Traumatic Brain Injury Hazards on Construction Sites

How do companies prevent TBIs on the job and what are the steps to take should an accident occur on a construction site?

• By David Perecman
• Aug 01, 2023

According to the Centers for Disease Control and Prevention (CDC), 176 Americans die from traumatic brain injuries (TBIs) daily. As many as 64,000 TBI-related deaths occurred in the United States in 2020.

While workers across various trades may be at risk for TBIs on job sites, the construction industry is one of the most at-risk occupations for this injury. According to NICOSH, from 2003-2010, over 2,000 construction workers died as a result of a TBI. During that time period, TBIs represented a quarter of all construction-related deaths and 24 percent of all TBI fatalities across all occupational sectors.

What are Traumatic Brain Injuries?

TBIs are injuries that affect the brain’s function and are often caused by a bump, blow or jolt or a penetrating injury to the head. There are three main types of TBIs: mild TBI or concussion, moderate TBI and severe TBI.

Depending on the severity of the injury, TBIs can range in symptoms. A headache, nausea or vomiting, fatigue, difficulties with speech, dizziness, sensitivity to light or sound and sensory issues such as blurred vision or ringing in the ears may characterize mild TBIs.

Moderate to severe TBIs can result in a loss of consciousness from several minutes to hours. These injuries are characterized by persistent headaches, vomiting, nausea, slurred speech, and confusion. Some may experience seizures or convulsions, dilation of one or both pupils, inability to awaken from sleep, loss of coordination, and coma. Depending on the severity, those affected may experience health effects from TBIs for a few days to the rest of their life.

Risks of TBIs on Construction Sites

According to the CDC, the leading cause of TBIs is falls, which account for half of all TBI-related hospitalizations. Construction workers risk falls from ladders, scaffolds, and roofs when working at elevated heights. In addition, these workers risk being struck by falling or flying objects on construction sites.

Some construction workers are more likely to suffer from TBIs than others. According to an Injury Prevention study published in 2015, those who worked for small construction companies with less than 20 employees were 2.5 times more likely to suffer a fatal TBI injury than those that worked in larger companies. Workers in the steel, structural iron or roofing construction subindustries were most at risk for these deaths due to TBIs and falls led to most of these incidents.

Preventing TBIs On the Job

While accidents are common on construction sites, many injuries can be prevented with proper safety precautions, risk mitigation, and training. Under Occupational Safety and Health Administration (OSHA) law, employers are obligated to provide a safe work environment for employees. For this reason, employers and safety site managers should take the lead in implementing safety initiatives on construction sites.

A worker’s first line of defense against head injuries is their hard hat. Hard hats protect the head from falling or flying objects, collision impact, debris, and shock, among other jobsite hazards. Workers who do not wear them while performing job tasks or wear damaged ones may be at greater risk for injury. Employers and safety site managers should provide workers with safety training and needed safety equipment like hard hats and safety harnesses. In addition, they should ensure that safety structures such as guardrails and safety nets are properly installed on sites where there is a risk of falls or falling objects.

Also, NIOSH, OSHA, and The Center for Construction Research and Training (CPWR) have teamed up to reduce falls through their campaign that outlines construction safety tips for those working on roofs, ladders, and scaffolds.

Here are worker safety tips from the campaign to consider:

• Roof
• Wear a harness and always stay connected
• Make sure your harness fits
• Use guardrails or lifelines
• Inspect all fall protection equipment before use
• Guard or cover all holes, openings, and skylights
• Ladder
• Choose the right ladder for the job
• Maintain three points of contact
• Secure the ladder
• Always face the ladder
• Scaffold
• Use fully planked scaffolds
• Ensure proper access to the scaffold
• Plumb and level
• Complete ALL guardrails
• Ensure stable footing
• Inspect before use

Steps to Take Should An Accident Occur on a Construction Site

Should a TBI-related accident occur on the jobsite, it is important for both employers and workers to know what steps to take, as immediate medical intervention could be life-saving for these types of injuries. Even TBIs that appear initially mild should be considered serious injuries, so it’s important to call 911 right away so the individual can be evaluated by a medical professional and receive treatment.

In many instances, a worker injured on a jobsite while performing workplace duties may recover financial losses from the accident, like medical expenses, lost wages, and disability benefits, by filing a workers’ compensation claim. Workers’ compensation laws vary from state to state, so workers may wish to seek the guidance of an experienced workers’ compensation attorney.

In some states like New York, workers have additional protections under their labor laws. New York’s Scaffold Law extends protections to workers who are injured as a result of negligence. For this reason, workers considering pursuing legal action against the negligent party for damages stemming from their workplace accident may wish to consult a personal injury lawyer experienced in these matters.

TBIs are serious, sometimes even life-altering or fatal, injuries. The construction industry is one of the most at-risk occupations for TBIs, so it’s important to take proactive measures to prevent these accidents where possible. Employers and safety site managers should lead the charge in implementing risk-mitigation strategies on worksites and ensuring workers have the proper equipment and training to perform their duties safely.

This article originally appeared in the August 1, 2023 issue of Occupational Health & Safety.