A report finds the construction industry in the Midwest is being disproportionately impacted by the opioid epidemic and it’s costing Iowa tens of millions of dollars a year.

Report co-author Jill Manzo, a researcher with the Midwest Economic Policy Institute, says construction work is particularly vulnerable to the epidemic because of the physical nature of the work.

“Nearly 1,000 construction workers across the Midwest died from an opioid overdose in 2015,” Manzo says. “It cost the construction industry and the Midwest economy over $5 billion in lost production, lost lifetime earnings, pain and suffering costs, and reduced quality of life costs every year.”

The report found 188 deaths in Iowa that same year from opioid overdoses, including 32 construction workers. Those deaths cost the industry and the Iowa economy 168-million dollars, according to the report.

“Construction is one of the most physically-demanding and dangerous occupations in the United States,” Manzo says. “Construction workers pull, lift, remove debris and work with heavy equipment every day and this causes wear and tear on the body. The injury rate for construction workers is 77% higher than the national average for other occupations.”

The report finds 15% of construction workers struggle with substance abuse, which is nearly twice the national average. Also, it found opioids account for about 20% of all total spending on prescription drugs in the construction industry — far higher than its share in other industries. Being a construction worker is a challenging occupation, Manzo says.

“They’re paid hourly and a lot of it is seasonal work and if they get injured, they want to pop a pill to go back to work, basically,” Manzo says. “There’s a lot of incentive, especially with the skilled worker shortage, they turn to opioids as opposed to physical therapy to get back to work at a faster rate.”

The report from the St. Paul, Minnesota-based institute offers recommendations for reversing the trend, including:

1. Provide health insurance that covers substance abuse and mental health treatment,

2. Adopt new policies in health plans that limit dosages of opioid medications.

3. Encourage physical therapy and anti-inflammatory medications for chronic wear-and-tear injuries.

4. Educate employees about responsible prescription opioid use.

5. Provide at least two weeks of paid sick leave.

6. Update employee policies to include regular drug testing, but do not immediately fire employees who test positive.

7. Temporarily put employees on prescription opioids in low-risk positions.

8. Fund substance abuse treatment programs and workforce development initiatives.