Alcohol and substance misuse in the construction industry

Suicide Among Roofers: Injury, Pain & Substance Misuse

OBJECTIVE

CDC has called for suicide research on the construction industry, an industry with a high suicide rate. The present study addresses this gap and focuses on roofers. It assesses which risk factors distinguish suicides by roofers from those of the general population. Alcohol and drug misuse, related to their high incidence of injury and pain, are seen as key potential drivers of roofer suicide.

METHODOLOGY

Data refer to 30,570 suicides and are taken from the National Violent Death Reporting System (NVDRS). Drawing from previous work on the health professions, 15 core predictors are selected, representing psychiatric morbidity, social strains, and demographics. Since the analysis seeks to differentiate roofers' suicides from others, the dependent variable is a dichotomy where roofers' suicides (=1) and other suicides (=0).

RESULTS

After adjusting for the other 14 risk factors, a multivariate logistic regression analysis found that roofers' suicides were 76% more apt (Odds ratio = 1.76, CI: 1.18, 2.63) than other suicides to have a known substance or alcohol problem that contributed to their suicide. Other constructs differentiating roofers' suicides from other suicides included marital status, gender, and race. Roofers were less protected by marriage.

CONCLUSION

The results inform prevention efforts and substance misuse can serve as a key warning sign for roofers' suicide. This is the first investigation of the drivers of suicide among roofers, and one of a few drawing links between occupational injury and suicide.

Stress, fear, and anxiety among construction workers: a systematic review

Objectives

The aim of this review was to assess the possible risk factors arising from working conditions, that could have an impact on the stress, fear, and anxiety of construction workers.

Methods

A systematic review was conducted following the PRISMA format in the Pubmed, Cochrane, Web of Science, Scopus, and PsycInfo electronic databases on February 3, 2023, using the following key words: anxiety, stress, fear, and construction workers. Methodological quality was assessed using the critical appraisal tools of the Joanna Briggs Institute.

Results

A total of 35 studies were included. The results showed a number of conditioning factors for stress, anxiety, and fear among construction workers such as age, inappropriate safety equipment, safety culture, high workload and long working hours, physical pain, low social support from direct supervisor or co-workers, lack of organizational justice and lack of reward, financial situation, maladaptive coping strategies, and characteristics of the pandemic.

Conclusions

There are a number of risk factors related to working conditions, organizations, and individuals that can affect the levels of stress, anxiety, and fear among construction workers, such as age, work hardship, safety culture and, especially, the long hours that construction professionals work. This may lead to an increase in the number of occupational accidents and higher associated fatality rates.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022367724, identifier: CRD42022367724.

Influence of Prefabricated Construction on the Mental Health of Workers: Systematic Review

Despite the significant contribution of the construction industry to national and global economies, the risk it poses to the health and safety of its workers is concerning. With substantial improvement in physical health and safety performance, especially in industrialised and developed economies, attention has shifted to the mental health of construction workers. The construction industry has implemented several worker-focused and management-oriented intervention programs, but problems related to poor mental health persist, and the industry ranks high in suicide figures. Entering the Construction 4.0 era, the use of technologies and new construction methods have been touted to have the potential to improve mental wellbeing. Therefore, this research addresses this lingering problem by: (1) identifying and classifying stressors of mental health and (2) assessing the relevance of adopting prefabricated construction to improving mental health. A two-phased PRISMA-guided systematic review was conducted due to the nonavailability of past studies that combine the concepts of prefabrication and mental health. Mental health stressors were grouped into three categories, with industry-related identified as having an influence on management/organisational and personal stressors. Prefabricated construction, on the other hand, by virtue of its benefits over traditional construction, is found to be capable of eliminating, or at least reducing, the impact of industry-related stressors and, by extension, promoting good mental health.

Opt-in HIV testing in construction workplaces: an exploration of its suitability, using the socioecological framework

Background

Late diagnosis of HIV remains a challenge, despite improved testing and treatment. Testing is often targeted at high-risk groups; workplace events might normalise testing and allow access to a wider population. The construction workforce has a number of risk factors for HIV. In the Test@Work study, HIV tests were delivered within general health checks to construction employees, with high uptake and acceptability. This paper reports on the experiences of construction managers and health professionals involved in Test@Work and explores the suitability of construction worksites as a venue for opt-in HIV testing.

Methods

Qualitative interviews (n = 24) were conducted with construction managers who had facilitated health check/HIV testing (n = 13), and delivery partners (n = 11) including i) healthcare volunteers who had delivered general health checks (n = 7) and, ii) HIV professionals who had conducted HIV testing (n = 4) at 21 Test@Work events held on construction sites. Interviews explored their experiences of these events and views towards HIV testing in the workplace. Exit questionnaires (n = 107) were completed by delivery partners after every event, providing qualitative data identifying facilitators and barriers to effective delivery. Thematic analysis identified themes that were mapped against a socioecological framework.

Results

Delivery partners reported high engagement of construction workers with workplace HIV testing, peer-to-peer encouragement for uptake, and value for accessibility of onsite testing. HIV professionals valued the opportunity to reach an untested population, many of whom had a poor understanding of their exposure to HIV risk. Managers valued the opportunity to offer workplace health checks to employees but some identified challenges with event planning, or provision of private facilities.

Conclusions

The construction sector is complex with a largely male workforce. Providing worksite HIV testing and education to an untested population who have poor knowledge about HIV risk helped to normalise testing, encourage uptake and reduce HIV-related stigma. However, there are practical barriers to testing in the construction environment. Rapid testing may not be the most suitable approach given the challenges of maintaining confidentiality on construction worksites and alternatives should be explored.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13787-5.

Domains of Psychosocial Risk Factors Affecting Young Construction Workers: A Systematic Review

Despite being a key provider of employment, construction work significantly contributes to poor mental health among young construction workers worldwide. Although there are studies on the psychosocial risk factors (PRFs) that make young construction workers susceptible to poor mental health, the literature is fragmented. This has obscured a deeper understanding of PRFs and the direction for future research, thus making it challenging to develop appropriate interventions. To address this challenge, we systematically reviewed the literature on young construction workers’ PRFs using meta-aggregation, guided by the PICo, PEO, and PRISMA frameworks. We sought to synthesize the domains of PRFs that affect young construction workers’ mental health, and to determine the relationships between the PRF domains, psychological distress, and poor mental health. A total of 235 studies were retrieved and 31 studies published between 1993 and 2020 met the inclusion criteria. We identified 30 PRFs and categorized them into ten domains, which were further classified into personal, socio-economic, and organizational/industrial factors. The findings of this review contribute to achieving an in-depth understanding of young construction workers’ PRF domains and their patterns of interaction. The findings are also useful to researchers and policymakers for identifying PRFs that are in critical need of attention.

Test@work: evaluation of workplace HIV testing for construction workers using the RE-AIM framework

BACKGROUND

Community testing for HIV can reach previously untested populations but is rarely offered in workplaces. Targeting the construction sector could reach workers from high risk populations.

METHODS

The RE-AIM framework was used to evaluate Test@Work, a workplace HIV testing intervention for construction workers implemented at 21 events (10 companies) in the UK. Test@Work had three components: 1) an online health toolkit to inform managers about health screening and HIV testing; 2) general health checks; and 3) opt-in HIV consultation and testing. Quantitative data were collected using registration and exit questionnaires with workers (n = 426) and pre/post-event questionnaires with managers (n = 15), with qualitative analysis of free text responses.

RESULTS

Reach 426 individuals had health checks. Participants were broadly representative of the UK construction workforce, but with a higher proportion of permanent workers. Most workers reported being in good health but also believed their work had an adverse impact on their health. Effectiveness: 97% of health check participants opted to have a consultation about sexual health (n = 413) and 82% had an HIV test (n = 348), of whom 78% had not previously been tested. All HIV tests were non-reactive. HIV testing at work was considered acceptable by most participants. Participants reported learning new things about their health (74%), said they would make changes as a result (70%) and felt confident of success (median score 8/10). Adoption: Recruitment of companies was challenging and time consuming. Seven of the participating companies were very large, employing over 1000 workers, which is atypical of construction generally.

IMPLEMENTATION

All events were completed as planned and were considered successful by all parties. Maintenance: All managers would arrange further events if they were offered them. Six managers incorporated sexual health awareness into their health programmes, but this was not possible for many as health agendas were set centrally by their organisations.

CONCLUSIONS

Opt-in HIV testing, when embedded within a general health check, has high uptake and acceptability in the UK construction sector, and reaches individuals at risk for HIV who may not otherwise attend for testing. Cost-effectiveness of this approach is yet to be determined.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04292002 .

Health condition at first fit note and number of fit notes: a longitudinal study of primary care records in south London

OBJECTIVES

The fit note replaced the sick note in the UK in 2010, with the aim of improving support for patients requiring sickness absence, yet there has been very little research into fit note use. This study aims to describe number of fit notes by condition, to improve our understanding of patterns of fit note use in primary care. Previous fit note research has relied on extracting diagnoses directly from fit notes, rather than extracting information from clinical records. In this paper, we extract information from clinical records to explore demographic factors and conditions associated with number of fit notes issued.

DESIGN

This is a longitudinal study of clinical data. We analysed individual-level anonymised data from general practitioner consultations, including demographic information and condition recorded at first fit note. The latter encompassed diagnoses, individual symptoms and psychosocial issues.

SETTING

A database called Lambeth DataNet, containing electronic clinical records on 326 415 adults (ages 16-60) from all 45 general practices within the London Borough of Lambeth from 1 January 2014 to 30 April 2017.

PARTICIPANTS

Our analytical sample contained 40 698 people with a condition recorded at first fit note.

PRIMARY OUTCOME MEASURE

Predicted number of fit notes in the period January 2014-April 2017 RESULTS: Of all studied diagnostic groups, mental illness had the highest predicted number of fit notes (n=3.3; 95% CI: 3.1 to 3.4) after controlling for demographic factors and long-term conditions. The highest predicted number of fit notes for any condition subgroup was among patients presenting for drug and/or alcohol misuse (n=4.5; 95% CI: 4.1 to 4.8).

CONCLUSIONS

For the first time, we show drug and/or alcohol misuse at first fit note are associated with the highest number of fit notes. Research is needed to understand the trajectories of individuals at highest risk of long-term sickness absence, in particular, people presenting with drug and/or alcohol misuse.

Impact of Alcohol on Occupational Health and Safety in the Construction Industry at Workplaces with Scaffoldings

The value, care, and customs of workers are essential in terms of occupational health and safety. The abuse of alcohol is widely regarded as a serious threat to the lives, health, and safety of employees. The aim of the research was to identify the main problems that are associated with alcohol abuse and consumption at work among employees in the construction industry, with particular emphasis on workstations where work is carried out on construction scaffoldings. Data for the analysis were obtained from two different sources. The first one was post-accident documentation on occupational accidents. The second one was surveys collected during the research project. This study confirmed that excessive and disproportionate alcohol consumption can be the cause of an accident, and consequently death at workplaces with scaffolding. Of 219 accident reports, 17.4% indicated alcohol as a contributing factor. Analysis of accident documentations shows that in cases where alcohol was indicated as a contributing factor in an accident, the alcohol was consumed during the workday. The results obtained on the basis of the conducted research were able to constitute a justification for the directions of preventive actions carried out in order to reduce the number of occupational accidents in the construction industry caused by alcohol.