Unfortunately, everyone is well aware of the ongoing opioid crisis here in the U.S. and Canada. According to the Centers for Disease Control and Prevention (CDC), opioids killed more than 42,000 people in the U.S. in 2016, with 40 percent of those deaths involving a prescription opioid. Statistics show that workers in the construction industry are anywhere from five to seven times more likely to die of an opioid overdose than workers in other professions.
At this point, it’s a safe bet that all of us know someone who has been affected by opioids in some way or another. The opioid crisis is a complicated issue, and we’ve discussed many of its aspects in Lifelines over the last several years, including topics like stigma, addiction, rehab programs, Narcan, legal vs. illegal opioids, questions to ask your doctor and how to host an event around the issue. With so many factors, it can be tough to identify solutions or concrete ideas about what can be done to combat the crisis.
One perspective that doesn’t get discussed enough is the possibility of stopping the demand for opioids by preventing them from being needed in the first place. That means preventing pain before it starts and preventing workers from being hurt on the job. It’s easy to say, “Let’s focus on prevention by stopping injuries in the first place,” but how can construction employers actually accomplish that?

LHSFNA Management Co-Chairman Noel C. Borck
One solution is to put more emphasis on a program that’s often looked at with skepticism in construction. Yes, I’m talking about preventing musculoskeletal disorders (MSDs) through ergonomics – the practice of fitting the job to the worker. There’s a stigma against ergonomics programs in construction, with naysayers claiming it can’t be done, that it’s too expensive or that it’s too large a problem to address. Not too long ago, some people said the same thing about controlling dust clouds on construction sites. Naysayers said it couldn’t be done and would be too expensive. Now, we’re several years into a nationwide silica standard in construction and dust clouds are a thing of the past, construction is booming and new dust prevention best practices and technologies are emerging. Why couldn’t we make the same level of progress with reducing MSDs?
Not only are MSDs the number one source of workplace injury, but they are also the number one source of chronic injury in the workplace. MSDs are injuries and disorders that affect the body’s movement or musculoskeletal system (i.e., muscles, tendons, ligaments, nerves, discs, blood vessels, etc.). Workers’ compensation costs related to MSDs are estimated at between $15-20 billion a year. When factoring in additional costs, such as the loss of productivity due to absenteeism, that estimate rises to as high as $54 billion annually.
“Employers are already required to provide a safe workplace. Part of that safe workplace should include an effective ergonomics program,” says LHSFNA Management Co-Chairman Noel C. Borck. “A commitment to such a program can reduce the risk for injury on the job and could lower the need for prescription pain medications.”
When working conditions don’t take ergonomics into account, MSDs will almost inevitably be the result, so it’s critical to find solutions sooner than later. Assessment, training, management support and proper work practices can help proactively identify and eliminate ergonomic issues before they result in on-the-job injuries.
According to the National Institute for Occupational Safety and Health (NIOSH), effective ergonomics programs include the following elements:
- A person in charge of the program authorized to make decisions and institute change
- Active employee involvement in identifying problems and finding solutions
- A clearly defined administrative structure (such as a committee)
- A system to identify and analyze risk factors
- A system to research, obtain and implement solutions
- Worker and management training
- Medical care for injured workers
- Maintaining good injury records
- Regular evaluation of the program’s effectiveness
Employers should follow the hierarchy of controls graphic below to design work tasks that limit the risk for MSDs. Engineering controls are the most desirable when elimination or substitution can’t be used. Administrative or work practice controls may be appropriate in conjunction with engineering controls or when engineering controls cannot be implemented. Personal protection solutions have only limited effectiveness when dealing with ergonomic hazards.
Reducing the number of opioids prescribed to workers may also have other benefits. We may see a positive impact on workers’ ability to return to work after an injury. Workers under the influence of opioids while at work are likely to be at increased risk for injury. For workers in safety-sensitive jobs, such as transportation and operators of heavy equipment, that could also mean lower risks for catastrophic events that impact bystanders, including coworkers and the public.
With proper planning, foresight and a positive attitude about the possibilities of ergonomics programs, employers can do their part to reduce injuries and lessen the number of workers experiencing pain on the job.
For more information on MSDs, order the Fund’s Laborers’ Guide to Sprains and Strains in Construction pamphlet in our online Publications Catalogue. You can also read more on OSHA’s Ergonomics webpage or use this Materials Handling Contractor Planning Tool created by CPWR – the Center for Construction Research and Training.
[Travis Parsons is the LHSFNA’s Associate Director of Occupational Safety & Health.]