Construction Program

Burden, Need and Impact

man climbing a ladder

There were approximately 10.7 million workers in Construction in 2017. Although only 6.9% of the workforce, this sector accounted for 19.7% of the fatalities for U.S. workers. It also had approximately 198,100 occupational injuries and illnesses, 5.8% of the total.1 Although injuries and illnesses are challenging to track and are frequently undercounted, this is the best estimate available at this time.2

NIOSH strives to maximize its impact in occupational safety and health. The Construction Program identifies priorities to guide investments, and base those priorities on the evidence of burden, need and impact. Priority areas for NIOSH’s Construction Program include traumatic injuries (i.e. from falls), musculoskeletal disorders, hearing loss, respiratory exposures, non-standard work arrangements, opioid and other substance use disorders prevention, suicide prevention robotics, automation and exoskeletons. Workers in the construction industry face a number of hazards, which are well-documented by the NIOSH Worker Health Charts and the NIOSH-funded National Construction Center, CPWR—The Center for Construction Research and Training in The Construction Chart Book, 6th editionexternal icon and in their Quarterly Data Reportsexternal icon.


Falls are the leading cause of fatalities in construction. In 2017, 51% (367 of the total 713) of fall fatalities occurred in construction.1 Examining 1,005 fatal falls in construction between 2015 and 2017, approximately 32% were falls from roofs, 24% were falls from ladders, and 15% were falls from scaffolding.1 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.2

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. 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.

Many safety professionals feel that hazards are inadvertently a part of construction projects, but could be eliminated with more focused Prevention through Design (PtD) efforts.PtD principles seek to eliminate hazards and controlling risks to workers “at the source” or as early as possible in the life cycle of items or workplaces.


Intervention and translation research addressing engineering and design, education and training, communication, and administrative issues is needed to address falls in construction and achieve meaningful results. Research to reduce falls among higher risk groups is especially needed, along with research to understand and evaluate 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).

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, limited safety research addresses the efficacy and safety of collaborative robots, mobile robots, and aerial robots in construction environments. 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.

Integrating occupational health and safety into the design of buildings helps keep workers in construction and maintenance, building occupants and demolition specialists safe and healthy. The NIOSH Construction and Prevention through Design (PtD) programs are collaborating on efforts to increase the use of building designs and construction practices that address safety and health hazards during all the stages of a building: pre-design; design; construction; occupancy and maintenance; and demolition. Additional work in this area is needed to continue the momentum that NIOSH has built, and the prospects for reducing construction illnesses and injuries using this approach are great.


The National Campaign to Prevent Falls in Construction encourages everyone in the construction industry to work safely and use the right equipment to prevent falls, especially falls from roofs, ladders and scaffolds. Launched in April 2012, the National Campaign grew out of multi-stakeholder discussions in the NORA Construction Sector Council, a public-private partnership co-led by NIOSH. The signature event of the Campaign is the annual National Safety Stand-Down, where companies stop work in order to give a toolbox talk on fall prevention. From 2014 through 2019, Stand-Down activities alone reached tens of thousands of construction employers and approximately 2.5 million workers annually.4 Although fall related fatalities in the construction industry are too high, progress has been made. For example, in 2017 the number and rate of fall related fatalities among roofers fell in 2017.1 Also, the rate of fatal falls among laborers from by 25% from 2011 to 2017.1

Equipment meant to improve efficiency and productivity while working at height (e.g., aerial lifts, ladders) adds complexity to an already challenging work environment. NIOSH has conducted research to improve safety while working at elevation. Reports from NIOSH’s Fatality Assessment and Control Evaluation (FACE) investigations provide recommendations on how construction workers and manager can prevent fall hazards. OSHA adopted NIOSH’s fall protection harness study results in its final rule for the 2016 update of the Walking-Working Surfaces and Fall Protection Standardsexternal icon.

Understanding that workers using aerial work platforms and equipment needs training, NIOSH researchers developed an educational tool and other products to create awareness about common workplace hazards when using aerial lifts. One such tool is NIOSH’s Aerial Lift Hazard Recognition Simulator. Employers, trainers, safety professionals, and other users can download this step-by-step guide designed to help potential aerial lift operators acclimate to aerial lift operation.

NIOSH has also developed a Mast Climbing Work Platform Daily Inspection Walkthrough Tool to help workers using mast climbers to identify common hazards. This educational resource can help employers, trainers, and safety and health professionals to prevent work-related falls. This free daily inspection walkthrough tool allows mast climber users to navigate through what is commonly inspected during a pre-shift daily inspection.

Fatalities and severe injuries can result from workers falling through roof and floor openings, and existing skylights. NIOSH worked with residential carpenters to design, develop, and patent a multifunctional guardrail system for use in residential and commercial-industrial work sites to prevent workers from falling to lower levels. The system sells commercially as The Protector Guardrail System.5

NIOSH developed and saw the adoption of a pilot credit for Leadership in Energy & Environmental Design (LEED) building certification by the U.S. Green Building Council (USGBC). The pilot credit promotes the use of prevention through design (PtD) methods to design-out worker hazards during construction and subsequent building operations and maintenance. Two webinars describing the PtD pilot credit are available to LEED users through the USGBC’s website. As of 2019, there were 217 projects that had registered to us the pilot credit. Approximately 68% of those registered to use the credit were awarded.

  1. CPWR [2019]. Quarterly data report. Trends of Fall injuries and prevention in the construction industry. Silver Spring, MD: CPWR- the Center for Construction Research and Training, iconexternal icon
  2. OSHA [2012] Workers’ compensation costs of falls in construction. Washington, DC: U.S. Department of Labor, Occupational Safety and Health Administration, icon
  3. Toole TM, Gambatese J [2008]. The trajectories of Prevention through Design in c J Saf Res 39(2):225-230
  4. CPWR [2020] National Campaign to Prevent Falls in Construction Evaluation Efforts. Silver Spring, MD: CPWR – (The Center for Construction Research and Training) icon
  5. NIOSH [2018]. NIOSH Construction Program: Evidence package from 2007-2017. Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, icon


Within the construction sector, 44% of workers are exposed to hazardous noise and about 31% of these noise-exposed workers report not wearing hearing protection.1 Thirteen percent of all construction workers have hearing difficulty and 7% have tinnitus.2 However, among noise-exposed construction workers, twenty-five percent have a material hearing impairment (average hearing threshold levels above 25 dB for 1, 2, 3, & 4 kHz) in at least one ear3 and 16% have hearing impairment in both ears.2 Hearing impairment is hearing loss that impacts day-to-day activities. Almost three-quarters (73%) of construction workers measured in a longitudinal study between (1999-2009) were exposed daily to full-shift, noise levels above the NIOSH recommended exposure level (REL) of 85 dBA.4 Many construction workers are also exposed to impulse or impact noise. Noise exposures are caused by a wide range of sources, including hand tools, larger machinery, heavy equipment, and generators.


Noise control engineering solutions are the most effective methods to reduce noise exposures and to assure the exposure levels stay below the NIOSH REL of 85 dB(A). Noise controls need to be developed and evaluated in the laboratory, followed by work with manufacturers to evaluate the feasibility of the noise control solutions through field studies. Noise hazards posed by power tools and heavy equipment in construction need to be controlled at the source. There is also a need to develop quieter powered hand tools. Researchers should continue to promote and develop “Buy Quiet” approaches that address supply and demand, in addition to development of databases of tools and the noise levels produced when operated. Noise labeling with the level of noise produced by equipment or use of Safety Data Sheets documenting the hazardous noise and the means to protect against it is also helpful. Areas in need of research include reducing impulsive noise generated by pneumatic tools and continued expansion of the ability to assess and control noise in construction.


Buy Quiet programs can play an important role in protecting workers from these dangerous noise levels. In addition to reducing the risk of hearing loss at the worksite, Buy Quiet programs help minimize the impact of occupational hearing loss on communities and help companies comply with OSHA and other noise regulation requirements. Buy Quiet may also reduce the long-term costs of audiometric testing, personal protective equipment, and workers’ compensation. NIOSH has led efforts to promote Buy Quiet, by developing a NIOSH Power Tools Database to make noise data available to tool buyers, users, and manufacturers of powered hand tools. This area targets the top of the hierarchy of controls and is likely to have significant impact in reducing noise induced hearing loss.

Health and safety professionals are using the NIOSH Sound Level Meter (SLM) application (or app) to assess risks, similarly to how they would use a professional sound level meter; workers can use the app to make informed decisions about potential  workplace hearing hazards. The NIOSH SLM app displays the sound level captured using the built-in microphone (or external microphone if used) and reports the instantaneous sound level in A, C, or Z-weighted decibels. Many construction and other organizations’ websites or their publications have highlighted the SLM app and its benefits for use in construction. A new Construction Noise & Hearing Loss Prevention Training Program was released in February 2018. The program incorporates findings from both NIOSH and CPWR research and includes a series of in-class and hands-on exercises using the NIOSH Noise SLM app.

NIOSH researchers also evaluate noise controls on construction equipment. Researchers tested a jackhammer shroud (jacket) and bellows (expanding tube) to reduce the noise radiating from the jackhammer body which reduced noise up to 4 dB for some jackhammers (because decibels are measured on a logarithmic scale, a 3-dB reduction is a 50% reduction in sound pressure level).  NIOSH researchers also collaborated with the University of Cincinnati to investigate noise controls for pneumatic nails guns. Applying a noise-absorbing foam to the outside of the nail-gun was a simple and effective noise-reduction technique. Researchers also designed and applied small mufflers to the nail gun exhaust, which were effective. This result indicated an overall noise level reduction by as much as 3.5 dB, suggesting that significant noise reduction is possible in construction power tools with minimal costs.

NIOSH also contributes to voluntary consensus standards related to noise exposure. NIOSH construction researchers participated in the development of a Society of Automotive Engineers International Standard that considers productivity, hand-arm vibration, noise, other safety and health factors, and life-cycle costs in procurement criteria for powered hand tools. This standard references NIOSH research on noise, vibration, and ergonomics. It also builds on other NIOSH efforts including the Buy Quiet Initiative and Prevention through Design. The U.S. Government Services Administration used this standard in an evaluation of powered hand tools, currently making approximately 140 quieter, lower-vibration, ergonomic tools available to federal users and aerospace original equipment manufacturers, while identifying new products based on customers’ supply support requests.

In efforts to reduce hearing loss in construction and bring NIOSH’s research to practice, NIOSH, working through the OSHA-NIOSH-CPWR r2p Work Group, co-authored and co-branded with CPWR a series of noise infographics, including some focused on Buy Quiet and Noise. These infographics pulled information from existing resources: the NIOSH’s Power Tools Database, the results of earlier research with the United Brotherhood of Carpenters and Joiners of America, and the CPWR Construction Chart Book. NIOSH redesigned the Noise and Hearing Loss Prevention topic page, and CPWR created a Preventing Hearing Loss topic page with a link to a Noise Infographics page to help promote the infographics. In 2016 and 2017, NIOSH and CPWR worked collaboratively, actively promoting the infographics to draw attention to NIOSH Buy Quiet resources and to CPWR’s resources related to noise in the construction industry, including Spanish-language materials.

  1. Tak S, Davis RR, Calvert GM [2009]. Exposure to hazardous workplace noise and use of hearing protection devices among US workers — NHANES, 1999-2004. Am J Ind Med 52(5):358-371.
  2. Masterson EA, Themann CL, Luckhaupt SE, Li J, Calvert GM [2016]. Hearing difficulty and tinnitus among U.S. workers and non-workers in 2007. Am J Ind Med 59:290-300.
  3. Masterson EA, Deddens JA, Themann CL, Bertke S, Calvert GM [2015]. Trends in worker hearing loss by industry sector, 1981-2010. Am J Ind Med 58:392-401.
  4. CPWR (The Center for Construction Research and Training) [2010]. The construction chart book. Silver Spring, MD: The Center for Construction Research and Training, iconexternal icon


Work-related musculoskeletal disorders (WMSDs) are common among construction workers due to the nature of the physically demanding work. In 2017, the rate of WMSDs in construction was about 9% higher than the rate for all industries combined.1 Lifetime risk of “overexertion” injuries in construction is about 21%, so more than 1 in 5 construction workers might be expected to get an overexertion injury during their career.2 Some of the trades that have elevated rates of overexertion injuries include masonry, concrete, drywall, plumbing, and flooring among others.3

Back injuries accounted for 42% of WMSDs in construction in 2017, the most common body part affected. The proportion of back injuries in construction was almost 2.6 times higher than all industries combined Construction trades with the highest rates of back injuries include masonry, roofing, drywall, plumbing, and glass and glazing. Many of these workers have an elevated or disproportionate risk including Hispanic workers, foreign-born workers, workers in small businesses, contingent workers, and older (55 and over) workers.3  


Prevention of WMSDs has been a major focus of NIOSH research for many years, especially ergonomic interventions.3,4 Ergonomic interventions often pay for themselves by improving productivity as well as reducing injuries.5 MSDs are a primary cause of occupational injuries and represent the largest portion of workers compensation costs. However, contractors may not understand the return on investment that comes from making ergonomics changes. Research is needed on methods to effectively transfer knowledge and intervention into workplace practices.

With changes in technology, novel approaches to risk reduction are being developed. For example, robotics, automation, and exoskeletons (or human augmentation devices) can be used to improve safety and reduce MSD risk factors that can cause back injuries, strains, and sprains. These devices are rapidly appearing in the workplace despite limited research on their effectiveness in reducing MSDs. When new technologies enter the workplace, their impact needs to be studied. Research is needed to identify the costs and benefits of the intervention (including any productivity gains).


NIOSH has published two documents that provide easy to understand information about simple and readily available work practices and equipment to prevent injuries: Simple Solutions for Home Building Workers: A Basic Guide for Preventing Manual Material Handling Injuries and Simple Solutions: Ergonomics for Construction Workers. NIOSH maintains effective partnerships with key stakeholders who have adopted and disseminated previous research outputs.

NIOSH research is often transferred into practice through partnerships. An Ergonomics Community of Practice (ECP) was established and facilitated by the NIOSH-funded CPWR-Center for Construction Research and Training to bring together researchers and industry stakeholders with a shared interest in addressing ergonomic issues in the construction industry. The ECP includes representatives from academia, organized labor, insurance companies, and the construction industry that use the research findings as the basis for creating and disseminating translational products—these include commercially available tools and equipment that contractors, workers, and trainers can use on jobsites.  For example, ECP used NIOSH-funded study results on MSDs in floor-layers in the development of their pilot social marketing program focused on reducing manual materials handling.

CPWR also participates in a Masonry r2P Partnership with the International Union of Bricklayers and Allied Craftworkers (BAC), the International Council of Employers (ICE), and the International Masonry Institute (IMI) to increase awareness and use of tools, materials, and work practices that have been found to reduce workers’ risk for injury or illness in the masonry industry. A NIOSH funded study provided strong evidence that forceful, frequent hand activity is an independent risk factor for carpal tunnel syndrome (CTS) and other MSDs influenced the decision of the Masonry r2p Partnership to raise awareness of carpal tunnel syndrome risks and effective interventions.6,7 The Partnership developed the website to provide industry stakeholders with ready access to evidence-based information on how to select and use common masonry hand tools to avoid carpal tunnel syndrome.

NIOSH research has been commercialized. Recent NIOSH vibration studies on grinding, welding, bucking bars, and mechanical assist arms have resulted in technical improvements to reduce vibration emissions.8,9 Several tool and glove manufacturers have communicated to NIOSH scientists how they have applied NIOSH’s experimental results and subject matter knowledge to development of their product. Similarly, a NIOSH-funded study developed a support rig for pneumatic rock drills or large hammer drills to reduce the risk of MSDs and improve usability of the rig. Ergomek Inc., a U.S. manufacturer, produces and distributes a commercial version of the drill rig, called the DrillBoss. Large civil and commercial construction contractors purchase the DrillBoss.

Several NIOSH studies have advanced the knowledge of human vibration and helped develop new methods and a standard for assessing the risk of the vibration exposure at workplaces.10 Several glove developers and manufacturers (Impacto, Chase Ergonomics, and Eureka Safety) have incorporated NIOSH suggestions into their gloves.

NIOSH developed a Revised NIOSH Lifting Equation (RNLE) mobile application (app). The app helps to: (1) raise worker awareness about risks associated with manual lifting; (2) inform workers about the potential hazards to their musculoskeletal health; and (3) serve as a job design guide for manual lifting tasks. The app provides instant information to help workers or their managers effectively control risks associated with the lifting task. The mobile app became available through Apple iTunes and Google Play stores in August 2017.

  1. CPWR [2019]. Quarterly data report. Trends of musculoskeletal disorders and interventions in the construction industry. Silver Spring, MD: CPWR – National Center for Construction Research and Training,
  2. Dong X, Ringen K, Welch L, Dement J. [2014]. Risks of a lifetime in construction, part I: traumatic injuries. Am J of Ind Med 57(9):973-83. doi: 10.1002/ajim.22363. Epub 2014 Jul 24
  3. CPWR [2013]. The Construction Chartbook. Fifth Ed. Silver Spring, MD: CPWR- the Center for Construction Research and Training, icon
  4. NIOSH [2007]. Simple Solutions: Ergonomics for Construction Workers. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2007–122, icon
  5. Hendricks H [1996]. Good ergonomics is good economics, iconexternal icon
  6. Dale AM, Harris-Adamson C, Rempel D, Gerr F, Hegmann K, Silverstein B, Burt S, Garg A, Kapellusch J, Merlino L [2013]. Prevalence and incidence of carpal tunnel syndrome in US working populations: pooled analysis of six prospective studies. Scand J Work Environ Health 39(5):495–505.
  7. CPWR [2017]. Safety & health: hand tools. Silver Springs, MD: CPWR—The Center for Construction Research and Training, icon.
  8. Chen Q, Lin H, Xiao B, Welcome D, Lee J, Chen G, Tang S, Zhang D, Xu G, Yan M, Yan H, Xu X, Qu H, Dong R [2017]. Vibration characteristics of golf club heads in their handheld grinding process and potential approaches for reducing the vibration exposure. Int J Ind Ergon 62:27–41.
  9. McDowell TW [2015]. Laboratory and workplace assessments of rivet bucking bar vibration emissions. Ann Occup Hyg 59(3):382–397.
  10. ISO [2017]. ISO/TR 18570 Mechanical vibration—measurement and evaluation of human exposure to hand transmitted vibration—supplementary method for assessing risk of vascular disorders. Geneva, Switzerland: International Organization for Standardization.


Many construction tasks generate complex airborne hazards. Exposure to mineral dusts occurs during many different construction activities, notably abrasive blasting, jack hammering, rock or well drilling, concrete drilling, tuck-pointing, cement finishing, brick and concrete block cutting and sawing, excavating, and highway work. In 2015, the U.S. Bureau of Labor Statistics (BLS) found approximately 500 nonfatal work-related “respiratory conditions” among construction workers.1

A large survey on the U.S. population aged 50 years and older, found that construction trade workers also had a higher percentage of deaths from respiratory diseases than their white-collar counterparts (13.4% versus 8.9%). 1 Construction activities and subsequent exposures can result in respiratory diseases (e.g., silicosis, asbestosis, chronic obstructive pulmonary disease [COPD], and lung cancer), and reduce a worker’s length and quality of life. Mixed exposures of particular current concern are welding fumes, those associated with abrasive blasting and those associated with the use of emerging advanced materials such as nanomaterials. Construction workers continue to be exposed from previously-installed asbestos containing materials in old buildings that is disturbed by renovation or demolition. An emerging issue potentially affecting construction workers is exposure to noncommercial elongate mineral particles (EMPs) with potential for asbestos-like health effects. These materials can be encountered by disturbing natural deposits during construction activities, or by using materials such as crushed stone products contaminated with EMPs.2


Workers and contractors need to recognize the hazards posed by complex airborne exposures, understand the risk factors, and take appropriate precautions. The research needed varies by agent and exposure. There is a need for basic/etiologic research to identify potential health hazards of new and emerging agents (such as nanomaterials, advanced manufacturing materials, and abrasive blasting agents); and improve understanding of dose-response relationships and use that information to better determine how much of a reduction in exposure is needed to prevent adverse health effects from these fibers. Surveillance research is needed to develop novel approaches for health and hazard surveillance that will improve the ability to track the burden of work-related illnesses. Intervention research is needed to improve the existence and performance of control technologies (engineering controls, personal protective equipment [PPE], etc.). There is also a need to evaluate the effectiveness of interventions.


As a member of the Silica/Asphalt Milling Machine Partnership, the Construction Program contributed to the groundbreaking Best Practice Engineering Control Guidelines to Control Worker Exposure to Respirable Silica during Asphalt Paving Milling. It was the culmination of more than ten years of collaborative research by labor, industry, and government to reduce respirable crystalline silica exposure during asphalt pavement milling in highway construction. Because of this research, all U.S. and foreign manufacturers of heavy-construction equipment that sell pavement-milling machines to the U.S. market agreed to put NIOSH evaluated silica dust controls on all new half-lane and larger asphalt milling machines. The average life of a milling machine is 5 to 10 years. Therefore, the outcome of this highway construction research is that new silica dust controls will be on at least half of the milling machines in the U.S. by 2021 and nearly all of U.S. machines by 2026. This will affect more than 367,000 U.S. workers employed in highway, street, and bridge construction. A study by the RAND Corporationexternal icon found that the value of these new dust controls from risk reductions in fatal and nonfatal illnesses ranged from $304 million to $1.1 billion per year, with an average of $692 million and contributed to an annual savings of $4.9 million in medical costs and lost productivity from fatal lung cancers.3

NIOSH surveillance data on silicosis mortality was used to support the development of  the OSHA Final Rule for Occupational Exposure to Respirable Crystalline Silicaexternal icon (RCS), including standards for construction, maritime, and general industry  published in 2016.  A significant portion of NIOSH research referenced in the standards related to either sampling and analytical methods or to engineering controls. Table 1pdf iconexternal icon of the construction silica standard is a list of 18 common construction tasks known to generate respirable crystalline silica dust, with engineering and work practice controls and respiratory protection prescribed for each task. Most of the entries in Table 1 relied upon NIOSH engineering control research for controlling RCS.

Advances in the availability of engineering controls for RCS exposure came about, at least in part, due to relationships between researchers and the manufacturing sector. In 1994, the CPWR-NIOSH Engineering Controls Work Group, a group of researchers, contractors, labor organizations, and government workers began meeting regularly with the goal of encouraging advances in engineering control research and research-to-practice (r2p) for the construction industry. The Work Group serves as a forum for government, academic, and industry representatives to share information on control technology research. Engineering controls for RCS has been an important priority for the work group. NIOSH construction researchers and their partners have investigated and developed engineering controls for RCS. The Work Group collaborates with CPWR’s r2p staff to get the control technology into practice on construction jobsites.

Engineered stone countertop products can contain >90% crystalline silica and working with this material during fabrication and installation causes excessive exposures to RCS. Nineteen cases of silicosis and 2 deaths among engineered stone countertop workers have been reported so far.4 NIOSH researchers conducted field studies in several other workplaces to measure the effectiveness of wet grinding and polishing in reducing worker exposures. Data collected to date show that existing engineering controls may not sufficiently protect workers’ health. These investigations are ongoing. Trade associations such as the Natural Stone Institute now produce training resources to assist employers in the stone countertop industry in protecting their workers. NIOSH published a NIOSH/OSHA alert on exposure to silica during countertop manufacturing, finishing and installation.

Fiber cement building products contain as much as 50% crystalline silica so cutting them can put workers at risk of exposure. NIOSH researchers found that using simple and low-cost local exhaust ventilation attached to dust-collecting circular saws to be effective in reducing worker exposure. NIOSH developed a Workplace Solution: “Reducing Hazardous Dust Exposure When Cutting Fiber-Cement Sidingpdf icon” that talks about this hazard and includes some recommended controls. At least two fiber cementexternal icon manufacturerspdf iconexternal icon recommend the dust controls tested by NIOSH researchers, and OSHA specified controls for cutting fiber cement board in Table 1 of the Construction Silica Standard based upon NIOSH research.

  1. CPWR [2018]. The construction chartbook. Sixth Ed. Silver Spring, MD: CPWR- the Center for Construction Research and Training. icon
  2. NIOSH [2011]. Asbestos fibers and other elongate mineral particles: state of the science and roadmap for research [Revised April 2011]. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2011-159,
  3. RAND [2017] Understanding the Economic benefit associated with research and services at the National Institute for Occupational Safety and Health: an approach and three case studies. Santa Monica, CA: RAND Corporation,
  4. CDC [2019]. Severe Silicosis in engineered stone fabrication workers — California, Colorado, Texas, and Washington, 2017–2019. Morbidity and Mortality Weekly Report (MMWR),


Construction industry jobs often involve short-term contracts. Relatively few construction jobs are considered “standard work arrangement.” Recently, nontraditional or nonstandard-work arrangements have become more common including use of on-call workers, day laborers, workers provided by contract firms, and gig workers. Studies have shown disproportionate risk for occupational injuries and illnesses associated with nonstandard work arrangements.1 Nonstandard work arrangements are more common in construction than for all industries combined, and nonstandard work arrangements in construction feature more independent contractors and less temporary help agency workers than other industries. In 2017, according to CPWR about 30% of construction workers were employed in nonstandard work arrangements; 22% were independent contractors and 8% were in alternative arrangements, and workers in contract firms

The opioid overdose epidemic has impacted construction workers more than other occupational groups. In 2007–2012, the percentage of opioid-related overdose deaths was higher in construction than in all occupation groups combined.2


Non-standard work arrangements are understudied but increasingly prevalent, and their determinants and health and safety consequences are poorly understood. Surveillance research is needed to better characterize and track risk factors for construction workers in non-standard work arrangements, as well as the burden suffered by the workers and their families, employers, and society. Translation research is needed to identify and disseminate barriers and aids to implementation of proven effective interventions to reduce health and safety hazards for workers in non-standard work arrangements. Intervention research is needed to evaluate the determinants and consequences of existing and new work arrangements.

There is a need within the construction industry to better understand the risks to construction worker safety, health, and well-being.  These risks need to be examined holistically to examine both occupational and non-occupational factors and the interaction between them.  Intervention research is needed to improve our understanding of the value of Total Worker Health® (TWH) programs, policies, and practices for the construction worker and their ability to improve workplace safety and health outcomes. There is also need for continued research to better understand the benefits of integrated approaches to prevention and to promote more comprehensive interventions. Many questions remain 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 interventions.


Many temporary workers in construction are employed through staffing agencies. These workers have two employers—a staffing company and a host employer— so there is sometimes confusion regarding which aspects of health and safety each employer has responsibility. To help address this, NIOSH and OSHA released Protecting Temporary Workers, a document of recommended practices. In addition, CPWR released a Quarterly Data Report on Opioid Deaths in Construction in 2018 and an important new Quarterly Data Report on Nonstandard Work Arrangements in 2019.1,3 The Construction Program will continue to develop recommendations to help reduce injuries and illnesses among workers in non-standard work arrangements.

  1. CPWR [2019]. Nonstandard work arrangements in the construction industry. Silver Spring, MD: CPWR – Center for Construction Research and Training, iconexternal icon
  2. Harduar Morano L, Steege A, Luckhaupt S [2018]. 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,
  3. CPWR [2019]. Overdose fatalities at worksites and opioid use in the construction industry. Silver Spring, MD: CPWR – Center for Construction Research and Training, iconexternal icon


1NIOSH [2019]. Current U.S. Workforce Data by NORA sector. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health,
2 BLS [2016]. An update on SOII undercount research activities. Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics, icon

Page last reviewed: October 23, 2018