Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to page options Skip directly to site content

Burden, Need and Impact

There  were approximately 9.94 million workers in Construction in 2015. Although only 6.68% of the workforce, this sector accounted for 20.4% of the fatalities for U.S. workers. It also had approximately 212,700 occupational injuries and illnesses, 5.9% 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. The priority areas for the Construction Program are evolving as the third decade of NORA unfolds. Two priority areas that will continue are falls and green construction.

	man climbing a ladder


Workers in the construction industry face a number of hazards, which are well-documented by the NIOSH-funded National Construction Center, CPWR—The Center for Construction Research and Training in The Construction Chart Book, 5th edition. Falls are the leading cause of fatalities in construction. In 2014:

  • There were 353 fall fatalities out of 908 total fatalities in construction, a 16% jump (change to increase) in just one year. Deaths from falls are preventable.3
  • There were more fatal injuries in construction than any other industry in the United States, accounting for nearly 20% of the nation’s 4,679 work-related deaths that year.3
  • Falls account for 35% of the work-related deaths suffered by construction workers. Almost two-thirds of those fatal falls were from roofs, scaffolds, and ladders.3

Sustainable construction or “green construction” is growing at a rapid rate. Jobs in green construction grew by 27.1% between 2010 and 2011, more than six times the growth rate for all industries combined (4.5%).4 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.5,6 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.


Educating supervisors, managers, employers and owners of construction companies about the need for fall protection equipment to be provided and used by all workers who are at risk for falls is a key need.  Training for supervisors and workers on the proper use of fall protection equipment is equally important. 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 Campaign to Prevent Falls in Construction encourages everyone in the construction industry to work safely and use the right equipment to reduce falls, especially those from roofs, ladders and scaffolds. Launched in April 2012, the 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. Over one million construction workers were reached through the National Safety Stand-Down in 2015.

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. Since formal posting of the PtD pilot credit (February 2015), and making the webinar available (July 2015), more than 650 LEED education subscribers have completed the webinar. 


1National Institute for Occupational Safety and Health. (2015). Current U.S. Workforce Data by NORA sector.
2Bureau of Labor Statistics. (2016). An update on SOII undercount research activities.
3CPWR Data Center. (2015). Quarterly Data Report: Third quarter 2016. CPWR – The Center for Construction Research and Training.
4CPWR Data Center. (2014). CPWR Data Brief: Green Construction Update. CPWR – The Center for Construction Research and Training.
5Schulte PA, Rinehart R, Okun A, Geraci C, Heidel DS. (2008). National Prevention through Design (PtD) Initiative. Journal of Safety Research. 39(2): 115-121
6Toole TM, and Gambatese J. (2008). The Trajectories of Prevention through Design in Construction. Journal of Safety Research. 39(2): 225-230