Length of time spent working on a commercial construction site and the associations with worker characteristics

Associations Between Work-Related Factors and Psychological Distress Among Construction Workers

OBJECTIVE

Identify work-related factors associated with the mental health and well-being of construction workers.

METHODS

We completed eight key informant interviews, six worker focus groups, and a survey, informed by the interviews and focus groups, of 259 construction workers on five construction sites. Negative binomial regressions examined associations between psychological distress and work-related factors including safety climate, work-to-family conflict, psychological demands, social support, harassment, and job security.

RESULTS

Three themes emerged from the interviews and focus groups, job demands and structure, social support and workplace relations, and job precarity. From the survey higher psychological demands, higher work-to-family conflict, lower supervisor support, higher discrimination, and higher likelihood of losing a job were associated with higher psychological distress. When combined into a single model job demands and work-to-family conflict remained significant.

CONCLUSIONS

Work-related factors were associated with high levels of distress.

Break-even Analysis of Respirable Crystalline Silica (RCS) Exposure Interventions in the Construction Sector

OBJECTIVE

We investigated long-term economic impacts of respirable crystalline silica (RCS) removal interventions in the construction at the societal level.

METHODS

We estimated costs and benefits of two RCS exposure interventions, use of "respirators" and "wet method," over a 30-year time period. We identified economic impacts of the interventions under four different scenarios.

RESULTS

Under current practices, we estimated that approximately 125 lung cancer cases attributable to RCS exposure would arise in 2060. Under the full exposure removal scenario, we estimated there would be 53 new cases. Over the 30-year time period, the estimated cumulative averted cases are 787 and 482 for respirators and wet method, respectively, which amount to net benefits of $422.13 and $394.92 million.

CONCLUSIONS

Findings provide important information for policymakers seeking to reduce the economic burden of occupational lung cancer in society.

Cell Phone Ownership and Cellular Text/Email Capabilities Among Temporary and Payroll Construction Workers

Background: With high rates of temporary workers and a transient worker population, the U.S. construction workforce presents a challenge for long-term research and outreach activities. Increasing availability of affordable cell phone technologies may provide an opportunity for research follow-up among construction workers once they leave the worksite. Using pilot study survey data we characterize and examine the association of cell phone technology ownership and cellular text/email services among a non-probabilistic sample of payroll and temporary construction workers.

Methods: A cross-sectional study design was used to administer a one-time paper-based anonymous survey to construction workers working at construction sites in Florida, USA. The survey featured questions on sociodemographic characteristics, occupational history, cell phone technology ownership, and cellular text/email services capabilities.

Results: Among the 223 construction worker survey respondents, 31.4% identified as temporary workers and 68.6% were on payroll and 87.4% owned a cell phone. Construction workers who own a cell phone had greater than a high school education (28.9% vs. 25.0%; p = 0.019), made >$30,000/year (27.1% vs. 14.8%; p = 0.011), had same cell phone number for >1 year (74.4% vs. 40.7%; p = 0.001), and were employed as a payroll worker (71.0% vs. 50.0%; p = 0.037). Temporary construction workers compared to their payroll counterparts were significantly less likely to have email services on their cell phone [unadjusted-odds ratio 0.41 (95% CI: 0.17–0.97)].

Conclusion: Cell phone ownership and smartphone-enabled technologies such as email/texting capabilities are higher among payroll than temporary construction workers. Further research on frequency of cell phone use and types of email/texting services used by construction workers are needed.

Influence of work organization and work environment on missed work, productivity, and use of pain medications among construction apprentices

BACKGROUND

Construction is among the most dangerous industries. In addition to traditional hazards for workplace injury and illness, other threats to health and well-being may occur from work organization and work environment factors, including irregular employment, long commutes, long work hours, and employer policies regarding health and safety. These nontraditional hazards may affect work and health outcomes directly, or through effects on health behaviors. The cumulative impacts of both traditional and nontraditional hazards on health-related outcomes among construction workers are largely unknown.

METHODS

We conducted a survey among apprentice construction workers to identify relationships between work organization and environmental factors with five outcomes of economic relevance to employers: missed work due to work-related injury, missed work due to any pain or injury, self-reported workability, health-related productivity, and use of prescription medications for pain.

RESULTS

A total of 963 surveys were completed (response rate 90%) in this young (mean age 28) working cohort. Multivariate Poisson regression models found associations between the outcomes of interest and multiple work factors, including job strain, safety behaviors of coworkers, and mandatory overtime. Univariate analysis showed additional associations, including precarious work, and supervisor support for safety.

CONCLUSIONS

Findings from this cross-sectional study suggest that work organization and environment factors influence health and work outcomes among young construction trade workers. Future work with longitudinal data will examine the hypothesized paths between work factors, health behaviors, health outcomes, and work outcomes.

A training intervention to improve frontline construction leaders' safety leadership practices and overall jobsite safety climate

INTRODUCTION

The 2.5 h Foundations for Safety Leadership (FSL) training program teaches construction supervisors the leadership skills they need to strengthen jobsite safety climate and reduce adverse safety-related outcomes.

METHODS

Using a quasi-experimental prospective switching replications study design, we examined (1) if FSL-trained jobsite safety leaders would report improved understanding and practice of the FSL leadership skills, safety practices and crew reporting of safety related conditions, and (2) if their crew perceived a change in (a) their supervisors' practices, (b) their own safety practices and reporting of safety-related conditions, and (c) overall jobsite safety climate. Twenty construction sub-contracting companies were recruited and randomly assigned to either an early or lagged-control training group. Participating supervisors and workers completed surveys at multiple time points before and after the FSL training. We used linear mixed modeling to test changes over time.

RESULTS

Only supervisors in the early group reported a statistically significant improvement in their understanding and practice of the leadership skills as well as safety practices from before to 2- and 4-weeks post-training. Overall, no significant change was detected in crew-reported outcomes from before to after their supervisors' participated in the FSL training.

CONCLUSIONS

These results provide evidence that the FSL training can, at least in the short-term, improve construction frontline leaders' jobsite leadership skills. Future research could include an evaluation of FSL refresher activities and a longer-term follow-up. Practical applications: The Foundations for Safety Leadership (FSL) program fills an identified need for construction frontline supervisors to learn and practice critical safety leadership skills on the jobsite. It has already reached over 60,000 leaders and has the potential to reach over 100,000 each year during either an OSHA 30-h or a stand-alone course.

The Effect of Workforce Mobility on Intervention Effectiveness Estimates

Background

Little is known about how mobile populations of workers may influence the ability to implement, measure, and evaluate health and safety interventions delivered at worksites.

Methods

A simulation study is used to objectively measure both precision and relative bias of six different analytic methods as a function of the amount of mobility observed in the workforce. Those six methods are then used to reanalyze a previously conducted cluster-randomized control trial involving a highly mobile workforce in the construction industry.

Results

As workforce mobility increases, relative bias in treatment effects derived from standard models to analyze cluster-randomized trials also increases. Controlling for amount of time exposed to the intervention can greatly reduce this bias. Analyzing only subsets of workers who exhibit the least amount of mobility can result in decreased precision of treatment effect estimates. We demonstrate a 59% increase in the treatment effect size from the reanalysis of the previously conducted trial.

Conclusions

When evaluating organizational interventions implemented at specific worksites by measuring perceptions and outcomes of workers present at those sites, researchers should consider the effects that the mobility of the workforce may have on the estimated treatment effects. The choice of analytic method can greatly affect both precision and accuracy of estimates.

A Cluster Randomized Controlled Trial of a Total Worker Health® Intervention on Commercial Construction Sites

This study evaluated the efficacy of an integrated Total Worker Health^® program, “All the Right Moves”, designed to target the conditions of work and workers’ health behaviors through an ergonomics program combined with a worksite-based health promotion Health Week intervention. A matched-pair cluster randomized controlled trial was conducted on ten worksites (five intervention (n = 324); five control sites (n = 283)). Worker surveys were collected at all sites pre- and post- exposure at one- and six-months. Linear and logistic regression models evaluated the effect of the intervention on pain and injury, dietary and physical activity behaviors, smoking, ergonomic practices, and work limitations. Worker focus groups and manager interviews supplemented the evaluation. After controlling for matched intervention and control pairs as well as covariates, at one-month following the ergonomics program we observed a significant improvement in ergonomic practices (B = 0.20, p = 0.002), and a reduction in incidences of pain and injury (OR = 0.58, p = 0.012) in the intervention group. At six months, we observed differences in favor of the intervention group for a reduction in physically demanding work (B = −0.25, p = 0.008), increased recreational physical activity (B = 35.2, p = 0.026) and higher consumption of fruits and vegetables (B = 0.87, p = 0.008). Process evaluation revealed barriers to intervention implementation fidelity and uptake, including a fissured multiemployer worksite, the itinerant nature of workers, competing production pressures, management support, and inclement weather. The All the Right Moves program had a positive impact at the individual level on the worksites with the program. For the longer term, the multi-organizational structure in the construction work environment needs to be considered to facilitate more upstream, long-term changes.

Improving safety climate through a communication and recognition program for construction: a mixed methods study

OBJECTIVES

This study aimed to evaluate the efficacy of a safety communication and recognition program (B-SAFE), designed to encourage improvement of physical working conditions and hazard reduction in construction.

METHODS

A matched pair cluster randomized controlled trial was conducted on eight worksites (four received the B-SAFE intervention, four served as control sites) for approximately five months per site. Pre- and post-exposure worker surveys were collected at all sites (N=615, pre-exposure response rate of 74%, post-exposure response rate of 88%). Multi-level mixed effect regression models evaluated the effect of B-SAFE on safety climate as assessed from surveys. Focus groups (N=6-8 workers/site) were conducted following data collection. Transcripts were coded and analyzed for thematic content using Atlas.ti (version 6).

RESULTS

The mean safety climate score at intervention sites, as measured on a 0-50 point scale, increased 0.5 points (1%) between pre- and post-B-SAFE exposure, compared to control sites that decreased 0.8 points (1.6%). The intervention effect size was 1.64 (3.28%) (P-value=0.01) when adjusted for month the worker started on-site, total length of time on-site, as well as individual characteristics (trade, title, age, and race/ethnicity). At intervention sites, workers noted increased levels of safety awareness, communication, and teamwork compared to control sites.

CONCLUSIONS

B-SAFE led to many positive changes, including an improvement in safety climate, awareness, teambuilding, and communication. B-SAFE was a simple intervention that engaged workers through effective communication infrastructures and had a significant, positive effect on worksite safety.