Loading ...
Sorry, an error occurred while loading the content.

120Fall injuries and fatalities in the construction industry in the U.S.

Expand Messages
  • alumnicass
    Jan 8 5:36 AM


      1.0 Abstract:

                   In 2014, 9.5 out of every 100,000 construction workers in private industry were killed on the job; and falls, slips and trips constituted the major causes of fatal injuries: about 40% of all fatalities in the industry; whereas in 2013, the fatality rate was 9.7 per 100,000 FTE workers.  Construction injuries and fatalities due to falls have increased from 2013 (13 per 100,000) to 2014 (14.2 per 100,000). This increase was attributed to falls to a lower level where, in many cases, the safety protocol mandated by the law was either absent or inappropriate.  Latino workers are the most vulnerable to fall injuries and fatalities in both residential and commercial construction sites.  In 2006-2008, the fatal injury rate of Latinos/Hispanics in the construction industry was 12.7 per 100,000 compared to 12.0 per 100,000 for all workers performing the same job.  Construction falls are also associated with improper/unsecured installation of scaffolding, crane malfunction, roofs, and ladders, among other mechanical and engineering factors.  In addition, construction workers face the risk of falling objects and electrocution and accrued numerous hours of lost wages due to broken bones or fractures, lacerations, shoulder and knee injuries, brain damage, and post-traumatic stress disorder.  The Occupational Safety and Health Administration (OSHA) has developed regulations to improve safety in the construction industry (29 CFR, 1926) and to reduce fatal injuries from falls at and above 6 feet by mandating that  guardrail systems, safety net systems, or personal fall arrest systems be installed when work is being performed in unprotected side and edge areas.  However, without effective fall prevention plans, the rate of fall related fatal injuries will continue to increase in the construction industry.  Besides the proper installation of the safety systems required by the law, workers need to be trained (in a language that they can understand) in order to identify the hazards and to take appropriate actions (within the appropriate timeframe) to avoid accidents on the job. OSHA standard 29 CFR 1926.502(k)(4) requires employers/contractors to hire competent individuals to supervise the implementation of their construction fall protection plans. 

      2.0 Evidence of the problem

      2.1 In the United States:

      The construction industry in the United States is very hazardous.  According to the U.S. Department of Labor, there are approximately 9 million people who work at about 252,000 construction sites across the nation every day, among whom, 27.3% are Hispanic/Latino and 5.9% African American; women represent 8.9% of the construction workforce (1).  The rate of fatal injuries related to construction work is higher than the national average for all industries. In the United States, in 2014, there were 874 fatalities in that industry (9.5 per 100,000 workers), which represents about 19% of the total fatal work injuries in the country; the rate of fatality for all U.S. workers in 2014 was 3.3 per 100,000 (2).  Although, in general, the number of occupational injuries in the U.S. has decreased from 1992 to 2014 (from 6,217 to 4,679), but there has been an increase (in fatal injuries) of 14% in the construction industry from 2011 (9.1 per 100,000) to 2014 (9.5 per 100,000) (3).  

      Sorock et al. (1993) argued that about 49% of fatal falls occur at 3.1 to 10 meters above the ground due to improper scaffolds, guardrails, platforms and improper use of personal protective equipment (PPE). In 2010, falls accounted for one-third of all construction worker fatalities in the U.S. (3).  The Bureau of Labor Statistics (BLS) reported that falls to lower levels accounted for 570 fatal work injuries in 2012 (about 73% of all fatalities in the industry). There were 585 fatal work injuries for the year of 2013, among which, slips, trips and falls accounted for 16% (595 fatal injuries caused by falls to a lower level).

      2.2 High Risk Groups:

      In 2013, fatal work injuries among Hispanic or Latino workers increased to the highest level since 2007 (3.9 per 100,000 in 2013 from 3.7 in 2012); however, the total of injuries among native-born Latinos was less (301 in 2008 to 275 in 2013) than those who were born outside of the United States (503 in 2008 to 542 in 2013).  In fact, two-thirds of fatally-injured Hispanic or Latino workers in 2013 were born outside of the United States: Hispanics accounted for 48.3 percent of the foreign-born labor force in the country.  Likewise, men had a higher rate of fatal injuries (5.4 per 100,000) than women (0.5 per 100,000); women accounted only for 7.5% of the total construction workforce in 2013 (4).  Older workers are more susceptible to injuries and take more time to heal; in 2012, BLS reported that those who were 60 years of age or older had a rate of fatal injury of 9.2 per 100,000.2.3 New York City

      The New York Times reported a series of construction fatal injuries in New York City in 2015: a 36-year old construction worker (Manuel Colorado) lost his balance and fell 19 feet to his death, Gurmeet Singh, a 58-year-old Indian immigrant landed on top of a sidewalk shed, Lukasz Stolarski, a 33 year-old worker fell 110 feet from the roof of an office building, among other cases (5).  In fact, according to the New York City Department of Buildings, there were more than 270 construction injuries reported in 2015; a 42% increase from 2011.  Likewise, the number of construction fatalities in 2015 was about 2.5 fold greater than in 2011 (Figure 1); it is worth to mention that the construction boom in NYC during the last decade has also been a factor attributed to falls and fatal injuries).  According to the New York State Department of Labor (employment statistics), the number of employment in construction and extraction in New York has increased from 111,040 in 2011 to 380,000 in 2015. 

      Figure 1

      3.0 Causes of Construction Injuries:


                There are multiple causes associated with construction injuries.  Three out of every 5 falls occurred at a height of 20 feet or less and 11% of the injuries were linked to falls from less than six feet (6).  Moreover, falls on the same level resulted in a median of 80 hours of lost wages, while falls to a lower level resulted in a median of 160 hours away from work (7).  The risk of construction falls are commonly linked to scaffolding, cranes, roofs, ladders, and other work performed 6 feet above ground.  Construction workers are not only facing the risk of falling on the job, but they are also at risk of falling objects (tools, pieces of debris, materials, among others).  In fact, in 2014, 8.4% of all construction related fatal injuries was caused by workers struck by falling objects (8).  The New York Daily News reported on December 15, 2015 that a worker was struck in the face by a falling piece of construction material dropped by another worker (9).  In Oceanside, California, FOX5 News reported on October 13, 2005 that a construction worker was crushed to death by a 3-by-5-foot concrete slab, about 1-foot thick (10) and this is the same unfortunate scenario all over the country.  Despite falls and falling objects, construction workers are also at risk of electrocutions (8.5% of all construction fatality injuries in 2014), caught-in/between (1.4%, in 2014) and equipment malfunction (11).  For example, in April 25, 2015, a 40-year old construction worker (Trevor Loftus, a crane operator) was crushed to death by a malfunctioning crane in midtown, Manhattan (12).

      4.0 Regulations:

                  The Occupational Safety and Health Administration (OSHA) has created safety and health regulations for construction (29 CFR, 1926), establishing the responsibilities of both employers and workers in the construction industry.   Standard number 1926.50 (13) provides directives on fall protection and mandates that guardrail systems, safety net systems, or personal fall arrest systems to be installed when work is being performed at 6 feet or more above the lower level in unprotected sides and edges areas. The legislation also calls for guardrail systems to be capable of “withstanding, without failure, a force of at least 200 pounds (890 N) applied within 2 inches (5.1 cm) of the top edge, in any outward or downward direction, at any point along the top edge” (14). Moreover, OSHA mandates that employers provide to their workers all needed personal protective equipment (PPE) that could help to save their lives in the event of an accident.  In Standard number 1926.503, OSHA makes employers responsible to provide adequate training to each employee who might be exposed to fall hazards. Those trainings will help employees to identify the hazards of falling and to understand their rights and duties vis-à-vis the reduction of these hazards.  Standard number 1926.503(c)(3) indicates that any inadequacies in an affected employee's knowledge or if s/he cannot fully and effectively use the fall protection systems or equipment provided by the employer, that should be a sign indicating that the employee fails to understand his/her rights and responsibilities.   Workers should be instructed in a language that they can understand prior to be placed in any construction job, where the majority of injured workers are Latinos and immigrants.  In New York State, because of the danger caused by falling objects on construction workers, a “special law” (Labor Law section 240) has been enacted to allow those who are injured from falling objects to have an “easy-to-prove” lawsuit claim against the owner(s) of the worksite, the general contractor, other contractors and subcontractors, and others as well (15).  OSHA’s regulations are being enforced by a group of trained federal employees in various occasions.  For example, in 2012, in New Jersey, 4 construction contractors were charged a total of $460,000 for exposing workers to fall hazards after OSHA’s inspectors have observed that many employees who were working on a fourth floor building did not have any personal fall protection or fall protection systems (16). In August 2012, OSHA cited 10 contractors from 6 states (NH, FL, TX, GA, CT and OH) for a total of $173,000 for many avoidable falls and electrical shock hazards.  Likewise, on April 1st, 2015, a Brooklyn contractor was fined $84,600 for the death of 51-year-old laborer Vidal Sanchez who fell to his death while raking freshly poured concrete at an unprotected 6th floor edge of a building in Brighton Beach (17).  Fall protection construction was the most frequently cited OSHA standard (29 CFR 1926.501) in 2015, there were 6 major construction enforcement cases in New York State with initial penalties above $40,000.  The citations along with other OSHA initiatives (such as training, public education, etc.) and worker’s union efforts can be considered as incentives towards safer construction worksites throughout the country.

      5.0 Prevention:

      Employers and contractors are required to develop a fall protection plan for each construction site.  Bobick et al. (1994) suggested an injury reduction matrix for skylight and roof construction openings that contains the responsibilities, work equipment needed and corrective actions to take before, during and after construction.  This matrix takes into account the design of skylights and the compliance monitoring for health and safety of workers.  Sally and Smart (2015) argue that although PPE provides safety to employees/workers, but engineering controls, administrative and work practice controls should always be considered first when assessing and mitigating hazards.  Similarly, Mroszczyk (2015) believes that design professionals should also help build less dangerous-to-maintain buildings, for the philosophy of safety in design; design for safety is a preventive approach that should be applied to reduce the risk of construction-related injuries.   OSHA (29 CFR 1926.501) also focuses on the responsibilities of construction employers/managers/contractors to provide safety standing support to workers along with adequate personal fall protection equipment.  However, when it comes to hiring and assigning workers to particular construction jobs, training and education, before commencing the job, is imperative.  Since Latino workers are more vulnerable to injuries and fatalities in the construction industry (because of their lack of training, their unfamiliarity with the risks associated with the job, most of them do not understand English and are afraid to report unsafe conditions for fear of being fired or deported), Vasquez and Stalnaker (2004) proposed an eight step prevention intervention to reduce injuries among Latino workers, which includes health and safety training in Spanish, andragogical approach (more situational materials than regular literature), keep a low-student-to-trainer ratio, provide financial incentives towards continuing education,.  Teaming up new workers with senior workers on site should provide a direct training to new workers and help reduce injuries and fatalities. Minkler et al (2010) found that a similar approach in the food industry has increased health and safety among Chinese workers in California.Kaskutas et al. (2010) reported that during a training program geared at improving safety in the construction industry, only 10% of foreman and crewmembers knew that standing on the top plate of walls was not an appropriate operating procedure in the absence of a personal fall arrest system.  Many construction supervisors have a lack of knowledge in safety awareness and an inadequate understanding of accident causation and prevention (Haslam, et al., 2005).  Moreover, on-site safety professionals are rare and many safety innovations in the construction industry lingered behind the services and transportation industries (Kaskutas et al, 2010). Thus more efficient training at all levels of worker’s experience will contribute to improving safety in the construction industry.  The fall prevention plan required by OSHA for each construction site also embraces the ideas mentioned above.  Standard 29 CFR 1926.502(k)(4) calls for a competent person to supervise the implementation of the fall protection plan.  NIOSH has developed a fall protection awareness program to warn workers and employers about the hazards of falls (from roof, ladder, scaffolds, etc.) and the appropriate steps to take when planning safe construction operation plans.  Other objectives of this program include the acceleration of the identification and adoption of evidence-based best practices throughout the industry, the assessment of changes in safety and health outcomes and the examination of the safety and health status of Hispanic construction workers. NIOSH is also experimenting with the participatory research method to conduct technical advisory group reviews and focus groups with construction laborers (journeymen) and apprenticeship instructors from many construction trades unions (18). 

      To make construction sites safer for commercial and residential construction workers, in 2001, OSHA reversed the Interim Fall Prevention Guidelines for Residential Construction (19) , which initially was exempt from standard 29 CFR 1926.501, and made home builders to subscribe to the conventional methods of fall prevention mandated in OSHA’s Construction Standards 1926. Despite regulations, an effective fall prevention plan will help to reduce construction-related injuries and fatalities and decrease the number of days-away-from-work accrued by construction workers.

      6.0 Notes:

      1.  BLS Labor Force Statistics: http://www.bls.gov/cps/cpsaat18.htm

      2.  U.S. Bureau of Labor Statistics, 2015.

      3.  Construction: NAICS 23. http://www.bls.gov/iag/tgs/iag23.htm#fatalities_injuries_and_illnesses

      4.  Bureau of Labor Statistics, 2011

      5.  U.S. Bureau of Labor Statistics, U.S. Department of Labor, 2015

      6.  DAVID W. CHEN; NOV. 26, 2015.  Safety Lapses and Deaths Amid a Building Boom in New York

      7.  BLS Census of Fatal Occupational Injuries Summary, 2013

      8.  Sally Smart (2015). Serious fall injuries can cost almost $100,000 per case. Circle:

      9.  BLS Nonfatal Occupational Injuries and Illnesses Requiring Days Away From Work, 2013

      10. https://www.osha.gov/oshstats/commonstats.html

      11. Article by Graham Rayman: Construction worker badly injured after falling object hit him in the face at Upper West Side site. NEW YORK DAILY NEWS, December 15, 2015, 12:17 PM

      12. Posted 10:27 AM, October 13, 2015, by Sharon Chen, Updated at 09:53pm, October 13, 2015

      13. OSHA: https://www.osha.gov/oshstats/commonstats.html

      14. Ben Yakas in News on Apr 25, 2015 10:10 am

      15. https://www.osha.gov/pls/oshaweb/owalink.query_links?src_doc_type=STANDARDS&src_unique_file=1926_0501&src_anchor_name=1926.5011926.502(b)(3)

      16. http://www.michaels-smolak.com/construction-workers-hit-by-falling-object.html

      17. OSHA Region 2 News Release: 12-1061-NEW (osha 12-077)

      18. NIOSH Funded Research Grants

      19. OSHA Directives, 2011


      7.0 References:


      1. Dement J, Welch L, Ringen K, Quinn P, Chen A, Haas S. (2015). A case-control study of airways obstruction among construction workers. Am J Ind Med.  Oct;58(10):1083-97. doi: 10.1002/ajim.22495. Epub 2015 Jun 29. PubMed PMID: 26123003.


      1. Dement JM, Welch L, Ringen K, Bingham E, Quinn P. (2010). Airways obstruction among older construction and trade workers at Department of Energy nuclear sites. Am J Ind Med. Mar;53(3):224-40. doi: 10.1002/ajim.20792. PubMed PMID: 20025074.


      3.      Boschman, J.S. van der Molen, H.F. Sluiter, J.K. and  Frings-Dresen, M.H.W. (2013). Psychosocial work environment and mental health among construction workers, Applied Ergonomics, Volume 44, Issue 5, September 2013, Pages 748-755, ISSN 0003-6870, http://dx.doi.org/10.1016/j.apergo.2013.01.004.


      1. Welch, L.S., Hunting,  K. L and Mawudeku,  A. (2001). Injury surveillance in construction: eye injuries. Applied Occupatioanl and Environmental Hygiene. 16(7):755-62.


      1. Bobick, T., Stanevich, R.,  Pizatella, L., Timothy.  J., Keane, P. et al. (1994). Preventing falls through skylights and roof openings.   Professional Safety; Sep 1994; 39, 9; ProQuest pg. 33



      1. Vazquez, R., Stalnaker, F and Keith, C. (2004). Latino Workers in the Construction Industry. Professional Safety; Jun 2004; 49, 6; ProQuest pg. 24


      1. Mroszczyk, J. (2015). Improving Construction Safety: A team effort. Construction Safety, June; pp. 55-68


      8.       Kaskutas, V., Dale, A., Lipscomb, H., Gaal, J., Fuchs, M. et al. (2010). Fall Prevention in Apprentice Carpenters.  Scandinavian Journal of Work and Environment Health. May; 36(3): 258–265.


      9.      Smart, S. (2015). Serious fall injuries can cost almost $100,000 per case.  Circle, pp.48-50


      10.  Haslam, R., Hide, S., Gibb, A., Gyi, D., Pavitt, T. et al. (2005).  Contributing factors in construction accidents. Applied Ergonomics, 36: 401-416


      11.  Sorock GS, Smith EO, Goldoft M. (1993).  Fatal occupational injuries in the New Jersey construction industry. Journal of Occupational Medicine.  35:916-921


      12.  Minkler, M., Salvatore, A. L., Chang, C., Gaydos, M., Liu, S. S., Lee, P. T., & ... Krause, N. (2014). Wage theft as a neglected public health problem: an overview and case study from San Francisco's Chinatown District. American Journal Of Public Health, 104(6), 1010-1020. doi:10.2105/AJPH.2013.301813