Nonfatal falls in construction workers: Predictors of injury severity

This study evaluated injury severity in a group of construction workers who sustained nonfatal falls at work. The convenience sample consisted of 255 adults, predominantly males, with a mean age of 34 years (standard deviation (SD) = 9.31). A full range of construction trades was represented in the sample population. More than one quarter of the sample were union members, and more than half worked in residential construction. The mean height of fall was 9.23 feet (SD = 7.05). The mean number of lost work days was 44.3 days (SD = 58.6). Cases were identified from Doctor's First Reports submitted to the California Department of Industrial Relations. Data were obtained from these reports, structured telephone interviews, medical records, and two standardized instruments--the Safety Climate Measure for Construction Sites and the Job Content Questionnaire. Two measures of injury severity were used--the Injury Severity Score and the disability section of the Health Assessment Questionnaire (HAQ) measuring functional limitations. There were 518 injuries reported including 61 extremity fractures, and four head injuries with five skull and facial fractures. Thirty-two individuals were hospitalized, and 41 required surgery. Seventeen participants (8%) were deemed permanently disabled and unable to continue working in construction. A simultaneous multiple regression model, using five independent variables, explained approximately 21% of the variance in HAQ scores. Independent variables making significant unique contributions to the variance in injury severity were height of fall, surface landed on, Safety Climate Measure score, and union status. Nonunion status and higher safety climate scores (i.e., indicating increased risk) were positively correlated with higher HAQ scores, as were greater heights and concrete surface. Higher scores on both injury severity measures were significantly and moderately associated with a greater number of days lost from work. There were no significant differences in means among the trades for either injury severity measure. These findings confirm that falls in construction workers are far too common, suggest that injury severity and permanent disability associated with falls is notable, and identify key target areas for intervention and prevention such as management commitment to safety, ongoing worker training, and hazard identification and control.