A review of the effects of noise, vibration, heat and cold on construction workers was presented. Measurements of construction noise levels and resultant hearing loss were cited from studies in the United States, Sweden, and Canada. Permissible noise levels enacted by the Environmental Protection Agency were cited for air compressors and medium and heavy trucks. Noise reduction by retrofitting existing equipment has been successfully pursued by agencies such as the Bureau of Mines. The general OSHA noise limit was 85 decibels measured to approximate human hearing (dBA). The only OSHA standard for construction noise required contractors to provide ear protective devices and ensure their use above permissible limits. The need for contractor noise surveys, improved hearing protection, regular hearing tests and worker training was discussed. The health effects of chronic whole body and hand/arm vibration were reviewed. Topics discussed included vibration measurement, symptoms, medical surveillance and treatment, prevention, and worker education and training. Extreme heat and cold exposure may result in reduced work time, reduced performance, increased error rates, and severe illness or fatalities due to hypothermia or heat stress. Although heat stroke was often the only reported heat related illness, it was cited as one of the top ten construction related health conditions. Heat exhaustion was considered far more common though unreported. Personal protection equipment required for abatement and hazardous waste cleanup may increase the risk of heat stroke. Protection from extreme cold was improved by increasing the layers of clothing worn. The authors conclude that the best way to limit exposure to the discussed hazards is by implementing hearing conservation programs, controlling vibrations, and proper medical surveillance.