Recently, several media outlets have reported on COVID-19 outbreaks on construction sites. If you only read the headlines (especially sensational ones), you might think COVID-19 cases are running rampant on construction jobsites. There’s not much data to support that, especially since there’s no nationwide system to track COVID-19 cases by occupation.

LIUNA General President
Terry O’Sullivan

“We commend all the steps that LIUNA District Councils, Local Unions, members and signatory contractors have taken to prevent the spread of COVID-19 on construction jobsites,” says LIUNA General President Terry O’Sullivan. “Their commitment to implementing the necessary safety and health protocols, and taking quick action when positive cases do occur, is why these essential projects have been able to remain open.”

In the construction industry, safety and health professionals often talk about getting to the root cause of injuries. The root cause is the fundamental, underlying reason why an incident occurred. The goal isn’t to point fingers or place blame, but to understand every link in the chain of events that led to the incident so it can be prevented in the future.

We need to apply the same concept to COVID-19 outbreaks in the construction industry. If we don’t identify the root causes behind cases and outbreaks, we risk choosing the wrong corrective measures. Rather than collecting anecdotal evidence to build a story about an entire industry, we need to dig into the root causes behind each individual outbreak.

For example, an investigation of an outbreak at a Colorado construction company traced the source to lax enforcement of wearing facial coverings in an enclosed area. The investigation noted that workers would wear their masks when new people were on the job, but when it was just their regular crew, management wouldn’t enforce wearing of masks or wearing them correctly. In another example, an outbreak at the construction site of a chemical plant in Pennsylvania was linked to either not having or not enforcing a physical distancing policy, which led to crowded buses bringing employees to and from work. In that instance, the employer also reported that contact tracing showed transmission was tied primarily to contact outside the jobsite.

These two examples alone illustrate how root cause investigations can lead to new policies or a redoubling of efforts to stem transmission. Because COVID-19 can be transmitted in several ways, and because transmission often starts off the job, root cause analysis is an effective tool that provides valuable information and context. An effective workplace COVID-19 risk assessment should also include the current level of community spread overall.

Another area where we need to be clear about root causes is when discussing COVID-19 hospitalizations and deaths in the construction industry. A recent study of construction workers in Texas generated a lot of headlines like this one: “Construction Workers Have Higher Risk of COVID-19 Hospitalization.” Headlines like these suggest that construction jobsites or tasks bring a higher risk for COVID-19 exposure. When we dig past the headline, however, we find that the risk is rooted in a lack of access to health care and the disproportionate impact COVID-19 is having on racial and ethnic minorities. As the study itself notes:

“Nearly 30 percent of the construction workforce in the U.S. are Latinx individuals … in Austin, 66 percent are Latinx individuals … Approximately 24 percent of all construction workers and nearly 48 percent of Latinx construction workers do not have health insurance and thus lack access to preventative care, have disproportionate comorbidities and are less likely to seek timely and safe treatment for COVID-19 infections. … Finally, transmission may be amplified by symptomatic cases continuing to work out of economic desperation and above-average sized households.”

The Fund recently covered the value of health insurance on improving worker health, including how union workers are far more likely to have access to health insurance through their employer. Texas has one of the lowest rates of unionization of any state, at only four percent. For more on the specific factors behind COVID-19’s disproportionate impact, see this month’s article, “COVID-19 Differs Widely Across Racial and Ethnic Lines.”

To limit the spread of COVID-19 and protect worker health and safety, we must be willing to read past the headlines and look at what’s truly driving new cases. Outbreaks can be caused by many factors, including inadequate infection control policies on the job, public health disparities or other causes. Performing root cause investigations and reviewing the science is the only way to ensure we have a full, accurate picture of the risks faced by construction workers.

[Nick Fox]