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Prevalence of Drugs and Alcohol Identified in Fatal Work-Related Injuries: A Two Office Experience

Work-related deaths are routinely encountered by medical examiners and it is generally considered standard practice to perform full autopsies including toxicology in these cases. A number of these may show the presence of drugs, alcohol, and/or other toxins in the decedent's blood at the time of death; however, national data on the rate of positive toxicology in occupational deaths are limited. We performed a retrospective review of all occupational deaths from two offices in northeastern Ohio (Cuyahoga and Summit Counties). Combined, there were 263 occupational deaths. Seventy-nine cases were excluded due to remote injury, seven had no data available, and 114 had negative toxicology screens. Of the cases with data available for review (177), 63 (36%) cases had positive toxicology screens and 32 (18%) showed the presence of ethanol, illicit drugs, and/or other drugs with high potential for impairment, similar to rates in other published series.