October 31, 2011, Washington DC

Lifetime Risk of Occupational Injuries & Illnesses among Construction Workers

Xiuwen Sue Dong, DrPH1 John Dement PhD2 Dement, Laura Welch, MD1 Knut Ringen, DrPH1
1. CPWR - The Center for Construction Research and Training 2. Duke University

Financial Disclosure
This study was funded by the U.S. National Institute for Occupational Safety and Health ( p y (NIOSH) g ) grant U60OH009762. The contents of this presentation are solely the responsibility of the authors and do not necessarily ibilit f th th dd t il represent the official views of NIOSH.

PROFILE OF THE CONSTRUCTION INDUSTRY

Construction employment, 1992-2010 (All types of employment)

11.8 11 8 10.9 10.0 Millions of employees o 1.5 8.0 6.0 4.0 6.4 2.0 0.0 1992 1994 1996 1998 2000 2002 2003 2004 2005 2006 2007 2008 2009 2010 6.7 7.9 8.0 8.5 8.6 8.7 8.9 8.3 7.0 0.6 0.8 0.9 1.2 1.6 2.1 21 2.3 2.6 2.9 3.0 2.7 9.7 2.3 2.2 9.1

12.0

7.1

7.4

7.8

7.4

6.9

Year

Non-Hispanic

Hispanic

Source: U.S. Bureau of Labor Statistics, 1992-2010 Current Population Survey. Calculations by The CPWR Data Center.

Occupational distribution in construction, Hispanic versus non Hispanic workers, 2010 non-Hispanic workers

Hispanic
3.4% 6.9%

Non-Hispanic
4.1% 4 1% 3.3% 24.4% Management/ professional Service/ administrative Construction/ extraction 7.9% 63.6%

86.5%

Other production

Source: U.S. Bureau of Labor Statistics, 2010 Current Population Survey. Calculations by The CPWR Data Center.

Construction establishments and employees, 2009 (With payroll)

Establishment size (Number of employees) 1 to 9 10 to 19 20 t 99 to 100 to 499 500 or more Total

Number of establishments 589,106 65,485 51,611 51 611 6,327 448 712,977 ,

% of all establishments 82.6% 9.2% 7 2% 7.2% 0.9% 0.1% 100.00%

Total number of employees 1,477,935 877,756 1 989 914 1,989,914 1,141,119 480,404 5,967,128 , ,

% of all employees 24.8% 15.1% 33 3% 33.3% 19.1% 8.1% 100.00%

Source: U.S. Census Bureau, 2009 County Business Patterns.

Self-employed workers in construction, 2010 p y

5%

28% Private employees Self-employed Public employees 67%

Source: U.S. Bureau of Labor Statistics, 2010 Current Population Survey. Calculations by The CPWR Data Center.

Average age of workers, construction versus all industries 1985-2010 industries,

43 42 41
Age (in years)

Construction All industries

41.8 41.5 41 5

40 39 38 37 36 35 1985 1990 1995 Year 2000 2005 2010

Source: U.S. Bureau of Labor Statistics, 1985-2010 Current Population Survey. Calculations by The CPWR Data Center.

Number of deaths from injuries in construction, Hispanic versus non-Hispanic workers, 1992-2010 p p , (Private and public sectors)
1,400 1,200 1,000 Number of deaths 800 600 400 200 0 1992 1994 1996 1998 2000 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year
P = Preliminary. Source: U.S. Bureau of Labor Statistics, 1992-2010 Census of Fatal Occupational Injuries.

1,077 1,095 963

108 116 137

1,207 1,183 1,153 1,171

215 278 245 264

1,278 1,243 1,297 1,239

317 360

321

317

1,016 1 016
250

879 780P
222 176

855

961

958

992

905

908

907

961

922

937

922 766 657 604

Non-Hispanic

Hispanic

Rates of fatal and nonfatal injuries in construction, Hispanic versus non-Hispanic , p p workers, 1992-2009
50 Deaths per 100,000 fu p ull-time work kers

Fatal: Hispanic Fatal: Non-Hispanic

500 Injurie per 10,000 full-time work es f kers

40

Nonfatal: Hispanic Nonfatal: Non-Hispanic

400

30

300

20

200

10

100

0 1992 1994 1996 1998 2000 2002 Year 2004 2006 2008

0 2009

Source: U.S. Bureau of Labor Statistics, 1992-2009 CFOI, SOII, and CPS. Calculations by The CPWR Data Center.

METHODS

Methods for Injuries (1) j ( )

Data Sources
Census of Fatal Occupational Injuries (CFOI) Survey of Occupational Injuries and Illnesses (SOII) Current Population Survey (CPS)

Measures
Fatality - Number of deaths per 1,000 FTEs Nonfatal injuries - Number of injuries per 100 FTEs
(Adjusted assuming nonfatal injury rates are proportional to fatal injury rates in the same worker group)

FTE = Full-Time Equivalent

Methods for Injuries (2)

Equation for Cumulative Rate Estimate* E ti f C l ti R t E ti t * WLTR = [1 (1 R)] * 1,000
WLTR = working lifetime risk R = probability of a worker having a work-related injury in a given year 1 R = probability of a worker not having a work-related injury in a work related given year = years of exposure to work-related injury (1 R) = probability of surviving years without a work-related injury 1 (1 R) = probability of having a work-related injury over years of employment f l
* References: OSHA, 1995; Fosbroke et al., 1997; Sygnatur, 1998; Drudi, 1998; Sasieni & Adams, 1999.

Methods for Injuries (3)

Annual rate estimate A l t ti t
Fatal: Hispanic
50 p ull-time worke ers Deaths per 100,000 fu 45 40 35
2003 2007

Fatal: Non-Hispanic Nonfatal: Hispanic Nonfatal: Non-Hispanic

450 Injuries per 10,000 fu ull-time worke ers 400 350 300 250 200 150 100 50 0 2009

30 25 20 15 10 5 0 1992 1994 1996 1998 2000 2002 Year 2004 2006 2008

Source: U.S. Bureau of Labor Statistics, 1992-2009 CFOI, SOII, and CPS. Calculations by The CPWR Data Center.

Methods for Injuries (4)

Annual rate estimate A l t ti t
Fatal: Hispanic 30.0 Deaths per 100,000 full-time workers s 25.0 20.0 15.0 10.0 10 0 50.0 5.0 0.0 2003 2004 2005 Year 2006 2007 0.0 Fatal: White, Non-Hispanic Nonfatal: Hispanic p Nonfatal: White, Non-Hispanic Injuries per 10,000 full-ti ime workers 200.0 200 0

150.0

100.0

Source: U.S. Bureau of Labor Statistics, 2003-2007 CFOI, SOII, and CPS. Calculations by The CPWR Data Center.

Methods for Chronic Diseases (1) ( )

Data Source
Building Trades Medical Screening Program (BTMED)

Definitions
COPD: Spirometry FEV1/FVC ratio below the lower limit of y normal (LLN) using the prediction equations of Hankinson et al. (1999) Chest X-ray Changes: B-reader ILO parenchymal profusions changes ( 1/0) Hearing Impairment: NIOSH (1998) criteria average hearing threshold for both ears that exceeds 25 dB at 1000, 2000, 3000, and 4000 Hz , , ,

Methods for Chronic Diseases (2) ( )

Life Table: Based on NCI DevCan program for lifetime cancer risks Logistic model: Age-specific prevalence estimated by construction trade using BTMED A Age-specific i id ifi incidence: E ti t d from ageEstimated f specific prevalence assuming:
Diseases are non-reversible after diagnosis non reversible Mortality risk for those with disease based on NIOSH Life Table Analysis System rates A Assumed stability of disease i id d bili f di incidence over time i

LIFETIME RISK ESTIMATES

Lifetime risk of work-related deaths from injuries in construction, Hispanic versus white, nonp Hispanic workers (45y)

7 6 Lif fetime risk pe 1,000 FTEs er 5 4 3 2 1 0 White, non-Hispanic Hispanic All construction

Point estimate

Upper 95% CL

Lower 95% CL

Lifetime risk of work-related deaths from injuries in construction, Hispanic versus white, nonp Hispanic workers, by leading cause (45y)
Lifetime risk per 1,000 FTEs Falls Transportation accidents Contact with objects/equipment j q p Exposure to harmful substances/environments Assaults and violent acts Fires and explosions All causes 0.13 0.13 0.11 0.11 5.65 4.72 0.75 0.62 2.24 1.34 1.26 0.75 1.15 1.23

Hispanic White, non-Hispanic

Lifetime risk of work-related deaths from injuries in construction, by selected occupations (45y) construction

50 45 Lifetime risk per 1,000 FTEs s 40 35 30 25 20 15 10 5 0

Ironworker Power installer Roofer Truck driver Laborer Welder Helper Op. Engineer All construction

Point estimate

Upper 95% CL

Lower 95% CL

Lifetime risk of work-related deaths from falls in construction, by selected occupations (45y) construction

30

25 Lifetime risk per 1,000 FTEs s

20

15

10

0
Ironworker Roofer Power installer Laborer Welder Sheet metal worker Helper Brickmason Painter Carpenter All construction

Point estimate

Upper 95% CL

Lower 95% CL

Lifetime risk of work-related injuries resulting in days away from work in construction, Hispanic versus white non Hispanic workers white, non-Hispanic (45y)
100 90 L Lifetime risk per 100 FTEs p s 80 70 60 50 40 30 20 10 0 White, non-Hispanic Hispanic All Construction

Estimated by SOII

Adjusted by CFOI

Lifetime risk of work-related injuries resulting in days away from work in construction, by y y y leading cause (45y)

Contact with object/equipment Overexertion Fall to lower level Fall on same level Transportation accidents Exposed to harmful substance Slip, trip, loss of balance--without fall Repetitive motion 0 5 10 15 20 25 30 Lifetime risk per 100 FTEs 35 40 45

Estimated by SOII Adjusted by CFOI

Lifetime risk of work-related injuries resulting in days away from work in construction, by y y y selected occupations (45y)
Helper Sheet metal Ironworker Laborer Insulator I l t Truck Driver Carpenter Heating Roofer Plumber Electrician Power installer Welder Brickmason Op. Op Engineer Drywall Foreman Machine Operator Painter Construction Manager

Adjusted by CFOI

20

40

60

80

100

Lifetime risk per 100 FTEs

Lifetime risk of work-related MSDs in construction, Hispanic versus white, nonp Hispanic workers (45y)
40 35 Lifetime risk per 100 FTE k Es 30 25 20 15 10 5 0 White, non-Hispanic Hispanic All Construction

Adjusted by CFOI

Estimated by SOII

Lifetime risk of work-related MSDs in construction, by leading cause (45y) construction

Overexertion Lifting Bending, climbing, crawling, reaching, twisting Holding/carrying

Estimated by SOII
Pulling/pushing Repetitive motion 0 5 10 Lifetime risk per 100 FTEs 15 20

Adjusted by CFOI

COPD risk among construction workers b age k by

Conclusion
A construction worker has a 1/200 chance of dying from a work-related injury over a 45-year career The likelihood of a Hispanic worker dying from a workrelated injury is 20% higher than a white, non-Hispanic counterpart If a construction worker is not killed at work, that worker has a 75% or greater likelihood of lost-time injuries over a 45 year 45-year career A construction worker who begins work at age 20 and survives until age 85 has a 15% likelihood of developing COPD and a 11% likelihood of dust-related parenchymal dust related chest x-ray changes

Strengths and Limitations

St Strengths th
Estimates for work-related deaths, injuries, and MSDs are based on national data which covers many years, providing a reasonably representative sample and more stable incidence rates. COPD, X-ray parenchymal changes, and hearing loss estimates are based on medical examinations of a very large population of construction workers using a standardized protocol and disease criteria.

Li it ti Limitations
All of the lifetime risk estimates are based on retrospective data reflecting past exposures and risks. Caution should be used in using these estimates to project future risks. While the BTMED data for DOE workers covers many trades, program participation is voluntary; therefore, it is unknown if results are representative all US construction workers. Lifetime risk estimates for work-related deaths, injuries, and MSD did not take work related deaths injuries into account changes in the population at risk due to other causes of death.

Thank You!

SDong@cpwr.com SD @ 8484 Georgia Avenue, Suite 1000 Silver Spring, MD 20910 Phone: (301) 578-8500 578 8500 Fax: (301) 578-8572 http://www.cpwr.com