations were identified. From 2008 to 2017 LEA rates increased (APC 3.15 [95% CI 1.1 to 5.2]) countered by two statistically insignificant periods of decline (2006–2008 and 2017–2019). From 2006 to 2019 the rate of minor LEA steadily increased (AAPC 3.9 [95% CI 2.4 to 5.4]) while major LEA decreased (AAPC -0.6 [95% CI − 2.1 to 5.4]). Fluctuations in the overall LEA rate nearly corresponded with fluctuations in major LEA with one period of rising rates from 2010 to 2017 (APC 4.2 [95% CI 0.9 to 7.6]) countered by two periods of decline 2006–2010 (APC -11.14 [95% CI − 16.4 to − 5.6]) and 2017–2019 (APC -19.49 [95% CI − 33.5 to − 2.5]). Overall UEA and minor UEA rates remained stable from 2006 to 2019 with too few major UEA performed for in-depth analysis. Males were twice as likely to undergo LA than females (RR = 2.2 [95% CI 1.99–2.51]) with no change in rate over the study period. Persons aged 50–74 years and 75+ years were respectively 5.9 (RR = 5.92 [95% Cl 5.39–6.51]) and 10.6 (RR = 10.58 [95% Cl 9.26–12.08]) times more likely to undergo LA than those aged 0–49 years. LA rate increased with increasing age over the study period. Conclusion The rise in the rate of minor LEA with simultaneous decline in the rate of major LEA concomitant with the rise in age of patients experiencing LA may reflect a paradigm shift in the management of diseases that lead to LEA. Further, this shift may alter demand for orthotic versus prosthetic intervention. A more granular look into the data is warranted to determine if performing minor LA diminishes the need for major LA.


Author(s):  
Jen Murphy ◽  
William Whittaker ◽  
Mark Elliot ◽  
Rathi Ravindrarajah

IntroductionNHS national targets mandate extended opening hours of doctors’ surgeries as a mechanism for increasing access to primary care, based on the assumption that unmet need is caused by a lack of appointments at the right time. Research has shown that other factors impact access and it may not simply be availability that limits an individual’s ability to access healthcare. Aims and Objectives To determine whether distance, familiarity and deprivation impact on the uptake of extended hours GP services that use a hub practice model. MethodsWe linked an appointments dataset to publicly available population datasets. With that linked dataset, we used negative binomial regression to model count data relating to uses of the extended hours service in one care commissioning group in the Greater Manchester city region. The dataset included 32,693 appointments across 4 hubs serving 37 practices. ResultsFamiliarity and distance are important in predicting the number of uses of the extended hours service at a GP practice level. For a theoretical pair of practices collocated at the hub location, the model predicts a use rate of 101.2 for the non hub compared with 283.7 for the hub, a 180% uplift. For a pair of non-hub practices, one located the mean distance from the hub, the other located one mile further away, the model predicts 64.8 uses for the nearer practice, and 46.5 uses for the far practice, a 28% penalty. ConclusionThe results indicate geographical inequity in the extended hours service. There may be many patients with unmet need for whom the extension of hours via a hub model does not address barriers to access. Providers should consider whether or not this type of model actually works to facilitate access. This is particularly of importance in the context of closing health inequality gaps.


2019 ◽  
pp. 75-90 ◽  
Author(s):  
Nadezhda Dulina ◽  
Dar'ja Moiseeva ◽  
Eugeniya Anufrieva ◽  
Vera Paramonova

Growth of volume in crediting to individuals in the Russian Federation during 2008-2018 and problems of debt maintenance have actualized the need of studying changes in the sphere of Russian crediting culture. The aim of the paper is to study credit attitude of modern student youth. At the first stage of the study the authors analyzed the correlation between key options: "credit culture", "credit attitude", "credit behavior", "financial culture", "financial attitude", "financial behavior". The investigators carried out the review of foreign and Russian research works aimed at studying the credit culture and credit behavior of students. They revealed features of foreign studies of credit culture / behavior, on this basis they conclude that this subject is poorly developed in Russia not only by individual socio-demographic groups, but also by the population generally. The working hypothesis of the research has been put forward: it is the change in the credit attitude of young people who do not have their own credit experience, which is the evidence of serious changes in the credit culture. At the second stage, the pilot study "Credit behavior of the population" (December 2017 -January 2018, Volgograd, accidental sampling (n = 404), the sample representation task was not set, the method of collecting information: on-line questioning) has been implemented. The results of the study let the authors to describe the credit culture of Volgograd Universities' students. The strong savings orientation among students has been defined. They are prone to saving money in a difficult situation and are ready to provide financial assistance, but they would not like to resort to it themselves in case of difficulties. Students realize the need of improving their level of financial literacy for building their own effective financial strategies. In the minds of students there is a necessity to correlate risk and result, but not all of them are ready to risk. Analysis of differences in the responses of full-time and extra-mural students has confirmed the working hypothesis. Credit attitude of students, in our point of view, testify the rootedness of the youth credit culture. The correlation between the results of estimating the impact of credit practice on credit culture and the modern scale of crediting to Russians makes it possible to hypothesize that there will be a strong transformation of the credit culture of Russians in the next 20 years. The authors plan to test this hypothesis in their further studies.


2019 ◽  
Vol 11 (17) ◽  
pp. 1958 ◽  
Author(s):  
Hanlin Zhou ◽  
Lin Liu ◽  
Minxuan Lan ◽  
Bo Yang ◽  
Zengli Wang

Previous research has recognized the importance of edges to crime. Various scholars have explored how one specific type of edges such as physical edges or social edges affect crime, but rarely investigated the importance of the composite edge effect. To address this gap, this study introduces nightlight data from the Visible Infrared Imaging Radiometer Suite sensor on the Suomi National Polar-orbiting Partnership Satellite (NPP-VIIRS) to measure composite edges. This study defines edges as nightlight gradients—the maximum change of nightlight from a pixel to its neighbors. Using nightlight gradients and other control variables at the tract level, this study applies negative binomial regression models to investigate the effects of edges on the street robbery rate and the burglary rate in Cincinnati. The Akaike Information Criterion (AIC) of models show that nightlight gradients improve the fitness of models of street robbery and burglary. Also, nightlight gradients make a positive impact on the street robbery rate whilst a negative impact on the burglary rate, both of which are statistically significant under the alpha level of 0.05. The different impacts on these two types of crimes may be explained by the nature of crimes and the in-situ characteristics, including nightlight.


Sign in / Sign up

Export Citation Format

Share Document