Construction’s Biggest Killer: Overdoses
At One Madison, a high-rise building under construction in New York, workers face dangers daily: live wires, electrical hazards, heavy machinery.
City and U.S. officials visited the site recently to give a safety presentation, but not about how to avoid falls or injuries. They were showing workers how to prevent the biggest killer in the industry: drug overdose.
“We ask you to do things based on getting home at the end of the day,” Brian Crain of the U.S. Labor Department’s Occupational Safety and Health Administration told more than 100 workers. “Addiction works the same way.”
Construction workers already had the highest on-thejob death toll of any industry in the United States. Now they are more likely to die of overdose than those in any other line of work, according to a new analysis by the U.S. Centers for Disease Control and Prevention. That stems in part from addictive medication workers are prescribed to manage pain from injuries, which are common because of the physical work.
It is an issue that the industry has struggled to manage
for more than a decade. The presentation at One Madison in November was one example of how the industry has started reckoning with the problem in recent years. Unions now employ full-time addiction and mental health specialists, and workplace safety experts have increasingly had to focus on preventing overdoses.
The C.D.C. study found that there were more than 162 overdose deaths per 100,000 construction workers in 2020. Data
suggested that construction workers were about 16 times as likely to die of an overdose as from a work-related injury.
A majority of construction workers are men, who are more likely than women to die of overdoses overall. Hispanic people are overrepresented in the industry and have a rising overdose mortality rate overall.
Construction workers also do not often get paid sick leave, which could make opioids an option for getting back to work quickly. And the work tends to be cyclical, adding to the pressure to work whenever possible.
Brendan Loftus, who provides addiction services for the International Union of Elevator Constructors, said the union had begun to notice that the overdose problem was getting severe in 2015 when it lost five members to overdoses in 11 months, and that the problem had gotten only worse.
“If we had lost five members to on-the-job fatalities, people would be picketing in the streets,” Mr. Loftus said. “But nobody wanted to talk about this, because it was a dirty little secret.”
One of the first members Mr. Loftus helped with recovery was Michael Cruz, a 25-yearold construction worker who had an opioid addiction. One day in October 2016, Mr. Cruz bought building supplies for an upcoming job. He had recently checked out of a 30-day rehab program and was eager to get back to work.
Later that night, he was found at his aunt’s apartment in New York, dead of an apparent overdose, lying next to a bag with the measuring tape and other supplies he had bought that evening.
Mr. Cruz’s addiction started with painkillers that he had been prescribed after a car accident left him with lingering back pain. His toxicology report showed traces of codeine, fentanyl and heroin in his system. Mr. Loftus said most workers addicted to substances like heroin had been addicted to painkillers first.
Part of the challenge the industry faces is the stigma of addiction. Lizbeth Rodas, Mr. Cruz’s sister, said that when she and her family were preparing his funeral, they were unsure whether to tell people he had died of an overdose. They chose to tell the truth.
“So many people came forward after that,” she said, including union colleagues.
Increasingly, construction companies are stocking job sites with Narcan, a brand name for the opioid overdose reversal medication naloxone.
“It’s not just about the physical safety of the workers on our job sites,” said Rebecca Severson, director of safety at one of those companies, Gilbane Building Company. “It’s also what goes on when they’re not on the construction site.”
Construction workers at the site of One Madison in New York listening to a presentation on drug overdose and prevention. Michael Cruz, left, died of an overdose at 25.