Two recent studies of occupational injuries and illness reaffirm important realities about danger and loss in the U.S. construction industry.

The Bureau of Labor Statistics (BLS) released an analysis of fatalities and injuries in 2003, the most recent year for which data was available.

As in all past years, construction had the highest number of fatalities (1,126) of any occupational sector. About one in five American workers killed was a construction worker. However, the construction industry rate of fatalities (11.7 fatalities per 100,000 workers) was fourth highest – behind agriculture, forestry, fishing and hunting (31.2), mining (26.9) and transportation and warehousing (17.5).

Within construction, laborers were the single largest category of fatalities (289). With a fatality rate of 25.1, laborers have a one in 4,000 chance of being killed on the job.

Construction ranked third in non-fatal injury incidence rate (behind transportation/warehousing and manufacturing) and second (behind transportation/warehousing) in cases with days away from work.

In a separate report, the Liberty Mutual Insurance Company – the nation’s largest provider of workers’ compensation insurance – released its annual assessment of the nature and cost of workplace injuries, adding year 2002 data to that collected since 1998.

Over the four-year period, the number of serious injuries (those that cause a worker to miss six or more days of work and establish eligiblity for workers’ compensation) has fallen. Nevertheless, the cost of these injuries has risen by 12.1 percent since 1998, including a dramatic increase of more than 50 percent in 2002, alone.

“The falling rate of serious injury demonstrates that many employers have improved safety and health at their worksites,” says LHSFNA Management Co-Chairman Noel C. Borck. “However, with costs continuing to rise, opportunities remain to improve the bottom line with still better risk management.”

A key element of improved risk management is a concrete assessment of the nature of injuries. The Liberty Mutual report offers some guidance. A close look at the three largest categories indicates that they are mostly sprain and strain injuries. By focusing efforts on limiting these types of injuries, employers can save themselves the most money.

“While the data is aggregate and not industry-specific,” says Borck, “it seems consistent with the general experience in construction. Many, many of our injuries are sprains and strains.”

While not the most common injuries, sudden on-set injuries (fractures of the ankle, foot or wrist are typical) have the longest median disability durations in construction. Because of their longer duration, these injuries are particularly costly for companies and their insurers.

In 2004, the Liberty Mutual study began an in-depth assessment of how these fractures occur.

Preliminary analysis indicates that falls to a lower level account for 31 to 41 percent of these fractures. Most frequently, these falls are from ladders, but scaffolding, roofs and non-moving vehicles are also common contributors. Struck-bys accounted for 38 percent of foot and 19 percent of ankle fractures.

Misstepping on uneven surfaces and slipping and tripping without a fall also contributed to many ankle and foot fractures. Wrist fractures were often the result of same-level falls.

Stronger fall protection training could have a dramatic impact on lost workdays by curtailing falls to lower levels. Same-level trips and slips are generally addressed in the context of sprain and strain prevention training.

“These data should be useful to companies who are trying to pinpoint the nature of the injuries they face so they can target their safety programs accordingly,” says Borck. “Persistent attention to these kinds of injuries should result in fewer injuries, a lower EMR and, eventually, a lower workers’ comp premium.”

For help devising a safety program that addresses ergonomic concerns, contact the Occupational Safety and Health Division.


Injury Type
$13.2 billion
Falls on Same Level
$6.2 billion
Bodily Reaction
$5.3 billion
Falls to Lower Level
$4.6 billion
Struck by Object
$4.4 billion
Repetitive Motion
$2.8 billion
Highway Incident
$2.6 billion
Struck against Object
$2.3 billion
Caught in or Compressed by
$1.9 billion
$0.4 billion
All Other
$5.8 billion
$49.6 billion