Participating core and specialty programs: Center for Occupational Robotics Research, Emergency Preparedness and Response, Health Hazard Evaluation, National Center for Productive Aging and Work, Occupational Health Equity, Prevention through Design, Safe-Skilled-Ready Workforce, Small Business Assistance, Surveillance, and Translation Research.
Insurance companies (including workers’ compensation), businesses, policy-makers, professional associations, and unions adopt interventions to prevent and protect from falls among construction workers.
NOTE: Goals in bold in the table below are priorities for extramural research.
|Health Outcome||Research Focus||Worker Population*||Research Type|
|A||Fatal and non-fatal injuries||Falls from elevation||Iron workers, sheet metal workers, roofers, power line installers, telecommunications workers, laborers, small businesses, vulnerable workers||Intervention Translation|
|B||Non-fatal injuries||Falls on the same level||All construction workers (especially laborers, small businesses, vulnerable workers)||Intervention Translation|
Activity Goal 6.2.1 (Intervention Research): Conduct intervention studies to develop and assess the effectiveness of falls prevention and protection interventions among construction workers.
Activity Goal 6.2.2 (Translation Research): Conduct translation research to understand barriers and aids to implementing effective falls prevention and protection interventions in the construction sector.
In 2016, there were over ten million workers in the U.S. construction industry, a number that has been rising since bottoming out in 2012 [CPWR 2017]. Between 2003 and 2016, there were between 267 and 448 fatal falls annually in construction. In 2015, almost six times as many fatal falls occurred in construction compared to manufacturing, the industry with the second highest number [CPWR 2017]. Examining 1,533 fatal falls in construction between 2011 and 2015, approximately 33% were falls from roofs, 24% were falls from ladders, and 15% were falls from scaffolding [CPWR 2017]. Occupations at higher risk include laborers, roofers, ironworkers, sheet metal workers, welders, and power-line installers [CPWR 2013, 2017]. Vulnerable workers at an elevated or disproportionate risk include Hispanic workers, foreign-born workers, workers in small businesses, workers with non-standard work arrangements, and older (55 and over) workers [CPWR 2013, 2017].
The burden of injuries from falls on the same level in construction is sometimes overlooked. In 2010, there were approximately 18,130 non-fatal injuries to construction workers as a result of falls. Approximately 40% of those injuries were the result of falls that occurred on the same level [CPWR 2013]. Fatal and non-fatal falls in construction result in heavy economic burdens on workers, families, employers, and society. Even when workers survive, many have traumatic brain or other injuries requiring lengthy rehabilitation, placing substantial emotional, medical, and financial burdens on their families. Falls also result in significant costs to employers, including lost productivity, loss of skilled workers, and increased workers’ compensation costs [OSHA 2012].
Intervention and translation research addressing engineering and design, education and training, communication, and administrative issues is needed to address this problem and achieve meaningful results. Future research to prevent and protect from falls should consider the effects and interactions of environmental, task-related, and personal factors that can affect workers’ balance. Improvements in the work environment, in construction materials and methods, and in work procedures and practices should reduce falls. Research to reduce falls among higher risk groups is especially needed, along with research to develop, evaluate, and understand the safety, productivity, and latent hazards of emerging work methods and technologies (e.g., advanced fall prevention and protection technologies, height access devices, drones, automation, and robots). There is a need to better understand the best approaches to train and educate construction workers, employers, and safety professionals on fall protection. Many of these groups include non-English speaking learners and low-literacy audiences. Additional efforts are needed to transfer findings from this research into influential documents such as guidance and voluntary consensus standards. There is also a need to translate research findings into software products, applications and interactive webpages to make information easily accessible for construction stakeholders.
Falls on the same level or slips, trips, and falls (STFs) are common in construction (representing approximately 19% of all construction falls requiring emergency room visits from 1998–2005) and a leading cause of workers’ compensation claims [Shislov et al. 2011]. Many causes of STFs are unique to construction, easily observable, and should be addressed through research; for example, housekeeping and maintenance are often major contributing factors to falls on the same level [Lipscomb et al. 2006]. A better understanding of causal factors will address the need to develop and enhance effective interventions and technologies that can be translated into the construction work environment.
Safety and health professionals, employers, labor organizations, consensus standard organizations, and robotics manufacturers use NIOSH information to prevent injuries related to automation technologies and robots and to improve safety among construction workers.
|Health Outcome||Issue||Worker population*||Research needed|
|A||Fatal and non-fatal injuries||Emerging ground robotics and automation technologies (e.g., collaborative robots, mobile robots)||Workers who interact with ground robots, vulnerable workers||Basic/etiologic
|B||Fatal and non-fatal injuries||Emerging aerial robotics and automation technologies (e.g., unmanned aerial vehicles [UAV])||Workers who work in close proximity to an aerial robot at a construction site, vulnerable workers||Basic/etiologic
|C||Fatal and non-fatal injuries||Codes and other methods needed to identify robot-related injuries
|Workers who interact with construction robots, vulnerable workers||Surveillance|
Activity Goal 6.3.1 (Basic/Etiologic Research): Conduct basic/etiologic research to better understand the benefits and risks of emerging ground/aerial robotics and automation technologies regarding injuries (or injury reduction) among construction workers.
Activity Goal 6.3.2 (Intervention Research): Conduct studies to evaluate robotics technologies as sources of, and interventions for, workplace injuries among construction workers.
Activity Goal 6.3.3 (Surveillance Research): Conduct surveillance research to develop new methods to identify robot-related injuries among construction workers.
More than ten million U.S. construction workers are at high risk of traumatic injuries because of inherently hazardous tasks and dynamic conditions of construction sites. With recent advances in automation and robotics, novel construction approaches are being developed with the potential to reduce occupational injury risks. New and emerging types of robots (e.g., collaborative robots, aerial robots) are becoming more available, and beginning to be more widely used in the construction industry to assist workers in handling hazardous tasks that have been performed traditionally by human workers. Ground robots can take on heavy loads; perform dirty, dangerous, or repetitive work; work at elevation, in hard to reach places, and perform tasks requiring awkward postures at a construction site. Unmanned Aerial Vehicles (UAVs) also can be used in the construction industry for various tasks including mapping of construction sites for project planning, monitoring workflow and logistics, inspecting and assessing structures and damages, and handling and transporting materials. In particular, UAVs can prevent construction worker injuries involving falls from heights by taking on tasks at higher elevations.
Market data show that average industrial robot sales worldwide increased 16% per year from 2010–2015, and continuing increases in adoption of industrial robots are predicted [IFR 2016]. It is estimated that more than 1.4 million new industrial robots will be installed in workplaces worldwide from 2016–2019 [IFR 2016]. Rapid advances and growth of applications of UAVs are particularly significant in the construction industry. It is estimated that the UAV market will increase to $100 billion by 2020 and the construction industry is expected to be the biggest market for commercial uses that are expected to account for over $11 billion [Goldman Sacks 2016]. Predicted growth of robotics in the construction industry can create new hazards to human workers who work in close proximity to or interact with these emerging technologies. This challenge can be particularly significant because of the characteristics of most construction projects: ever-changing work environments, the need for multiple skilled craftsmen, multiple employers sharing a common worksite, and the interactions of multiple pieces of automated equipment.
Basic and etiologic research are needed to expand our understanding of applications of robotics and automation technologies in the construction industry and associated injury risks. Due to the rapid growth in these technologies, safety research is needed to address the efficacy, safety, and productivity improvements related to use of collaborative robots, mobile robots, and aerial robots in construction environments. Studies are needed on the impact of personal, environmental, and task-related risk factors in reducing worker injuries associated with robotics. In addition, developing engineering and administrative controls to enhance uptake of automation and robotic solutions and minimize robot-related incidents used in construction are topics warranting further study. There is a need to better understand the best approaches to train and educate construction workers, employers, and safety professionals on construction hazards. Many of these groups include non-English speaking learners and low-literacy audiences. Additional efforts are needed to transfer findings from this research into influential documents such as guidance and voluntary consensus standards. There is also a need to translate research findings into software products, applications and interactive webpages to make information easily accessible for construction stakeholders.
There is also an urgent need to expand occupational injury surveillance capabilities to better identify, monitor, and quantify the burden of fatal and nonfatal injury incidents involving the robotics and automation technologies in the construction industry. For instance, new source or event codes for automation- and robot-related incidents need to be developed for effective surveillance.
Insurance companies (including workers’ compensation), businesses, policy-makers, professional associations, government agencies, and unions adopt interventions to reduce injuries and risk factors for opioid use, illicit drugs, and substance use/misuse.
|Health Outcome||Research Focus||Worker Population*||Research Type|
|A||Fatal and non-fatal injuries||Patterns and risk factors for prescription drug (incl. opioids), illicit drug, and substance use/misuse||Iron workers, sheet metal workers, roofers, power line installers, telecommunications workers, laborers, small businesses, vulnerable workers||Basic/Etiologic
|B||Fatal and non-fatal injuries||Effectiveness of employer-based interventions for prescription drug (incl. opioids), illicit drug, and substance use/misuse||Iron workers, sheet metal workers, roofers, power line installers, telecommunications workers, laborers, small businesses, vulnerable workers||Intervention Translation|
Goal 6.19.1 (Basic/Etiologic Research): Conduct basic/etiologic research to better understand risk factors for prescription drug (incl. opioids), illicit drug, and substance use/misuse among construction workers.
Activity Goal 6.19.2 (Intervention Research): Conduct studies to develop and assess the effectiveness of interventions for prescription drug (incl. opioids), illicit drug, and substance use/misuse among construction workers.
Activity Goal 6.19.3 (Translation Research): Conduct translation research to understand barriers and aids to implementing effective interventions for prescription drug (incl. opioids), illicit drug, and substance use/misuse among construction workers.
Activity Goal 6.19.4 (Surveillance Research): Conduct surveillance research to develop new methods and tools to understand patterns of prescription drug (incl. opioids), illicit drug, and substance use/misuse among construction workers.
Construction comprises residential and commercial building and heavy and civil engineering (e.g., water and sewer lines, highways, and bridges), and includes specialty trades such as roofing, plumbing, electrical, and drywall. Over 10 million workers are employed in construction in the U.S. [BLS 2017], and these workers face risks of fatal and non-fatal injuries resulting from falls from elevated surfaces, struck-by incidents, and musculoskeletal disorders (MSDs), as well as adverse health effects from noise, silica, and other exposures. Construction work is demanding and labor-intensive, involving significant manual material handling and awkward postures in challenging environments on dynamic work sites. Many of the building trades require skilled workers who are sometimes in short supply [CPWR 2018b].
Recent research demonstrates that workers and workplaces are impacted by the opioid crisis.overdose epidemic. According to the National Survey of Drug Use and Health, an estimated 4% of respondents age 18 years or older reported illicit opioid use in 2017, and an estimated 67% of these self-reported users were employed [SAMHSA 2018]. Prescription opioids may be both a personal risk factor for and a consequence of work-related injury. [Kowalski-McGraw et al. 2017].
The opioid crisis overdose epidemic impacts construction workers more than other occupational groups. Construction workers have been commonly prescribed opioids to treat pain associated with MSDs and injuries [Thumula and Liu 2018], contributing to the opioid overdose epidemic. In 2007–2012, the percentage of opioid-related overdose deaths was higher in construction than the percentage of opioid-related overdose deaths in all occupation groups combined [Harduar Morano et al. 2018]. A recent analysis of data from the Bureau of Labor Statistics’ Census of Fatal Occupational Injuries similarly found that the construction industry had high numbers and rates of drug overdose deaths at work compared to other industries [Tiesman et al. 2019]. Studies in Massachusetts and Ohio reported opioid overdose deaths among constructions workers that were 6 and 7 times higher than for other workers [Massachusetts Department of Public Health 2018; CPWR 2018a]. In another study, over half of those who died from an overdose had suffered at least one job-related injury [Cheng et al. 2013].
Misuse of illicit drugs and other substances is a public health problem that also affects the workplace. Numerous studies have documented the adverse impact of illicit drug and alcohol use (including heavy drinking) on workers [Wiebe 1995]. These negative outcomes can include absenteeism, turnover, accidents, reduced performance and productivity. This problem has had a greater impact on the construction industry and its workers than many other industry sectors. Studies of this issue have looked at prevalence of use and high-risk industries, demographic variables, the impact (including links to workplace accidents), and how employers have responded [Wickizer et al. 2004; Pidd et al. 2011; Cook et al. 2004].
Surveillance is a significant part of the national response to the opioid crisis. Overdosew epidemic. Data collection and analyses related to prescription drug (incl. opioids), illicit drug, and substance use/misuse in construction are needed. A better understanding of the work-related factors and exposures that occur in construction and may increase the use of these substances would be helpful. There are many questions about the impact of substance use and misuse on construction workers and the work they do, the role of the work environment on use and misuse, and the effectiveness of employer-based interventions. Epidemiologic analyses of federal, state, and local data are needed to identify work-related factors, trends, and to evaluate prevention efforts. The following databases and data sources are promising: workers’ compensation systems, prescription drug monitoring programs, emergency medical services runs, emergency department data, medical examiner data, data from ESOOS (Enhanced State Opioid Overdose Surveillance) and SUDORS (State Unintentional Drug Overdose Report System), and employer data. Methodologic challenges include: absence of validated survey instruments and questions about occupational exposures; absence of data on work-relatedness and work context in many systems; unstructured narrative data; improving data timeliness; database linkages to maximize the quality and utility of data on work and opioids; identifying type(s) of opioids, and whether use was licit or illicit; and assessing a range of outcomes for workers and employers (e.g. injuries, absenteeism, economic costs, mental health impacts). Potential areas of research include: teasing out temporal associations between construction work factors and substance use/misuse; and assessing the effectiveness of efforts by construction employers, unions, and communities to reduce the impacts of substances on construction workers and workplaces.
Intervention research is needed to evaluate the determinants and consequences of existing and new employer-based interventions to reduce use/misuse of prescription drugs (incl. opioids), illicit drugs, and substances. Evaluation of these interventions should consider their effectiveness in reducing use of these substances and ultimately the impact on workplace safety and health including potential links to traumatic injuries. Such efforts might consider the business case for safety, owner and management commitment to safety, and novel work arrangements and their impact on leading and lagging indicators of safety and health. Translation research is needed to disseminate barriers and aids to implementation of proven effective interventions to reduce use/misuse of prescription drugs (incl. opioids), illicit drugs, and other substances and the impact on traumatic injuries. Findings from this research need to be incorporated into standards, guidance and other influential documents. There is also a need to translate research findings into software products, applications and interactive webpages, short videos, and other communication products to maximize its impact on construction stakeholders.
BLS . 2017 Current Population Survey. Washington, DC: U.S. Department of Labor, U.S. Bureau of Labor Statistics, https://www.bls.gov/iag/tgs/iag23.htm
Cheng M, Sauer, BC, Johnson E, Porucznik C . Comparison of opioid-related deaths by work-related injury. Am J Ind Med 56:308-316.
Cook RF, Hersch RK, Back AS, McPherson TL . The prevention of substance abuse among construction workers: a field test of a social-cognitive program. J Prim Prev 25(3):337-357.
CPWR [2018a]. Hazard Alert: Opioid Deaths in Construction. Silver Spring, MD: CPWR-The Center for Construction Research and Training. https://www.cpwr.com/sites/default/files/publications/Opioids-Hazard-Alert.pdf
CPWR [2018b]. The Construction Chart Book—The US construction industry and its workers. Silver Spring, MD, CPWR-The Center for Construction Research and Training, https://www.cpwr.com/publications/research-findings-articles/construction-chart-book
CPWR . Quarterly data report. Fall injuries and prevention in the construction industry. Silver Spring, MD: CPWR- the Center for Construction Research and Training, http://www.cpwr.com/sites/default/files/publications/Quarter1-QDR-2017.pdfpdf iconexternal icon
CPWR . The construction chartbook. Fifth Ed. Silver Spring, MD: CPWR- the Center for Construction Research and Training. http://www.cpwr.com/publications/construction-chart-bookexternal icon
Goldman Sachs . Drones reporting for work. http://www.goldmansachs.com/our-thinking/technology-driving-innovation/dronesexternal icon.
Harduar Morano L, Steege A, Luckhaupt S . Occupational patterns in unintentional and undetermined drug-involved and opioid-involved overdose deaths – United States, 2007 – 2012. MMWR Morb Mortal Wkly Rep 67(33):925-930, https://www.cdc.gov/mmwr/volumes/67/wr/mm6733a3.htm
IFR . Executive summary world robotics 2016 industrial robots. Frankfurt, Germany: International Federation of Robotics. https://ifr.org/img/uploads/Executive_Summary_WR_Industrial_Robots_20161.pdf.external icon
Kowalski-McGraw M, Green-McKenzie J, Pandalai SP, Schulte PA . Characterizing the interrelationships of prescription opioid and benzodiazepine drugs with worker health and workplace hazards. J Occup Environ Med 59(11):1114-1126.
Lipscomb HJ, Glazner JE, Bondy J, Gaurini K, Lezotte D. . Injuries from slips and trips in construction. Appl Ergon 37:267–274
Massachusetts Department of Public Health . Opioid-related overdose deaths by industry and occupation, 2011-2015. Boston, MA: Massachusetts Department of Public Health, Occupational Health Surveillance Program. https://www.mass.gov/files/documents/2018/08/15/opioid-industry-occupation.pdf
OSHA  Workers’ compensation costs of falls in construction. Washington, DC: U.S. Department of Labor, Occupational Safety and Health Administration, https://www.osha.gov/doc/topics/residentialprotection/2012_fall_costs/index.htmlexternal icon
Pidd, K, Roche AM, Buisman-Pijlman F . Intoxicated Workers: findings from a national Australian Survey. Addiction 106(9):1623-33.
SAMHSA (Substance Abuse and Mental Health Services Administration) . Results from the 2017 National Survey on Drug Use and Health: Detailed Tables, Table 1.65A, B. Rockville, MD: SAMHSA, Center for Behavioral Health Statistics and Quality, September 7, https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2017/NSDUHDetailedTabs2017.pdf
Shislov KS, Schoenfisch AL, Myers DJ, Lipscomb HJ . Non‐fatal construction industry fall‐related injuries treated in U.S. emergency departments, 1998–2005. Am J Ind Med 54(2):128-135.
Thumula V, Liu T . Correlates of opioid dispensing. Report No. WC-18-48. Cambridge, MA: Workers Compensation Research Institute.
Tiesman HM, Konda S, Cimineri L, Castillo DN . Drug overdose deaths at work, 2011-2016. Inj Prev, http://dx.doi.org/10.1136/injuryprev-2018-043104external icon [ePub ahead of print]
Wickizer, TM, Branko K, Franklin G, Joesch J . Do drug-free workplace programs prevent occupational injuries? Evidence from Washington State. Health Serv Res 39:1 (Feb 2004).
Wiebe J, Vinje G, Sawka E . Alcohol and drug use in the workplace: a survey of Alberta workers. Am J Health Promot 9(3):178-181.
Note: Goal 6.19 was added in October 2019.