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To Your Health: Overdose leading cause of preventable death among fishermen

he pandemic has made people much more aware of health and safety over the last year and a half. Understanding health and safety in commercial fishing, however, is not new. In the years 2000-2014, 693 commercial fishermen died from occupational causes in United States fisheries, 225 of which were in the Atlantic in the northeast states. Fifty occurred in the Atlantic scalloping fishery alone. In this article, I describe what some colleagues and I learned from looking at death certificate records in two fishing ports in Massachusetts.

People use death certificate data to learn if there are preventable deaths happening at an unexpected rate. For example, if accidental drownings occur at a higher rate among fishermen than among non-fishermen, there’s an incentive to work on ways to prevent these drownings from happening.

We looked at data from all the records of people who died in New Bedford and Gloucester from 2000 to 2014. The data allowed us to compare what was causing fishermen and non-fishermen to die. We studied 670 records of fishermen and 25,634 non-fishermen who died in those ports during those years.

Fishermen in New Bedford and Gloucester die at greater rates than non-fishermen, research shows. Photo Courtesy: Destination New Bedford

It might surprise you to know that, while Gloucester and New Bedford are famous as fishing ports, fishermen are only about one percent of the employed male population of each city. The comparison between fishermen and non-fishermen is more clear when looking at actual fishing communities, like these two cities, rather than an entire state. The residents there, fishermen or non-fishermen, share characteristics such as strong traditions, similar lifestyles and things like housing, educational and healthcare services, all of which can affect health.

Among fishermen in Gloucester and New Bedford, the largest number of deaths (73) were caused by accidents; this category included accidental overdose deaths. Accidental deaths were about 3 times (300%) as likely to have occurred among fishermen than non-fishermen. The data show that these deaths, in fact, were mostly accidental overdose deaths. If you subtracted the accidental overdose deaths, then other forms of accidental deaths were “only” about 50% more common among fishermen than non-fishermen.

The second most common cause of death in fishermen (66) was the category” opioid overdose.” Fishermen were more than four times as likely to have occurred among fishermen than non-fishermen.

Opioid overdoses can have many underlying causes. In some cases, addiction to opioids may have originated after prescription pain treatment for a non-fatal injury. The interaction between exposure to risk for pain or injury in commercial fishing and other factors may increase the overall risk of opioid overdose. In other words, an injury can be the beginning of a series of events which are compounded by the need to keep working and the distress of working in pain.

Injuries and chronic pain in commercial fishing are very common. Pain treatment with opioids might have an unintended consequence of contributing to a pathway to opioid overdose. This may be more common among fishermen than non-fishermen because there are more injuries and pain in fishing than other industries. The fact that a recent study showed a high rate of non-fatal injuries in lobstering is cause for concern in this context.

Several studies have shown that the risk of prescription opioids leading to addiction is quantifiable. Preventing commercial fishing injuries, then, should be thought of as a policy tool in the effort to end the opioid epidemic. Similarly, pain treatment ought to take the work environment of the fishermen into consideration.

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