Injury surveillance in construction: injuries to laborers

Construction trade and extraction workers: A population at high risk for drug use in the United States, 2005-2014

OBJECTIVE

To estimate prevalence of past-month marijuana, cocaine, and nonmedical prescription opioid (NPO) use and determine employment-related correlates of drug use among construction trade/extraction workers (CTEW).

METHODS

We analyzed ten years of data (2005-2014) from 293,492 adults (age≥18) in the National Survey on Drug Use and Health, comparing CTEW and non-CTEW.

RESULTS

CTEW were 5.6% (n = 16,610) of the sample. Compared to non-CTEW, CTEW were significantly more likely to report past-month marijuana (12.3% vs. 7.5%), cocaine (1.8% vs. 0.8%), and/or NPO use (3.4% vs. 2.0%; Ps<.001). Among CTEW, past-week unemployment and working for >3 employers was associated with increased odds of marijuana and NPO use. Missing 1-2 days in the past month because the participant did not want to go into work was associated with increased odds for use of marijuana, cocaine, and NPO use. Missing 3-5 days of work in the past month because sick or injured was associated with double the odds (aOR = 2.00 [95% CI: 1.33-3.02]) of using NPO. Having written drug policies was associated with reduced odds for cocaine use, and workplace tests for drug use during hiring and random drug testing were also associated with lower odds of marijuana use.

CONCLUSIONS

CTEW are a high-risk population for drug use. Precarious employment is associated with higher prevalence of drug use while some workplace drug policies were associated with lower prevalence. Coupled with reports of high overdose mortality among CTEW, these findings suggest that prevention and harm reduction programming is needed to prevent drug-related morbidity and mortality among CTEW.

The influence of demographics and working conditions on self-reported injuries among Latino day laborers

BACKGROUND

The majority of day laborers in the USA are Latinos. They are engaged in high-risk occupations and suffer high occupational injury rates.

OBJECTIVES

To describe on-the-job injuries reported by Latino day laborers, explore the extent that demographic and occupational factors predict injuries, and whether summative measures for total job types, job conditions, and personal protective equipment (PPE) predict injuries.

METHODS

A community survey was conducted with 327 participants at 15 corners in Houston, Texas. Hierarchical and multiple logistic regressions explored predictors of occupational injury odds in the last year.

RESULTS

Thirty-four percent of respondents reported an occupational injury in the previous year. Education, exposure to loud noises, cold temperatures, vibrating machinery, use of hard hats, total number of job conditions, and total PPE significantly predicted injury odds.

CONCLUSION

Risk for injury among day laborers is not only the product of a specific hazard, but also the result of their exposure to multiple occupational hazards.

Nonfatal unintentional injuries and related factors among male construction workers in central China

BACKGROUND

Work-related injuries (WRIs) among construction workers have recently emerged as an important public health issue as the construction industry is booming in China. We investigated nonfatal unintentional work-related injuries and risk factors among male construction workers in central China.

METHODS

A purposive sampling method was used in 2008 to select 1,260 male workers from 24 construction sites. WRIs that occurred in the past 12 months and possible risk factors were asked about in face-to-face interviews.

RESULTS

Among 1,260 male construction workers, 189 workers reported WRIs. The annual prevalence of nonfatal WRIs was 15.0 per 100 workers (95% confidence interval (CI): 13.0-17.0). The top three leading causes of injuries were collisions (27.3 per 100 workers), cuts/piercings (17.5 per 100 workers), and falls (15.5 per 100 workers). WRIs were significantly associated with high cigarette pack-year index (PYI > or = 20 vs. nonsmoker: adjusted odds ratio (OR) = 2.50, 95% CI: 1.31-4.76), serious alcohol consumption (> or =30ml/day vs. nondrinker: adjusted OR = 1.73, 95 %CI: 1.12-2.69), not having injury prevention and safety education (adjusted OR = 2.05, 95% CI: 1.22-3.44), and had depressive symptoms (adjusted OR = 2.63, 95% CI: 1.22-5.67).

CONCLUSIONS

Our results suggest that annual prevalence of nonfatal construction injuries is high in central China and serious cigarette smoking, serious alcohol consumption, not having injury prevention and safety education, and depressive symptoms are considered important factors for those injuries.

Nonfatal construction industry-related injuries treated in hospital emergency departments in the United States, 1998-2005

BACKGROUND

This study documented the burden of nonfatal construction industry work-related injuries treated in hospital emergency departments in the United States (US) from 1998 through 2005 and described injured worker demographics and injury characteristics.

METHODS

Data from the National Electronic Injury Surveillance System work-related injury supplement (NEISS-Work) were used to identify and describe construction industry-related injuries. Rates were estimated using data from the Current Population Survey.

RESULTS

An estimated 3,216,800 (95% CI 2,241,400-4,192,200) construction industry-related injuries were seen in US emergency departments during the 8-year period; this represented an injury rate of 410/10,000 full-time equivalents and suggests that there are a greater number of construction injuries than reported through the Bureau of Labor Statistics' Survey of Occupational Injuries and Illnesses (BLS SOII). Common characteristics included diagnoses of laceration, sprain/strain, and contusion/abrasion; events of contact with an object/equipment, bodily reaction/exertion, and falls; and sources of injury of parts/materials; structures/surfaces; and tools/instruments/equipment. The upper extremities were most often affected.

CONCLUSIONS

These data highlight the high burden of nonfatal construction industry-related injuries. The limitations of national occupational injury data sources inherent in relying on OSHA logs highlight the utility of NEISS-Work data in occupational injury research. While data captured from emergency departments are not immune to factors that influence whether a worker or an employer reports an injury as work-related or files a workers' compensation claim, emergency department data as collected through NEISS-Work do not rely on employer involvement in order to be classified as work-related.

The impact of a peer-led participatory health and safety training program for Latino day laborers in construction

BACKGROUND

Immigrant Latino day laborers working in residential construction are at particularly high risk of fatal and non-fatal traumatic injury and benefit from targeted training.

OBJECTIVE

To understand the impact of a participatory, peer-facilitated health and safety awareness training customized to the needs of Latino day laborers.

METHODS

Baseline surveys exploring exposures, PPE use, attitudes, work practices and work-related injuries were collected from more than 300 New Jersey Latino day laborers in construction prior to their participation in a one day (minimum of six hour) Spanish language health and safety training class. The classes, led by trained worker trainers, engaged participants in a series of tasks requiring teamwork and active problem solving focused on applying safe practices to situations they encounter at their worksites. Follow-up surveys were difficult to obtain among mobile day laborers, and were collected from 70 men (22% response rate) 2-6 months following training. Chi-square analysis was used to compare pre- and post-intervention PPE use, self protective actions, and self-reported injury rates. Focus groups and in-depth interviews addressing similar issues provided a context for discussing the survey findings.

RESULTS

At baseline, the majority of day laborers who participated in this study reported great concern about the hazards of their work and were receptive to learning about health and safety despite limited influence over employers. Changes from baseline to follow-up revealed statistically significant differences in the use of certain types of PPE (hard hats, work boots with steel toes, safety harnesses, and visible safety vests), and in the frequency of self-protective work practices (e.g., trying to find out more about job hazards on your own). There was also a suggestive decrease in self-reported injuries (receiving an injury at work serious enough that you had to stop working for the rest of the day) post-training based on small numbers. Sixty-six percent of workers surveyed post-training reported sharing information from their safety workbook with friends and co-workers. Focus groups and interview results generally confirmed the quantitative findings.

CONCLUSIONS

Participatory, peer led training tailored to the needs of construction day laborers may have a positive effect on Latino immigrant workers' attitudes, work practices, and self reported injury rates, but major changes would require employer engagement.

IMPACT ON INDUSTRY

Health and safety researchers have identified reducing the number of traumatic injuries among the immigrant construction workforce as an increasingly important priority. This project provides one model for collaboration between university-based researchers, a union, and a community-based organization. The specific elements of this project-participatory curriculum customized to the needs of day laborers in residential construction, training day laborers to facilitate training classes, and involving peer leaders in outreach and research-could be adapted by other organizations. The findings of this study suggest that the Latino day laborers have a strong interest in and some ability to act on health and safety information. Widespread implementation of this type of training, especially if supported with cooperation from residential contractors, could lead to reduced rates of traumatic injury in the residential construction industry.

Factors contributing to construction injury at Denver International Airport

BACKGROUND

Detailed information about factors contributing to construction injury is important to support design of safety programs directed at particular risks.

METHODS

We linked over 4,000 injury reports, including text describing injury events, with an administrative workers' compensation (WC) database, and, using Haddon's matrix as a framework, classified factors contributing to injury during construction of Denver International Airport (DIA).

RESULTS

Patterns of contributing factors varied according to injury mechanism and type of work: environmental factors contributed more than any other factor to slip/trip injuries, and building materials contributed to more than 40% of injuries to workers in carpentry, concrete construction, glass installation, and roofing. Rates at which factors contributed to injury also varied among types of work: environmental factors contributed at relatively high rates to injuries in glass installation, metal/steel installation and iron/steel erection >or= 2 stories, and victim factors contributed at high rates to conduit construction and metal/steel installation injuries. WC payment rates for different factors varied widely, ranging from $0.53/$100 payroll to $3.08/$100.

DISCUSSION

This approach allows systematic analysis of classes of injuries, contributing factors, types of work, and other variables to assist in setting prevention priorities.

Disabling and fatal occupational claim rates, risks, and costs in the Oregon construction industry 1990-1997

This study estimated injury and illness rates, risk factors, and costs associated with construction work in Oregon from 1990-1997 using all accepted workers' compensation claims by Oregon construction employees (N = 20,680). Claim rates and risk estimates were estimated using a baseline calculated from Current Population Survey data of the Oregon workforce. The average annual rate of lost-time claims was 3.5 per 100 workers. More than 50% of claims were by workers under 35 years and with less than 1 year of tenure. The majority of claimants (96.1%) were male. There were 52 total fatalities reported over the period examined, representing an average annual death rate of 8.5 per 100,000 construction workers. Average claim cost was $10,084 and mean indemnity time was 57.3 days. Structural metal workers had the highest average days of indemnity of all workers (72. 1), highest average costs per claim ($16,472), and highest odds ratio of injury of all occupations examined. Sprains were the most frequently reported injury type, constituting 46.4% of all claims. The greatest accident risk occurred during the third hour of work. Training interventions should be extensively utilized for inexperienced workers, and prework exercises could potentially reduce injury frequency and severity.

Toxic inhalation fatalities of US construction workers, 1990 to 1999

Construction workers account for a disproportionately large number of occupational fatalities. A small percentage of these deaths is attributable to poisoning. Risk factors for such deaths using national data have not been reported previously. Construction poisoning fatalities from 1990 to 1999 in the Occupational Safety and Health Administration Integrated Management and Information System data set were analyzed. Risk and risk factors were determined using Bureau of Labor Statistics and census data. Eighty-seven poisoning deaths of construction workers are characterized, all attributable to toxic inhalation. Cellular and simple asphyxiants accounted for the largest numbers of fatalities. The majority of these deaths occurred in confined spaces. Water, sewer, and utility line workers are at increased risk for poisoning fatality. Toxic inhalation fatalities in the construction industry are preventable. Extending the Occupational Safety and Health Administration's confined space standard could save lives, particularly among water, sewer, and utility line industry workers.