CDC Reports Increases in Drug and Opioid Overdose Deaths in US 2000-2014

Workers' Compensation has experienced the consequences of the national epidemic of drug and opioid deaths. The issue continues to be reported and addressed at the national levels. Unfortunately employers and workers' compensation insurance companies, as cost cost containment item, continue to use this information to merely restrict drug benefits to injured workers while not meeting the real challenge of the epidemic.

The United States is experiencing an epidemic of drug overdose (poisoning) deaths. Since 2000, the rate of deaths from drug overdoses has increased 137%, including a 200% increase in the rate of overdose deaths involving opioids (opioid pain relievers and heroin). CDC analyzed recent multiple cause-of-death mortality data to examine current trends and characteristics of drug overdose deaths, including the types of opioids associated with drug overdose deaths. During 2014, a total of 47,055 drug overdose deaths occurred in the United States, representing a 1-year increase of 6.5%, from 13.8 per 100,000 persons in 2013 to 14.7 per 100,000 persons in 2014. The rate of drug overdose deaths increased significantly for both sexes, persons aged 25–44 years and ≥55 years, non-Hispanic whites and non-Hispanic blacks, and in the Northeastern, Midwestern, and Southern regions of the United States. Rates of opioid overdose deaths also increased significantly, from 7.9 per 100,000 in 2013 to 9.0 per 100,000 in 2014, a 14% increase. Historically, CDC has programmatically characterized all opioid pain reliever deaths (natural and semisynthetic opioids, methadone, and other synthetic opioids) as "prescription" opioid overdoses (1). Between 2013 and 2014, the age-adjusted rate of death involving methadone remained unchanged; however, the age-adjusted rate of death involving natural and semisynthetic opioid pain relievers, heroin, and synthetic opioids, other than methadone (e.g., fentanyl) increased 9%, 26%, and 80%, respectively. The sharp increase in deaths involving synthetic opioids, other than methadone, in 2014 coincided with law enforcement reports of increased availability of illicitly manufactured fentanyl, a synthetic opioid; however, illicitly manufactured fentanyl cannot be distinguished from prescription fentanyl in death certificate data. These findings indicate that the opioid overdose epidemic is worsening. There is a need for continued action to prevent opioid abuse, dependence, and death, improve treatment capacity for opioid use disorders, and reduce the supply of illicit opioids, particularly heroin and illicit fentanyl.

The National Vital Statistics System multiple cause-of-death mortality files were used to identify drug overdose deaths.* Drug overdose deaths were classified using the International Classification of Disease, Tenth Revision (ICD-10), based on the ICD-10 underlying cause-of-death codes X40–44 (unintentional), X60–64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent) (2). Among the deaths with drug overdose as the underlying cause, the type of opioid involved is indicated by the following ICD-10 multiple cause-of-death codes: opioids (T40.0, T40.1, T40.2, T40.3, T40.4, or T40.6); natural and semisynthetic opioids (T40.2); methadone (T40.3); synthetic opioids, other than methadone (T40.4); and heroin (T40.1). Some deaths involve more than one type of opioid; these deaths were included in the rates for each category (e.g., a death involving both a synthetic opioid and heroin would be included in the rates for synthetic opioid deaths and in the rates for heroin deaths). Age-adjusted death rates were calculated by applying age-specific death rates to the 2000 U.S standard population age distribution (3). Significance testing was based on the z-test at a significance level of 0.05.

During 2014, 47,055 drug overdose deaths occurred in the United States. Since 2000, the age-adjusted drug overdose death rate has more than doubled, from 6.2 per 100,000 persons in 2000 to 14.7 per 100,000 in 2014 (Figure 1). The overall number and rate of drug overdose deaths increased significantly from 2013 to 2014, with an additional 3,073 deaths occurring in 2014 (Table), resulting in a 6.5% increase in the age-adjusted rate. From 2013 to 2014, statistically significant increases in drug overdose death rates were seen for both males and females, persons aged 25–34 years, 35–44 years, 55–64 years, and ≥65 years; non-Hispanic whites and non-Hispanic blacks; and residents in the Northeast, Midwest and South Census Regions (Table). In 2014, the five states with the highest rates of drug overdose deaths were West Virginia (35.5 deaths per 100,000), New Mexico (27.3), New Hampshire (26.2), Kentucky (24.7) and Ohio(24.6).† States with statistically significant increases in the rate of drug overdose deaths from 2013 to 2014 included Alabama, Georgia, Illinois, Indiana, Maine, Maryland, Massachusetts, Michigan, New Hampshire, New Mexico, North Dakota, Ohio, Pennsylvania, and Virginia.

In 2014, 61% (28,647, data not shown) of drug overdose deaths involved some type of opioid, including heroin. The age-adjusted rate of drug overdose deaths involving opioids increased significantly from 2000 to 2014, increasing 14% from 2013 (7.9 per 100,000) to 2014 (9.0) (Figure 1). From 2013 to 2014, the largest increase in the rate of drug overdose deaths involved synthetic opioids, other than methadone (e.g., fentanyl and tramadol), which nearly doubled from 1.0 per 100,000 to 1.8 per 100,000 (Figure 2). Heroin overdose death rates increased by 26% from 2013 to 2014 and have more than tripled since 2010, from 1.0 per 100,000 in 2010 to 3.4 per 100,000 in 2014 (Figure 2). In 2014, the rate of drug overdose deaths involving natural and semisynthetic opioids (e.g., morphine, oxycodone, and hydrocodone), 3.8 per 100,000, was the highest among opioid overdose deaths, and increased 9% from 3.5 per 100,000 in 2013. The rate of drug overdose deaths involving methadone, a synthetic opioid classified separately from other synthetic opioids, was similar in 2013 and 2014.

Discussion

More persons died from drug overdoses in the United States in 2014 than during any previous year on record. From 2000 to 2014 nearly half a million persons in the United States have died from drug overdoses. In 2014, there were approximately one and a half times more drug overdose deaths in the United States than deaths from motor vehicle crashes (4). Opioids, primarily prescription pain relievers and heroin, are the main drugs associated with overdose deaths. In 2014, opioids were involved in 28,647 deaths, or 61% of all drug overdose deaths; the rate of opioid overdoses has tripled since 2000. The 2014 data demonstrate that the United States' opioid overdose epidemic includes two distinct but interrelated trends: a 15-year increase in overdose deaths involving prescription opioid pain relievers and a recent surge in illicit opioid overdose deaths, driven largely by heroin.

Natural and semisynthetic opioids, which include the most commonly prescribed opioid pain relievers, oxycodone and hydrocodone, continue to be involved in more overdose deaths than any other opioid type. Although this category of opioid drug overdose death had declined in 2012 compared with 2011, and had held steady in 2013, there was a 9% increase in 2014.

Drug overdose deaths involving heroin continued to climb sharply, with heroin overdoses more than tripling in 4 years. This increase mirrors large increases in heroin use across the country (5) and has been shown to be closely tied to opioid pain reliever misuse and dependence. Past misuse of prescription opioids is the strongest risk factor for heroin initiation and use, specifically among persons who report past-year dependence or abuse (5). The increased availability of heroin, combined with its relatively low price (compared with diverted prescription opioids) and high purity appear to be major drivers of the upward trend in heroin use and overdose (6).

The rate of drug overdose deaths involving synthetic opioids nearly doubled between 2013 and 2014. This category includes both prescription synthetic opioids (e.g., fentanyl and tramadol) and non-pharmaceutical fentanyl manufactured in illegal laboratories (illicit fentanyl). Toxicology tests used by coroners and medical examiners are unable to distinguish between prescription and illicit fentanyl. Based on reports from states and drug seizure data, however, a substantial portion of the increase in synthetic opioid deaths appears to be related to increased availability of illicit fentanyl (7), although this cannot be confirmed with mortality data. For example, five jurisdictions (Florida, Maryland, Maine, Ohio, and Philadelphia, Pennsylvania) that reported sharp increases in illicit fentanyl seizures, and screened persons who died from a suspected drug overdose for fentanyl, detected similarly sharp increases in fentanyl-relateddeaths (7).§ Finally, illicit fentanyl is often combined with heroin or sold as heroin. Illicit fentanyl might be contributing to recent increases in drug overdose deaths involving heroin. Therefore, increases in illicit fentanyl-associated deaths might represent an emerging and troubling feature of the rise in illicit opioid overdoses that has been driven by heroin.

The findings in this report are subject to at least three limitations. First, several factors related to death investigation might affect estimates of death rates involving specific drugs. At autopsy, toxicological laboratory tests might be performed to determine the type of drugs present; however, the substances tested for and circumstances under which the tests are performed vary by jurisdiction. Second, in 2013 and 2014, 22% and 19% of drug overdose deaths, respectively, did not include information on the death certificate about the specific types of drugs involved. The percent of overdose deaths with specific drugs identified on the death certificate varies widely by state. Some of these deaths might have involved opioids. This increase in the reporting of specific drugs in 2014 might have contributed to some of the observed increases in drug overdose death rates involving different types of opioids from 2013 to 2014. Finally, some heroin deaths might be misclassified as morphine because morphine and heroin are metabolized similarly (8), which might result in an underreporting of heroin overdose deaths.

To reverse the epidemic of opioid drug overdose deaths and prevent opioid-related morbidity, efforts to improve safer prescribing of prescription opioids must be intensified. Opioid pain reliever prescribing has quadrupled since 1999 and has increased in parallel with overdoses involving the most commonly used opioid pain relievers (1). CDC has developed a draft guideline for the prescribing of opioids for chronic pain to address this need.¶

In addition, efforts are needed to protect persons already dependent on opioids from overdose and other harms. This includes expanding access to and use of naloxone (a safe and effective antidote for all opioid-related overdoses)** and increasing access to medication-assisted treatment, in combination with behavioral therapies (9). Efforts to ensure access to integrated prevention services, including access to syringe service programs when available, is also an important consideration to prevent the spread of hepatitis C virus and human immunodeficiency virus infections from injection drug use.

Public health agencies, medical examiners and coroners, and law enforcement agencies can work collaboratively to improve detection of outbreaks of drug overdose deaths involving illicit opioids (including heroin and illicit fentanyl) through improved investigation and testing as well as reporting and monitoring of specific drugs, and facilitate a rapid and effective response that can address this emerging threat to public health and safety (7). Efforts are needed to distinguish the drugs contributing to overdoses to better understand this trend.

1Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC.

Corresponding author: Rose A. Rudd, rvr2@cdc.gov, 770-488-3712.

References

1. Paulozzi LJ, Jones C, Mack K, Rudd R. Vital signs: overdoses of prescription opioid pain relievers—United States, 1999–2008. MMWR Morb Mortal Wkly Rep 2011;60:1487–92.
2. Bergen G, Chen LH, Warner M, Fingerhut LA. Injury in the United States: 2007 chartbook. Hyattsville, MD: National Center for Health Statistics; 2008 Available at http://www.cdc.gov/nchs/data/misc/injury2007.pdf .
3. Murphy SL, Xu JQ, Kochanek KD. Deaths: final data for 2010. National vital statistics reports. Hyattsville, MD: National Center for Health Statistics; 2013. Available at http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf .
4. CDC. Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2015. Available athttp://wonder.cdc.gov.
5. Jones CM, Logan J, Gladden RM, Bohm MK. Vital signs: demographic and substance use trends among heroin users—United States, 2002–2013. MMWR Morb Mortal Wkly Rep 2015;64:719–25.
6. Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The changing face of heroin use in the United States: a retrospective analysis of the past fifty years. JAMA Psychiatry 2014;71:821–6.
7. CDC. Increases in fentanyl drug confiscations and fentanyl-related overdose fatalities. HAN Health Advisory. Atlanta, GA: US Department of Health and Human Services, CDC; 2015. Available at http://emergency.cdc.gov/han/han00384.asp.
8. Davis GG. Complete republication: National Association of Medical Examiners position paper: recommendations for the investigation, diagnosis, and certification of deaths related to opioid drugs. J Med Toxicol 2014;10:100–6.
9. Volkow ND, Frieden TR, Hyde PS, Cha SS. Medication-assisted therapies—tackling the opioid-overdose epidemic. N Engl J Med 2014;370:2063–6.

Rose A. Rudd, MSPH1; Noah Aleshire, JD1; Jon E. Zibbell, PhD1; R. Matthew Gladden, PhD1

* Additional information available at http://www.cdc.gov/nchs/nvss/mortality_public_use_data.htm.

† Additional information available at http://www.cdc.gov/drugoverdose/data/statedeaths.html.

§ Additional information available at http://pub.lucidpress.com/NDEWSFentanyl/.

¶ Additional information available at http://www.cdc.gov/drugoverdose/prescribing/guideline.html.

** Additional information available at https://store.samhsa.gov/shin/content/SMA13-4742/Overdose_Toolkit_2014_Jan.pdf .

Avoidable Deaths from Heart Disease, Stroke, and Hypertensive Disease — United States, 2001–2010

The US CDC reports that deaths attributed to lack of preventive health care or timely and effective medical care can be considered avoidable. In this report, avoidable causes of death are either preventable, as in preventing cardiovascular events by addressing risk factors, or treatable, as in treating conditions once they have occurred. Although various definitions for avoidable deaths exist, studies have consistently demonstrated high rates in the United States. Cardiovascular disease is the leading cause of U.S. deaths (approximately 800,000 per year) and many of them (e.g., heart disease, stroke, and hypertensive deaths among persons aged <75 years) are potentially avoidable.

Long COVID-Related Illness is a Significant Cause of Death

Long COVID-Related deaths are statistically significant and will be reflected in an increase in workers' compensation dependency awards. More Than 3,500 Americans Have Died from Long COVID-Related Illness in the First 30 Months of the Pandemic. 

Asbestos Deaths Predicted to Continue for Decades

The National Institute for Occupational Safety and Health (NIOSH) has released a draft Intelligence Report concerning asbestos and mesothelioma in an effort to create a "road-map for research."

"Asbestos has been a highly visible issue in public health for over three decades. During the mid- to late-20th century, many advances were made in the scientific understanding of worker health effects from exposure to asbestos fibers and other elongate mineral particles (EMPs). It is now well documented that fibers of asbestos minerals, when inhaled, can cause serious diseases in exposed workers. However, many questions and areas of confusion and scientific uncertainty remain. For instance, due to the mineralogical complexity of the asbestos minerals, the scientific literature contains various inconsistencies in the definition and application of the term asbestos for health protection guidance and regulatory purposes."

"The purpose of the Roadmap is to outline a research agenda that will guide the development of specific research programs and projects that will provide a broader and clearer understanding of the important determinants of toxicity for asbestos and other EMPs. NIOSH recognizes that results from such research may impact environmental as well as occupational health policies and practices. Many of the issues that are important in the workplace are also important to communities and to the general population.Therefore, NIOSH envisions that the planning and conduct of the research will be a collaborative effort involving active participation of multiple federal agencies, including the Agency for Toxic Substances and Disease Registry (ATSDR), the Consumer Product Safety Commission (CPSC), the Environmental Protection Agency (EPA), the Mine Safety and Health Administration (MSHA), the National Institute of Environmental Health Sciences (NIEHS), the National Institute of Standards and Technology (NIST), the National Toxicology Program (NTP), the Occupational Safety and Health Administration (OSHA), and the United States Geological Survey (USGS), as well as labor, industry, academia, health and safety practitioners, and other interested parties, including international groups. This collaboration will help to focus the scope of the research, to fund and conduct research, and to develop and disseminate informational materials describing research results and their implications for establishing new occupational and public health policies."

Asbestos Deaths Predicted to Continue for Decades

"NIOSH has annually tracked U.S. asbestosis deaths since 1968 and malignant  mesothelioma deaths since 1999 using death certificate data in the National Occupational  Respiratory Mortality System (NORMS). NORMS data, representing all deaths among  U.S. residents, show that asbestosis deaths increased almost 20-fold from the late 1960s  to the late 1990s (Figure 6) [NIOSH 2007b]. Asbestosis mortality trends are expected to substantially trail trends in asbestos exposures (see Section 2.4.2) for two primary  reasons: (1) the latency period between asbestos exposure and asbestosis onset is 2 typically long, commonly one or two decades or more; and (2) asbestosis is a chronic disease, so affected individuals can live for many years with the disease before succumbing. In fact, asbestosis deaths have apparently plateaued (at nearly 1,500 per year) since 2000 (Figure 3) [NIOSH 2007b]. Ultimately, it is anticipated that the annual  number of asbestosis deaths in the United States will decrease substantially as a result of  documented reductions in exposure. However, asbestos usage has not been completely  eliminated, and asbestos-containing materials remain in place in structural materials and  machinery, so the potential for exposure remains. Thus, asbestosis deaths in the United  States are anticipated to continue to occur for several decades."

Mesothelioma Strongly Linked to Occupational Exposures

"Malignant mesothelioma, an aggressive disease that is nearly always fatal, is known to be  caused by exposure to asbestos and some other mineral fibers [IOM 2006]. The occurrence of mesothelioma has been strongly linked with occupational exposures to asbestos [Bang et al. 2006]. There had been no discrete International Classification of Disease (ICD) code for mesothelioma until its most recent 10th revision. Thus, only seven years of NORMS data are available with a specific ICD code for mesothelioma (Figure 4); during this period, there was a 9% increase in annual mesothelioma deaths, from 2,484 in 1999 to 2,704 in 2005 [NIOSH 2007b]. A later peak for mesothelioma deaths than for asbestosis deaths would be entirely expected, given the longer latency for mesothelioma [Järvholm et al. 1999]. One analysis of malignant mesothelioma incidence based on the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program data found that an earlier steep increase in incidence had moderated and 1 that mesothelioma incidence may have actually peaked sometime in the 1990s in SEER-2 covered areas [Weill et al. 2004]. In contrast to NORMS data, which represents a census 3 of all deaths in the entire United States, the analyzed SEER data were from areas in 4 which a total of only about 15% of the U.S. population resides."

NIOSH  has invited Public Comment Until April 16, 2010 5:00pm EDT

Click here to read more about asbestos and workers compensation.

Click to read more about asbestos litigation.

Preventing Occupational Heart Fatalities

The US CDC has published a report on co-morbidity factors that precipitate fatal heart disease. This is yet another case why "wellness examinations" and prevention should be integrated into workers' compensation insurance coverage, especially in light of an aging workforce. 

Rates* of avoidable death from heart disease,
 stroke, and hypertensive disease,†
by county — United States, 2008–2010

Deaths attributed to lack of preventive health care or timely and effective medical care can be considered avoidable. In this report, avoidable causes of death are either preventable, as in preventing cardiovascular events by addressing risk factors, or treatable, as in treating conditions once they have occurred. Although various definitions for avoidable deaths exist, studies have consistently demonstrated high rates in the United States. Cardiovascular disease is the leading cause of U.S. deaths (approximately 800,000 per year) and many of them (e.g., heart disease, stroke, and hypertensive deaths among persons aged <75 years) are potentially avoidable.

National Vital Statistics System mortality data for the period 2001–2010 were analyzed. Avoidable deaths were defined as those resulting from an underlying cause of heart disease (ischemic or chronic rheumatic), stroke, or hypertensive disease in decedents aged <75 years. Rates and trends by age, sex, race/ethnicity, and place were calculated.

In 2010, an estimated 200,070 avoidable deaths from heart disease, stroke, and hypertensive disease occurred in the United States, 56% of which occurred among persons aged <65 years. The overall age-standardized death rate was 60.7 per 100,000. Rates were highest in the 65–74 years age group, among males, among non-Hispanic blacks, and in the South. During 2001–2010, the overall rate declined 29%, and rates of decline varied by age.

Nearly one fourth of all cardiovascular disease deaths are avoidable. These deaths disproportionately occurred among non-Hispanic blacks and residents of the South. Persons aged <65 years had lower rates than those aged 65–74 years but still accounted for a considerable share of avoidable deaths and demonstrated less improvement.

Click here to read more.

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One in 10 deaths among working-age adults due to excessive drinking

Shared from the cdc.com Excessive alcohol use accounts for one in 10 deaths among working-age adults ages 20-64 years in the United States, according to a report from the Centers for Disease Control and Prevention published today in Preventing Chronic Disease. Excessive alcohol use led to approximately 88,000 deaths per year from 2006 to 2010, and shortened the lives of those who died by about 30 years.  These deaths were due to health effects from drinking too much over time, such as breast cancer, liver disease, and heart disease; and health effects from drinking too much in a short period of time, such as violence, alcohol poisoning, and motor vehicle crashes.  In total, there were 2.5 million years of potential life lost each year due to excessive alcohol use. Nearly 70 percent of deaths due to excessive drinking involved working-age adults, and about 70 percent of the deaths involved males.  About 5 percent of the deaths involved people under age 21.  The highest death rate due to excessive drinking was in New Mexico (51 deaths per 100,000 population), and the lowest was in New Jersey (19.1 per 100,000). “Excessive alcohol use is a leading cause of preventable death that kills many Americans in the prime of their lives,” said Ursula E. Bauer, Ph.D., M.P.H., director of CDC’s National Center for Chronic Disease Prevention and Health Promotion. “We need to redouble our efforts to implement scientifically...

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Found on

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NFL Players Tackling Heart Disease

Many football players are essentially paid to be big—really big—especially those whose job is to block or stop the big guys on the other team.  They also suffer from medical conditions that are work related and claim medical benefits and other benefits available under the Workers' Compensation Act. 

There is a good chance that these players weigh in at sizes that are classified as obese as defined by body mass index (BMI).  In the general population, high BMI generally correlates with high body fat, and we know that high body fat is a risk factor for death (mortality) and heart disease.  Is the same true for elite athletes, for whom high BMI may relate to increased muscularity rather than increased body fat?  What if the athlete plays a position where size simply matters, regardless of whether size is related to muscle or to body fat?   And what happens when former athletes are no longer conditioning at their playing-day levels?  Do professional football players die earlier than or more often from heart disease or cancer than the average American male?   New research from the National Institute for Occupational Safety and Health (NIOSH) helps answer these and other questions.

In 1994, NIOSH published research examining death rates and risk factors for former National Football League (NFL) players.¹  At that time the research was based on all deaths that had occurred through 1991.   After following these players for an additional 16 years, NIOSH has just published new research on the topic in the American Journal of Cardiology.  

The study included 3,439 retired NFL players from the 1959 through 1988 seasons.  The study found that:

• Players had a much lower overall rate of death compared to men in the general U.S. population of similar age and racial mix. On average, NFL players are actually living longer than the average American male. Out of the 3,439 players in the study, 334 were deceased. Based on estimates from the general population, we anticipated roughly 625 deaths.
• Players also had a much lower rate of cancer-related deaths compared to the general U.S. population. A total of 85 players died from cancer when we anticipated 146 cancer-related deaths based on estimates from the general population.
• Players who had a playing-time BMI of 30 or more had twice the risk of death from heart disease compared to other players. Similar findings have been noted in other studies. Offensive and defensive linemen were more likely to have a BMI greater than 30. A BMI of 30 or more is considered obese in the general population whereas a healthy BMI is between 18.5-24.9.
• African American players had a 69% higher risk of death from heart disease compared to Caucasian players.   The study controlled for player size and position and determined that those factors are not the reason for this difference.
• Defensive linemen had a 42% higher risk of death from heart disease compared to men in the general population. A total of 41 defensive linemen died of heart disease, when we anticipated 29 deaths based on estimates from the general population.  Among the 41 defensive linemen who died of heart disease, 8 deaths were due to cardiomyopathy (a specific kind of heart disease that causes the heart to enlarge and can lead to heart failure). We anticipated fewer than two deaths from cardiomyopathy. We saw this increased risk only among the defensive linemen.

Source The NIOSH Science Blog

Read Also: 

Body Mass Index, Playing Position, Race, and the Cardiovascular Mortality of Retired Professional Football Players

"The initial cohort included 3,732 NFL players but 292 players with unknown race and 1 “player” who was actually a trainer were excluded. By the end of follow-up in 2007, the final cohort of 3,439 players contributed 104,776 person-years at risk and 334 deaths. On average the cohort was followed for 26.8 ± 8.7 years (mean ± SD) after retirement from the NFL. For players still alive, the median age at the study end date was 57 years; 60% of the players were white (including 15 Hispanics) and 39% were African-American..."

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State With the Highest Deaths on the Job

Today's post was shared by CAAA and comes from 247wallst.com



Work-related deaths dropped slightly from 2012 to 2103, according to the Bureau of Labor Statistics (BLS), down from 4,628 to 4,405. Maybe worker safety programs are yielding better results. The states with the highest death rates are the largest by population, which should come as no surprise.

According to the BLS:
The rate of fatal work injury for U.S. workers in 2013 was 3.2 per 100,000 full-time equivalent (FTE) workers, compared to a final rate of 3.4 per 100,000 in 2012.

And:
Seventeen states and the District of Columbia reported higher numbers of fatal work injuries in 2013 than in 2012, while 30 states reported lower numbers. Three states reported the same number as in 2012. For more detailed state results, contact the individual state agency responsible for the collection of CFOI (Census of Fatal Occupational Injuries) data in that state.

Although Texas has the second largest population, it has the largest number of work-related deaths last year. Deaths, however, did fall from 536 to 493. California, the largest state by population, reported deaths rose from 375 to 385. In third place, work-related deaths in Florida rose from 218 to 234. In fourth place, work-related deaths in New York fell from 202 to 160.

Since the number was down so slightly from year to year, it may be a decade before it will be reasonable to call it a trend.

Methodology: The Census of Fatal Occupational Injuries (CFOI), part of the BLS...

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A fatal trend: N.J. train deaths have increased since state launched safety initiative

Transportation accidents continue to be a major cause of work-related accidents. Today's post was shared by WCBlog and comes from www.nj.com

Spurred by the deaths of three teenage boys on the train tracks in a 24-hour period in 2011, the state Department of Transportation and NJ Transit redoubled safety efforts. The agencies extended fencing, stepped up patrols and placed new warning signs at stations. They increased education in schools and filmed hard-hitting public service announcements, one of them bluntly titled "You’re Dead." They even took to social media, targeting kids and adults alike with the message that a train is a brutally efficient killer. But more than a year after that safety initiative was launched, the deaths continue to mount. Worse, they have accelerated.

Trump Administration May Bring a Surge in Occupational Disease Claims

Mesothelioma death rates remain high in the US even on the eve of an anticipated national ban of the asbestos fiber. Things may radically change for the worse as the Trump Administration goes forward with its announced intention to dismantle environmental regulation now in place and placed on-track for enactment during the former Obama Administration. With anticipated less EPA and OSHA regulation under the Trump administration, there is the potential for a serious surge of future occupational disease claims in the United States.

FDA Warns Zithromax® / Zmax® Antibiotics Potential Risk of Fatal Heart Rhythms

The U.S. Food and Drug Administration (FDA) is warning the public that azithromycin (Zithromax or Zmax) can cause abnormal changes in the electrical activity of the heart that may lead to a potentially fatal irregular heart rhythm. Patients at particular risk for developing this condition include those with known risk factors such as existing QT interval prolongation, low blood levels of potassium or magnesium, a slower than normal heart rate, or use of certain drugs used to treat abnormal heart rhythms, or arrhythmias. 

This communication is a result of the FDA's review of a study by medical researchers as well as another study by a manufacturer of the drug that assessed the potential for azithromycin to cause abnormal changes in the electrical activity of the heart.

The azithromycin drug labels have been updated to strengthen the Warnings and Precautions section with information related to the risk of QT interval prolongation and torsades de pointes, a specific, rare heart rhythm abnormality. Information has also been added regarding the results of a clinical QT study which showed that azithromycin can prolong the QTc interval. (see Data Summary)

Health care professionals should consider the risk of fatal heart rhythms with azithromycin when considering treatment options for patients who are already at risk for cardiovascular events (see Additional Information for Health Care Professionals below).  FDA notes that the potential risk of QT prolongation with azithromycin should be placed in appropriate context when choosing an antibacterial drug: Alternative drugs in the macrolide class, or non-macrolides such as the fluoroquinolones, also have the potential for QT prolongation or other significant side effects that should be considered when choosing an antibacterial drug.

COVID Predictions Now Estimating Second Wave Beginning Sept 15 in US and 200,000 deaths

The Sun-Belt States, lead by Florida, are now reporting a huge upswing in US-COVID reinfection rates. Implementation of rapid return to work scenarios, and lackadaisical attitudes by 14-50 year olds in failing to adhere to social distancing and use of face masks, is now causing a massive increase in COVID hospitalizations and deaths. The new modeling prediction is going to create further uncertainty as to financial stability in the workers' compensation arena going forward. 

Five US Airports that Put Employees and Passengers At Risk For Environmental Tobacco Smoke

Secondhand Smoke Is Deadly

Air pollution from secondhand smoke five times higher outside smoking rooms and other designated smoking areas than in smoke-free airports

Average air pollution levels from secondhand smoke directly outside designated smoking areas in airports are five times higher than levels in smoke-free airports, according to a study by the Centers for Disease Control and Prevention. The study conducted in five large hub U.S. airports also showed that air pollution levels inside designated smoking areas were 23 times higher than levels in smoke-free airports. In the study, designated smoking areas in airports included restaurants, bars, and ventilated smoking rooms.

Five of the 29 largest airports in the United States allow smoking in designated areas that are accessible to the public. The airports that allow smoking include Hartsfield-Jackson Atlanta International Airport, Washington Dulles International Airport, McCarran International Airport in Las Vegas, Denver International Airport, and Salt Lake City International Airport. More than 110 million passenger boardings—about 15 percent of all U.S. air travel—occurred at these five airports last year.

"The findings in today’s report further confirm that ventilated smoking rooms and designated smoking areas are not effective," said Tim McAfee, M.D., M.P.H., director of CDC’s Office on Smoking and Health. "Prohibiting smoking in all indoor areas is the only effective way to fully eliminate exposure to secondhand smoke."

A 2006 Surgeon General’s Report concluded that there is no risk-free level of exposure to secondhand smoke. Although smoking was banned on all U.S. domestic and international commercial airline flights through a series of federal laws adopted from 1987 to 2000, no federal policy requires airports to be smoke-free.

"Instead of going entirely smoke-free, five airports continue to allow smoking in restaurants, bars or ventilated smoking rooms. However, research shows that separating smokers from nonsmokers, cleaning the air and ventilating buildings cannot fully eliminate secondhand smoke exposure," said Brian King, Ph.D., an epidemiologist with CDC’s Office on Smoking and Health and co-author of the report. "People who spend time in, pass by, clean, or work near these rooms are at risk of exposure to secondhand smoke."

Secondhand smoke causes heart disease and lung cancer in nonsmoking adults and is a known cause of sudden infant death syndrome or SIDS, respiratory problems, ear infections, and asthma attacks in infants and children. Even brief exposure to secondhand smoke can trigger acute cardiac events such as heart attack. Cigarette use kills an estimated 443,000 Americans each year, including 46,000 heart disease deaths and 3,400 lung cancer deaths among nonsmokers from exposure to secondhand smoke.

For an online version of this MMWR report, visit http://www.cdc.gov/mmwr.  For quitting assistance, call 1-800-QUIT-NOW (1-800-784-8669) or visit www.smokefree.gov.  Also, visit www.BeTobaccoFree.gov for information on quitting and preventing children from using tobacco. For real stories of people who have quit successfully, visit http://www.cdc.gov/tips. For state-specific tobacco-related data, visit CDC's State Tobacco Activities Tracking and Evaluation System at http://www.cdc.gov/tobacco/statesystem.

Read More About "Secondhand" Environmental Smoke

Workers' Compensation: Occupational Secondhand Smoke ...

Apr 23, 2011

"Secondhand smoke (SHS) exposure causes lung cancer and cardiovascular and respiratory diseases in nonsmoking adults and children, resulting in an estimated 46,000 heart disease deaths and 3,400 lung cancer deaths ...

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Casino Employee in NJ Wins Cancer Suit for Second-Hand Smoke ...

Feb 20, 2008

An Atlantic City NJ casino card dealer employed at the Claridge Hotel who was exposed to second hand tobacco smoke was awarded workers' compensation benefits. NJ Judge Cosmo Giovinazzi award $150,00 for lost ...

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The Great American Smoke-out - November 15, 2012

Nov 14, 2012

"Secondhand smoke (SHS) exposure causes lung cancer and cardiovascular and respiratory diseases in nonsmoking adults and children, resulting in an estimated 46,000 heart disease deaths and 3,400 lung cancer deaths .

http://workers-compensation.blogspot.com/

Workers' Compensation: The New Danger of Thirdhand Smoke ...

Oct 06, 2011

Lubick (2011) discussed the global health burden of secondhand smoke, and Burton (2011)emphasized a new and alarming consequence of smoking in indoor environments—“thirdhand smoke”—a term first coined in 2006 ...

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BLS Reports Fatal Accident Rates Soared in 2021

The 3.6 fatal occupational injury rate in 2021 represents the highest annual rate since 2016. A worker died every 101 minutes from a work-related injury in 2021.

Winter Warning: Portable Generators Hold Top Spot in CPSC Report on Carbon Monoxide Deaths & Incidents

Garment workers protest in Savar, Dhaka, on 24 November 2013

Carbon monoxide (CO) is an invisible killer, and portable gas generators emit a lot of CO. Portable generators were involved in the majority of carbon monoxide deaths involving engine-driven tools from 1999 through 2012.  At a carbon monoxide safety event in Chicago today, U.S. Consumer Product Safety Commission Acting Chairman Robert Adler announced that a new agency report finds that portable generators were linked to more than 85 percent of non-fire CO deaths associated with engine-driven tools, or 800 out of 931 deaths, during that 14-year period.  Most of the deaths have occurred since 2005, when Hurricane Katrina and a series of winter ice storms hit the U.S. CPSC’s report also found that African Americans died at nearly twice their proportion of the population.  CPSC staff found that 23 percent of generator-related fatalities involved African Americans. African Americans make up about 12 percent of the U.S. population, according to the U.S. Census Bureau. Men of any race were most likely to die from CO poisoning from generators, accounting for 73 percent of the deaths. Most of the generator fatalities, or 74 percent, occurred at fixed-structure homes. Many of these incidents involved generators that were operated in the home’s living space. Portable generators have fuel-burning engines.  Engine exhaust contains high levels of poisonous carbon monoxide, which can be fatal within minutes if used...

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Study: Air Pollution Causes 200,000 Early Deaths in US

Today's post was shared by FairWarning and comes from www.voanews.com

Air pollution causes about 200,000 early deaths each year in the United States, according to a new study from the Massachusetts Institute of Technology (MIT). Researchers at MIT’s Laboratory for Aviation and the Environment, say emissions from road transportation are the leading single cause of pollution, contributing 53,000 premature deaths, and that electrical power generation causes another 52,000. “In the past five to 10 years, the evidence linking air-pollution exposure to risk of early death has really solidified and gained scientific and political traction,” says Steven Barrett, an assistant professor of aeronautics and astronautics at MIT. “There’s a realization that air pollution is a major problem in any city, and there’s a desire to do something about it.”

US Workplace Deaths Decrease

A preliminary total of 4,340 fatal work injuries were recorded in the United States in 2009, down from a final count of 5,214 fatal work injuries in 2008. The 2009 total represents the smallest annual preliminary total since the Census of Fatal Occupational Injuries (CFOI) program was first conducted in 1992. Based on this preliminary count, the rate of fatal work injury for U.S. workers in 2009 was 3.3 per 100,000 full-time equivalent (FTE) workers, down from a final rate of 3.7 in 2008. Counts and rates are likely to increase with the release of final 2009 CFOI results in April 2011. Over the last 2 years, increases in the published counts based on information received after the publication of preliminary results have averaged 156 fatalities per year or about 3 percent of the revised totals.

Economic factors played a major role in the fatal work injury decrease in 2009. Total hours worked fell by 6 percent in 2009 following a 1 percent decline in 2008, and some industries that have historically accounted for a significant share of fatal work injuries, such as construction, experienced even larger declines in employment or hours worked. In addition, some source documents used by CFOI State partners to identify and verify fatal work injuries were delayed, due at least in part to fiscal constraints at some of the governmental agencies who regularly provide source documentation for the program.

Key preliminary findings of the 2009 Census of Fatal Occupational Injuries: 

- Workplace homicides declined 1 percent in 2009, in contrast to an overall decline of 17 percent for all fatal work injuries. The homicide total for 2009 includes the 13 victims of the November shooting at Fort Hood. Workplace suicides were down 10 percent in 2009 from the series high of 263 in 2008.

 - Though wage and salary workers and self-employed workers experienced similar declines in total hours worked in 2009, fatal work injuries among wage and salary workers in 2009 declined by 20 percent while fatal injuries among self-employed workers were down 3 percent. 

- The wholesale trade industry was one of the few major private industry sectors reporting higher numbers of fatal work injuries in 2009. 

- Fatal work injuries in the private construction sector declined by 16 percent in 2009 following the decline of 19 percent in 2008.

- Fatalities among non-Hispanic black or African-American workers were down 24 percent. This worker group also experienced a slightly larger decline in total hours worked than non-Hispanic white or Hispanic workers. 

- The number of fatal workplace injuries in building and grounds cleaning and maintenance occupations rose 6 percent, one of the few major occupation groups to record an increase in fatal work injuries in 2009.

 - Transportation incidents, which accounted for nearly two-fifths of all the fatal work injuries in 2009, fell 21 percent from the 2,130 fatal work injuries reported in 2008. 

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• Workplace deaths fall to lowest level since 1992 (usatoday.com)

Click here for more information on how Jon L Gelman can assist you in a claim for workers' Compensation claim benefits. You may e-mail Jon  Gelman or call 1-973-696-7900.
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Comment:

The BLS fatality figures are the fatalities from injuries that occurred at the worksite or shortly thereafter, and do not include occupational illness fatalities, the latter primarily from toxic chemical exposures in the workplace.

Worker deaths from toxic exposures, other work illnesses are conservatively estimated by NIOSH, Steenland, Markowitrz, and other researchers at 50,00 to 60,000 deaths each year, or ten times the number of fatalities from work injuries. It is a disaster of monumental proportions that goes largely unrecorded. The United States has no comprehensive occupational health data collection system.

As we have lagged behind other nations in our lack of a national comprehensive medical and statistical database on occupational illnesses, occupational injuries; we have lagged behind in the research into the causes and consequences of occupational illnesses that would lead to improved diagnosis, treatment, prognosis, and ultimately prevention, of occupational toxic exposures and resultant diseases.

Patrice Woeppel, Ed.D.

Author: Depraved Indifference: the Workers' Compensation System

www.patricewoeppel.us