Solutions for the Big Five

Nailing the top five disabling injury causes will build safer construction sites.

The construction industry reported 155,420 disabling work-related injuries in 2003, according to the Bureau of Labor Statistics. Of these, 109,400, or 70 percent, fell into five categories: overexertion, same-level falls, bodily reaction, falls from heights, and struck by object.

TRUE, the construction industry's disabling injury rate is steadily declining, but there is still room for improvement. Providing a safe work environment is the right thing to do and requires focusing on and developing practical safety program elements to address the causes of disabling injury. The time you invest will improve both your reputation and your bottom line.

Below are the top five causes of disabling injury as reported by Liberty Mutual's Workplace Safety Index. With them are corresponding prevention tips to help you make your work site safer.

Topping the List: Overexertion
Overexertion caused nearly 20 percent of all disabling injuries reported by the construction industry in 2003, making it the number one source of disability among construction workers. This is not a surprising statistic because pushing, pulling, lifting, and carrying materials--all are tasks that can lead to overexertion--comprise a large part of what construction workers do every day. Still, because of its culture, the construction industry has been slower to embrace ergonomic solutions while other industries have effectively redesigned jobs and use mechanical aids to reduce overexertion.

In construction, 80-pound loads are still acceptable. Workers may not even question the risk of performing heavy lifting or carrying tasks until they have suffered an injury. In reality, 80-pound loads should be the exception, not the rule. While it is reasonable to expect a well-conditioned male to lift an 80 pound weight on occasion, the Liberty Mutual Manual Materials Handling Tables indicate less than 13 percent, of men, and even fewer women, can do so on a repetitive basis without overexertion. By reducing weights to 40 pounds, more than 75 percent of the adult population can handle the load repetitively.

Practical issues such as the pressure to get projects done on schedule also keep construction companies from changing their practices. Addressing overexertion issues through means and methods takes time and may not seem to be worth the long-term benefits. Still, you can take some fairly simple measures to reduce overexertion injuries:

* Conduct an accident analysis. Identify where the majority of overexertion injuries happen, then perform a job safety analysis to determine how to minimize hazards.
* Employ team lifting where two workers perform manual materials handling tasks of more than 50 pounds.
* Train workers to lift in a linear and smooth fashion. Jerky motions and awkward body posture when handling and/or manipulating materials cause injury.
* Investigate the long-term payoff of mechanical aids before discounting such devices as unnecessary or too much trouble. Productivity gains usually result once employees get accustomed to the new equipment.

A Close Second: Struck by Objects
Right behind overexertion, "struck by object" is the most frequent cause of disabling injuries to construction workers. These injuries occur when workers are struck by wind-borne or falling debris or materials or when equipment malfunctions during use. Although typically low in severity, "struck by" injuries occur frequently, accounting for 18 percent of all disabling construction injuries reported in 2003.

Hard hats, safety boots, and safety glasses are obvious protections. But you also need to maintain and assess equipment periodically. For example, grinding wheels can break apart if not properly maintained, and the impact of the flying debris can be as severe as a bullet. Metal striking tools such as a hammer on a cold chisel or punch can also produce struck by injuries, because over time the head of the tool "mushrooms," allowing small pieces of metal to break and fly off when struck.

Even common power tools can be the source of struck by injuries. Each time a powered hand tool is used, the employee is exposed to reaction forces, or kickback, that can cause him to lose grip on the tool. These reaction forces carry a powerful punch and can cause the tool or material being worked to strike back at the worker, causing injury.

While it may be impossible to completely eliminate falling or flying materials on the job site, here are some pointers than can reduce struck by injuries:

* Coordinate work so that crews do not work above one another to prevent injuries from dropped tools or materials striking workers below.
* Keep sites free of unnecessary clutter and debris through proper housekeeping procedures and "clean as you go" policies.
* Inspect equipment routinely for wear and maintain/replace as needed. Install manufacturers' guards on grinding wheels and dress metal tool heads or grind off expanded, flattened metal to eliminate small pieces.
* Adjust power tool motor speed or clutch to fit the demands of the task, and always use the protective devices and guards that come with the tool.

Third: Falls from Heights
Despite many advances in fall protection equipment and safety regulations, falls from heights rank third in the top five causes of disabling injuries in construction because there is no easy way to prevent them. Many workers still resist using full-body harnesses and self-retracting lifelines for both cultural and practical reasons. In some cases, workers feel it takes longer to find and fit fall arrest equipment than it does to do the job without protection. Front-line supervisors need to enforce protective equipment use and implement training to counteract the dangerous assumption that "falls only happen to the other guy."

Owners, contractors, site managers, and workers must share a commitment to reducing falls from heights that supersedes schedule and exceeds basic regulatory requirements. Two fundamental components of a safety-driven culture are training and enforcement. Here are some examples of how a company can reduce falls from heights:

* Install fall protection devices such as guardrails, barricades, or nets so fall arrest equipment is not necessary.
* Train workers on how to use their fall protection equipment. Increase awareness about the severity of injuries and provide information on proper use, care, and inspection of the equipment.
* Train everyone on procedures for rescuing suspended workers.
* Enforce protective equipment use with task planning so no one has an excuse that fall arrest equipment wasn't available.
* Immediately remove any worker improperly using equipment to remind the workforce of what is expected. Disciplinary action may be required for multiple incidents.

Fourth: Bodily Reaction
Accounting for 10 percent of all disabling construction injuries, bodily reaction injuries occur when a worker a tries to regain a loss of balance during bending, climbing, and slipping or tripping without falling. Often misclassified into other injury categories--such as slips, trips and falls, or overexertion--these injuries tend to be overlooked.

How can you prevent an injury when the injury-causing reaction is instinctual? The key is prevention. Before beginning a task, workers should think about the steps needed to complete the task. For example, by setting materials between knuckle and shoulder height rather than below the knees, you eliminate bending and reduce the chance of overreaching or loss of balance when bending.

To reduce bodily reaction injuries:

* Enforce housekeeping and maintain clear travel areas, especially areas where materials must be moved.
* Train workers to "let it go" if they begin to lose control while carrying materials on the job site.
* Wear proper footwear to help prevent slips, trips, and falls.

Last But Not Least: Same-Level Falls
They may rank last, but same-level falls remain a significant concern for the construction industry with more than 14,600 cases reported in 2003, according to BLS. Injuries resulting from same-level falls include broken bones, such as wrist and ankle fractures that can leave workers disabled for long periods of time.

The good news: Most same level falls are preventable by keeping floors "broom" clean and providing adequate lighting. But keeping the work site clean is often seen as "someone else's job." Managers must understand that a clean site increases safety and productivity and, ultimately, produces a higher-quality product.

Some simple ways to reduce same level falls:

* Implement, and strictly enforce, a daily cleanup policy that requires regular removal of trash and debris.
* Deliver materials "just in time" to avoid hazardous stockpiling.
* Adequately illuminate all areas so small objects on the floor can be distinguished.
* Highlight changes in surface elevation, especially small ones that may be difficult to distinguish.

The Importance of Planning
Pre-planning can have a big impact on each of these top five causes of worker injuries. In most cases, little changes in means and methods such as these will result in a safer job:

* Reduce overexertion with a table at the mortar mix station that puts cement bags between knuckles and shoulders.
* Use web straps to secure bundles of insulation and other light materials to reduce wind-borne objects striking workers.
* Prevent falls by pre-planning with each crew where to anchor their equipment lanyards or lifelines.
* Put down gravel or install duckboards between the building and trailers, fabrication areas, and port-a-johns to help eliminate bodily reaction injuries caused by loose and slippery footing.

The key to having your job come in on schedule and on budget is to be proactive with safety rather than reactive, eliminating those unplanned events we call accidents.

This article appeared in the October 2005 issue of Occupational Health & Safety.

This article originally appeared in the October 2005 issue of Occupational Health & Safety.

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