Surveillance
of Construction Workers in North Carolina, Ohio, and Missouri
(Summary of Final Report to CPWR : January 2001)
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John M. Dement,
PhD, CIH
Hester Lipscomb, PhD
Carol Epling, MD, MPH
Tejas Desai, MS
Leiming Li, MS
Barbara De Larco, BS
Duke University Medical Center (Division of Occupational and Environmental
Medicine)
A study
of North Carolina records of deaths over 10 years found that construction
workers have a high risk of deaths from accidental falls from elevations,
transportation injuries (as drivers, passengers, and pedestrians), and
electrocutions, mostly when equipment contacts a power line or other electrical
source (see table 1).
In the death records of 43,900 men for whom construction was listed as
the usual occupation, even if they had retired, the analysis found a high
risk of deaths for some trades for lung illnesses (such as lung cancers,
asbestosis, emphysema, or silicosis) and diseases such as cirrhosis of
the liver and mouth cancer, which are tied to a combination of factors,
including tobacco use, alcohol use, and exposures to some solvents or
metals (table 2).
John Dement and five
coworkers at the Duke University Medical Center, in North Carolina, looked
at all causes of deaths, not just those listed as work-related. That approach
is important because no one knows how many construction workers die each
year from illnesses that may have come from their jobs. The problem is
workers may not get sick for many years after they've been exposed on
the job to hazards like metal fumes that can cause cancer or to silica.
The authors used
PMRs (proportionate mortality ratios), statistics that show the risk of
death for construction workers compared with all men in North Carolina
matched by race, age, and sex. For instance, roofers had a PMR for respiratory
tuberculosis of 453, more than four times the usual risk.
In addition, injury
claims were compared for three groups residential construction
in North Carolina, residential construction in St. Louis, and union carpenters
in Ohio. "Struck by/against" and overexertion (sprains and strains)
were the first and second most common cause of injury for each of the
three groups. Falls from elevations were also a common problem for the
groups.
In terms of costs, in North Carolina, of 9,205 homebuilder claims, falls
were the most costly claims for six of the trades: carpenters, drywall
installers, insulators, masons, painters, and plumbers; roofers were not
included in the data (table 7). Falls were the most expensive of 838 carpenter
claims in St. Louis (table 8).(Costs were not calculated for the Ohio
claims.)
The authors looked
closely at 553 injuries by nail guns "struck by" injuries
and found that pneumatic nail guns caused more than 4% of workers'
compensation claims. The tools caused 97% of puncture wounds in residential
work, two-thirds of the time after a trigger mechanism safety doesn't
work or is bypassed, causing an unwanted discharge or misfire.
Among the authors'
recommendations:
- Careful compliance with OSHA standards to protect workers from
exposures to silica and asbestos
- Research to prevent falls, transportation injuries, electrocutions
(from contact with power lines), and "struck by" injuries, including
those from nail guns
- Interventions to reduce sprains and strains from heavy and repetitive
lifting, often in awkward postures
- Programs to prevent smoking and alcohol abuse.
Besides Dement, the
researchers were Hester Lipscomb, Carol Epling, Tejas Desai, Leiming Li,
and Barbara De Larco. For statistical reasons, the study focused on men,
although some women who worked in construction were killed or injured.
The work was done as part of CPWR's cooperative agreement with the National
Institute for Occupational Safety and Health, NIOSH, which is part of
the CDC.
For more information,
contact CPWR, at 301-578-8500.
1.
Selected causes of deaths, male construction workers, North Carolina,
1988-97
Cause
of death |
(PMR) |
#
of deaths |
Asbestosis |
(270) |
26 |
Electrocutions |
(220)
|
73 |
Silicosis |
(191) |
10 |
Alcoholism |
(142)
|
423 |
Homicide |
(141)
|
1,379 |
Mouth
and pharynx cancers |
(132)
|
303 |
Accidental
poisoning |
(139)
|
359 |
Larynx
cancer |
(125) |
151 |
Cirrhosis
of liver |
(125)
|
912 |
Accidental
falls |
(123)
|
317 |
Lung
cancers |
(113)
|
4,388 |
Pneumoconiosis |
(112)
|
2,073 |
Transportation
accidents |
(108)
|
2,120 |
Note: Statistically significant (p<0.05) proportionate mortality ratios
for 10 years and 43,939 deaths (compared to male population matched
for age, race, and sex in North Carolina), listed as usually working
construction (SIC 15, 16,17), who lived and died in North Carolina;
list is not all-inclusive. PMR above 100 means a higher risk of death;
200 shows twice the risk. Accidental poisoning usually involves alcohol.
Mouth cancers may be tied to a mix of factors, such as tobacco use,
alcohol use, and exposures to some metals and solvents. Pharynx includes
nasal passages and area in back of throat. Transportation accidents
include pedestrian deaths. |
2.
Selected causes of deaths, by trade, male construction workers, North
Carolina, 1988-97
Occupation |
Cause
of death (PMR) |
Brick/stone
masons, tile setters |
Asbestosis
( 400), accidental falls (169) |
Carpenters |
Alcoholism
(171), homicide (161) |
Concrete,
terrazzo finishers, glaziers |
Liver
cirrhosis (204) |
Drywall
installers |
Asbestosis
(2,639), accidental poisoning (227) |
Electricians |
Alcoholism
(178) |
Insulators |
Asbestosis
(10,700), homicide (209), lung cancer (173) |
Laborers |
Mouth
cancer (261), alcoholism (149) |
Operating
engineers |
Emphysema
(172) |
Painters,
paperhangers, plasterers |
Alcoholism
(198), accidental poisoning (192), throat/neck cancer (178), homicide
(169),
liver cirrhosis (158) |
Plumbers,
pipefitters, steamfitters |
Asbestosis (1,214), liver cirrhosis (158) |
Roofers |
Respiratory
TB (453), mouth cancer (299), accidental falls (285), throat/neck
cancer (218), homicide (204) |
Welders,
cutters |
Silicosis
(1,932), asbestosis (938), accidental falls (310) |
Note: Selected statistically significant (p<0.05) proportionate
mortality ratios for deaths (compared with male population in North
Carolina matched for age, race and sex), over 10 years listed as usually
working construction (SIC 15, 16,17), who lived and died in North
Carolina; list is not all-inclusive. PMR above 100 means a higher
risk of death; 200 shows twice the risk. Accidental poisoning usually
involves alcohol. Mouth cancers may be tied to tobacco use and alcohol
abuse. Transportation accidents include pedestrian deaths. |
3. Leading causes of injuries, by trade, residential construction,
North Carolina, 1996-99
|
Cause
of injury |
%
of total for trade
(no. of claims for
Cause of injury that cause) |
Brick,
stone masons |
Overexertion |
26%
(107) |
Carpenters |
Struck |
26%
(1,085) |
|
Overexertion |
18%
(762) |
Concrete,
terrazzo finishers |
Overexertion |
26%
(107) |
|
Struck
by |
25%
(105) |
Drywall
installers |
Fall
from elevation |
28%
(70) |
|
Overexertion |
22%
(55) |
Electricians
|
Struck
by |
21%
(108) |
|
Cut |
21%
(107) |
Insulators |
Fall
from elevation |
28%
(21)* |
Mechanics,
repairers |
Struck
by |
20%
(118) |
|
Cuts |
18%
(106) |
Operating
engineers |
Struck
by |
28%
(55) |
Painters,
paperhangers |
Fall
from elevation |
24%
(106) |
|
Overexertion |
22%
(99) |
Plumbers |
Overexertion |
24%
(62) |
|
Struck
by |
23%
(60) |
*Insulators had the highest estimated rate of falls 1997-98, followed,
in order, by carpenters and drywall installers, then painters; but
laborers and roofers were not included in these comparisons.
Note: Based on 9,205 claims filed with North Carolina Residential
Homebuilders' Association for 41 months, July 1996-November 1999.
Laborers and roofers were not included; numbers for welders were too
small to be useful. Data include 16 fatal injuries. |
4. Most common causes of injuries, North Carolina residential
contractors, July 1996 - November 1999
Cause
of injury |
%
of total |
Number
of claims |
Struck
by/against |
23%
|
2,130 |
Overexertion |
21% |
1,922 |
Cut |
17%
|
1,552 |
Fall
from elevation |
14% |
1,247 |
Note: 7,500 contractors, 41 months, 9,205 claims to self-insured compensation
fund of the North Carolina Homebuilders' Association; data exclude
laborers and roofers. |
5. Most common causes of injuries, Ohio union contractors,
1994-97
Cause
of injury |
%
of total |
Number
of claims |
Struck
by/against |
50% |
1,888 |
Overexertion
|
14%
|
516 |
Abraded |
9% |
325 |
Fall
from elevation |
6% |
232 |
Note: 13,487 carpenters, 45 months, 1/1/94-9/30/97; 3,806 workers'
compensation claims with details available; rates based on union hours
logged. |
6. Most common causes of injuries, St. Louis residential
carpenters, 1995-99
Cause
of injury |
%
of total |
Number
of claims |
Struck
by/against |
26%
|
215 |
Overexertion |
18% |
151 |
Cut |
8% |
68 |
Fall
from elevation |
8% |
68
|
Puncture
wound |
7%
|
57 |
Note: 5 years, 1995-99, 838 claims. |
7. Most costly injuries, by trade North Carolina residential
contractors, July 1996 - November 1999
- Falls from elevations (carpenters, drywall installers, insulators,
masons, painters, plumbers)
- Overexertion (electricians, concrete and terrazzo, mechanics, engineers
and managers)
- Struck by (operating engineers)
Note: 7,500 contractors, 41 months, 9,205 claims to self-insured
compensation fund of the North Carolina Homebuilders' Association; data
exclude roofers.
8. Ranking of injuries by total and median workers' compensation
costs, St. Louis residential carpenters, 1995-99
Injury |
Total
cost |
Median |
Number |
Fall
from elevation |
$1,667,000 |
$2,631 |
68
claims |
Overexertion |
$980,000 |
$782 |
151
claims |
Struck
by/against |
$796,000 |
$450
|
215
claims |
Note: 5 years, 1995-99, from total 838 claims, St. Louis. The
median is the midpoint; half the claims cost more and half cost less.
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