Injury inequalities among U.S. construction workers

Physical and Psychosocial Correlates of Occupational Physical Injury in the Global Construction Industry: A Scoping Review

Purpose

The construction industry is a diverse sector with exposure to multiple psychosocial and environmental workplace hazards that increase the risk of injury. This scoping review aims to consolidate the existing literature on the physical and psychosocial determinants influencing the risk of occupational physical injuries among construction workers globally.

Methods

A scoping review was conducted using the PRISMA extension checklist guided. Literature searches were performed between June and October 2023 in electronic academic databases.

Results

A total of 77 studies were identified, encompassing various geographical regions, including North America (n = 29), Africa (n = 18), Europe (n = 12), Asia (n = 9), the Middle East (n = 5), and Oceania (n = 4). The review identified physical and psychosocial factors in 3 domains influencing occupational physical injuries: workplace physical environment (eg, exposure to physical hazards, availability and utilization of personal protective equipment, company size, and job type), workplace culture (eg, psychosocial stressors, gender-related barriers, migrant and ethnic disparities, educational background), and physical wellbeing, health and aging (eg, age, obesity, sleep quality, marital stats, and physical health status). Notably, workers from social minority groups (eg, women, ethnic and migrant workers) of young (<25 years old) or older ages (45-55 years old) employed in smaller construction companies are vulnerable to increased injury risk and exposure to physical and psychosocial hazards in the workplace.

Conclusion

The review emphasizes a global paucity of research examining the implications of physical and psychosocial factors on injury risk within the construction industry. Future research should prioritize investigating the impact of psychosocial hazards on younger and older workers to detect age-related differences in injury rate, treatment access, and work-related health outcomes.

Occupational Injuries Among Construction Workers by Age and Related Economic Loss: Findings From Ohio Workers' Compensation, USA: 2007-2017

Background

This study examined age-group differences in the rate, severity, and cost of injuries among construction workers to support evidence-based worker safety and health interventions in the construction industry.

Methods

Ohio workers' compensation claims for construction workers were used to estimate claim rates and costs by age group. We analyzed claims data auto-coded into five event/exposure categories: transportation incidents; slips, trips, and falls (STFs); exposure to harmful substances and environments; contact with objects and equipment (COB); overexertion and bodily reaction. American Community Survey data were used to determine the percentage of workers in each age group.

Results

From 2007-2017, among 72,416 accepted injury claims for ∼166,000 construction full-time equivalent (FTE) per year, nearly half were caused by COB, followed by STFs (20%) and overexertion (20%). Claim rates related to COB and exposure to harmful substances and environments were highest among those 18-24 years old, with claim rates of 313.5 and 25.9 per 10,000 FTE, respectively. STFs increased with age, with the highest claim rates for those 55-64 years old (94.2 claims per 10,000 FTE). Overexertion claim rates increased and then declined with age, with the highest claim rate for those 35-44 years old (87.3 per 10,000 FTE). While younger workers had higher injury rates, older workers had higher proportions of lost-time claims and higher costs per claim. The total cost per FTE was highest for those 45-54 years old ($1,122 per FTE).

Conclusion

The variation in rates of injury types by age suggests that age-specific prevention strategies may be useful.

Epidemiology of occupational injuries in construction workers between 2009 and 2018 in South Korea

BACKGROUND

This study aimed to investigate the characteristics of occupational injuries based on fatality, sex, and classification of occupations among construction workers using workers' compensation (WC) insurance data in South Korea.

METHODS

We collected WC insurance data from the Korea Workers' Compensation & Welfare Service for all construction workers between 2009 and 2018. Data from 158,947 accepted claims for occupational injury were extracted, and the demographic features, occupational injury types, and annual trends were analyzed for fatal and nonfatal cases. The annual incidence and mortality trends of occupational injury were estimated using negative binomial regression and Poisson regression models, for injury incidence and mortality respectively.

RESULTS

Among a total of 158,947 occupational injury cases, there were 155,772 (98%) nonfatal injuries and 3175 (2%) fatal injuries. For all occupational injuries, Construction Elementary Workers (6th Korean Standard Classification of Occupations (KSCO) 910; 45.7%) was the most frequent occupation, followed by Construction-Related Technical Workers (6th KSCO 772; 39.2%). The most frequent injury type was a fracture, followed by ruptures or lacerations and contusions. The incidence of all occupational injuries increased from 700.36 per 100,000 persons in 2009 to 1,195.98 per 100,000 persons in 2018. Further, deaths from injuries at work followed a significantly increasing annual trend [mortality rate ratio 1.04 (95% CI: 1.03-1.05)] from 2009 to 2018.

CONCLUSION

The over two-thirds increased incidence of occupational injuries and significantly increasing mortality trends for occupational injuries during the last 10 years indicate the need for aggressive intervention in occupational safety and health management within the Korean construction industry.

Worker Perspectives on COVID-19 Risks: A Qualitative Study of Latino Construction Workers in Oakland, California

Latino construction workers in the U.S. have faced a disproportionate risk for COVID-19 infection in the workplace. Prior studies have focused on quantifying workplace risk for COVID-19 infection; few have captured workers' experiences and perspectives. This study describes COVID-19-related workplace risks from the perspectives of Latino construction workers. We conducted a qualitative study using semi-structured phone interviews with Latino construction workers from the Fruitvale District of Oakland, California. Twenty individuals were interviewed from December 2020 to March 2021. Nearly all participants (19/20) were Spanish-speaking men; mean age 42.6 years. The majority were low-income and over one-third did not have health insurance. Participants worked in varied construction-related jobs ranging from demolition to office work; additionally, four were day laborers, and three belonged to a labor union. We identified four major themes with public health policy and workplace safety implications: (1) Major concern about the risk of SARS-CoV-2 infection for family health and economic wellbeing; (2) Clarity about mask use and social distancing but not disclosure; (3) Variability in access to additional resources provided by employers; and (4) Uncertainty around structural support for SARS-CoV-2 quarantine/isolation. Our findings provide further evidence from workers' own perspectives of the major gaps experienced during the pandemic in workplace protections and resources.

Sick Days: Logical Versus Survey Identification of the Foreign-Born Population in the United States

The self-reported number of workdays missed due to injury or illness, or sick days, is a reliable measure of health among working-aged adults. Although sick days is a relatively underexplored health-related outcome in migration studies, it can provide a multidimensional understanding of immigrant wellbeing and integration. Current understandings of the association between migration status and sick days are limited for two reasons. First, in the United States, few nationally representative surveys collect migration status information. Second, researchers lack consensus on the most reliable approach for assigning migration status. We use the 2008 Survey of Income and Program Participation (SIPP) to examine sick days and draw comparisons between two methods for assigning migration status—a logical approach and a survey approach. The logical method assigns migration status to foreign-born respondents based on characteristics such as government employment or welfare receipt, while the survey approach relies on self-reported survey responses. Sick days among immigrants was correlated with and predicted by other health conditions available in the SIPP. Comparisons of sick days by migration status vary based on migration assignment approach. Lawful Permanent Residents (LPRs) reported more sick days than non-LPRs and appear less healthy when migration status is assigned using the logical approach. The logical approach also produced a gap in sick days between LPRs and non-LPRs that is not replicated in the survey approach. The results demonstrate that if migration status is not measured directly in the data, interpretation of migration status effects should proceed cautiously.

Trends in fatal occupational injuries in Latino/a workers relative to other groups, North Carolina 2000-2017

BACKGROUND

Latino/a workers may experience higher fatal occupational injury rates than non-Latino/a workers. In North Carolina, the Latino/a population more than doubled between 2000 and 2017. We examined fatal occupational injuries among Latino/a and non-Latino/a workers in North Carolina over this period.

METHODS

Information on fatal occupational injuries was abstracted from records of the North Carolina Office of the Chief Medical Examiner and the death certificate records held by the North Carolina Office of Vital Records. Estimates of the working population were derived from the decennial census and American Community Survey. Estimates of annual rates of fatal occupational injury for the period January 1, 2000 to December 31, 2017 were derived for Latino/a workers and compared to Black and White workers not identified as Latino/a.

RESULTS

Over the study period, 1,783 fatal occupational injuries were identified among non-Latino/a workers and 259 fatal occupational injuries among Latino/a workers in North Carolina. The majority of fatal occupational injuries among Latino/a workers occurred among males employed in construction and agriculture. While the fatal occupational injury rate among Latino/a workers declined over the study period, the rate among Latino/a workers was higher than among non-Latino/a White and Black workers; moreover, fatal occupational injury rates for Latino/a workers trended upwards during the most recent years of the study period.

CONCLUSIONS

Latino/a workers in North Carolina have the highest fatal occupational injury rate of any race/ethnicity group.