A new report from the Massachusetts Department of Public Health (DPH) revealed that nearly a quarter of opioid-related deaths over a four year period occurred among people in construction-related jobs. The Boston Globe noted that the pain and pressure associated with such highly-physical roles is an “overlooked hazard” of the job.

The study looked at information from Massachusetts death certificates from 2011 to 2015 to figure out how many opioid overdoses resulted in death across various industries and occupations. Construction and extraction workers accounted for over 24 percent of all opioid-related deaths among the state’s working population. Both professions had an equally high rate with 150.6 deaths per 100,000 workers and 1,096 fatal opioid overdoses out of 4,302 total deaths (with usable occupational information) in the state.

Opioid overdoses occurring within the fields of agriculture, forestry, fishing, and hunting had the second highest rates of deaths while transportation, material moving occupations, maintenance and repair jobs, as well as service-related positions also reported significant fatality rates.

The report infers that such deaths are higher among workers with jobs where the risk of a work-related injury or illness is high, and employees are often turning to prescription drugs to manage acute and chronic pain. Additionally, it stated that the fatality rate is higher in jobs that have less paid sick leave and substantially less job security. Men were also reported to suffer higher death rates from opioid misuse as opposed to women.

The DPH said that further in-depth research needs to be done in order to clarify whether these complex factors as directly contributing to the opioid epidemic in the state of Massachusetts. According to the report, the state is committed to taking serious steps to address the issue by enacting education and policy interventions on overdose prevention and by improving workers’ compensation systems. The DPH reported in May that opioid-related overdose deaths declined by an estimated five percent for the first three months of this year when compared to the first three months of 2017.