Ontario study finds hundreds of opioid deaths among construction workers and trades
New Ontario research links hundreds of opioid deaths to construction workers and trades between 2018 and 2024, highlighting risks across agriculture, resources and shift-based jobs.
A new Ontario study finds that opioid deaths among construction workers and skilled trades accounted for more than a third of overdose fatalities with a known occupation from 2018 to 2024, underscoring persistent workplace and public-health vulnerabilities. The analysis, conducted by the Ontario Drug Policy Research Network, estimates roughly 1,340 construction and trades workers died of opioid toxicity in that period. The study also flags elevated death rates in agriculture, natural resources and hospitality sectors, raising concerns about how work conditions compound risk.
Study quantifies toll in construction and trades
The research reviewed opioid-related deaths in Ontario from 2018 through 2024 and compared occupation information where it was available. Investigators report that, of the roughly 16,000 opioid deaths over that span, the coroner had confirmed employment information in about 22 percent of cases. Within that subset, construction and trades occupations represented over one-third of deaths, a concentration experts say is disproportionate to workforce size.
Tara Gomes, an epidemiologist and lead investigator with the Ontario Drug Policy Research Network, told colleagues the pattern confirms earlier signals that workers in construction and related trades face heightened overdose risk. The study’s authors note the figure of roughly 1,340 victims is an estimate based on cases with recorded occupational data, and that the true burden may be larger once unknown or unclassified records are resolved.
Patterns of polydrug use found among victims
Toxicology results in the study show high levels of co-occurring substances among construction and trades victims at time of death. Nearly half — 49 percent — had cocaine detected, while 23 percent tested positive for amphetamines. Researchers point to the interplay between stimulants and opioids as an important factor shaping overdose risk in these populations.
Investigators say stimulants may be used to offset the sedating effects of opioids, particularly among workers doing long hours or night shifts. That pattern of polydrug use complicates clinical and workplace prevention strategies because it increases unpredictability of toxicity and may limit the effectiveness of single-focused interventions.
Rates elevated in agriculture and natural-resources sectors
Beyond construction, the study identifies elevated opioid death rates in the agriculture and natural-resources sectors. In 2024, the recorded rate for natural-resources workers was about 32 deaths per 100,000 workers, compared with 54.5 per 100,000 in construction. Although the absolute number of deaths in agriculture and resources is smaller, researchers warn that those populations may have been overlooked in prevention planning.
The study’s authors emphasize that lower total counts do not equate to lower risk for individuals working in remote or seasonal roles. Workers in agriculture and natural resources often face limited local health services, irregular schedules and physical demands that may increase injury-driven opioid exposure and subsequent reliance on unregulated supplies.
Hospitality and retail sectors also show elevated rates
The analysis found the restaurant and accommodation industry had a recorded opioid death rate of 8.9 per 100,000 workers in 2024. Researchers argue that sectors characterized by precarious employment, irregular hours and limited benefits show vulnerability to overdose harms, even when absolute death counts are lower than in construction.
Tara Gomes and her team note that precarious work conditions, such as contract labour and shift-heavy schedules, may both increase exposure to injury and reduce access to consistent health care. Those factors can push workers toward informal or illicit drug markets when pain management or prescription access is limited.
Employment precarity and workplace risk factors identified
The study points to several workplace-related mechanisms that likely increase overdose risk among affected workers. High physical risk of injury, irregular shift patterns, and insecure employment are cited as pathways that can lead to pain, interrupted treatment, and reliance on non-prescribed substances. Investigators also highlight the role of workplace culture and stigma in discouraging help-seeking.
Researchers caution that the coroner’s data limitations — employment was confirmed in only about one-fifth of all opioid deaths — mean that occupational patterns may be undercounted. They call for improved data collection on occupation in overdose investigations to better target prevention and support measures where they are needed.
Experts call for integrated workplace and public-health responses
Clinical and addiction specialists responding to the study say the findings should prompt both workplace-focused and broader public health action. Dr. Leslie Buckley, head of addictions at Toronto’s Centre for Addiction and Mental Health, described the research as an important step toward understanding contributing factors and urged innovative solutions to reduce risk. She and other experts recommend measures ranging from safer supply and expanded treatment access to workplace-based prevention and injury management.
Advocates say employers, unions and public-health agencies need to coordinate on practical interventions such as on-site naloxone training, supportive return-to-work policies, and eliminating barriers to prescribed pain management. They also emphasize tailoring approaches to sectors with remote worksites or seasonal labour to ensure consistent access to services.
Public-health officials and researchers are urging policymakers to consider the study’s findings when allocating resources for prevention, treatment and occupational safety programs. They recommend expanding surveillance of occupational information in overdose cases and piloting sector-specific interventions to evaluate what reduces harm.
The study reinforces that opioid-related harms are not confined to any single demographic and that occupation and work conditions play a central role in shaping risk, according to the authors and responding specialists.
