Traumatic Brain Injuries Common Among Construction Workers: NIOSH

Date First Published on SafetySmart Compliance: June 7th, 2016
Topics: Ladders | PPE |

An eight-year study by the National Institute for Occupational Safety and Health (NIOSH) has found that one-quarter of all construction workers who died between 2003 and 2010 succumbed to traumatic brain injuries (TBIs).

“Falling 25 feet to the ground from a roof, being struck in the head by a steel beam as it is transported across a worksite, or getting hit by a vehicle moving supplies—these are only a few examples of why the construction industry has the greatest number of both fatal and non-fatal traumatic brain injuries among US workplaces,” says NIOSH.

The situation is similar in Canada, where the Canadian Centre for Occupational Health and Safety (CCOHS) reported a 371 percent increase in work-related concussions—the most common form of TBI— in Ontario between 2004 and 2013. In Canada, the highest rates of work-related concussions occur in the construction, storage, government and primary industries, including forestry, fishing and mining.

In the US, work-related TBIs killed 2,210 construction workers between 2003 and 2010. NIOSH researchers examining these deaths found that:

  • Workers in small construction companies (with fewer than 20 employees) were more than 2.5 times more likely to die from a TBI than construction workers employed by companies with 100 or more workers.
  • Males were seven times more likely to die from a TBI than females. The reason is that construction largely remains a male-dominated industry today.
  • Workers 65 and older were four times more likely to experience a fatal TBI than workers ages 25 to 34.
  • The TBI fatality rate was significantly higher for foreign-born workers than for native-born workers.
  • Falls, especially from roofs, ladders and scaffolds, led to more than 50 percent of fatal work-related TBIs.
  • Structural iron and steel workers and roofers had the highest fatal TBI rate, and TBIs related to falls caused most of their deaths.

NIOSH says safety and health professionals can work to prevent fatal TBIs in construction by encouraging everyone in that industry to work safely and use the right safety equipment while working at heights—such as while on roofs, ladders and scaffolds.

Misjudging ladder angle is a significant risk factor for a fall. If set too steeply, a ladder is more likely to fall backwards or slide away during use, and if it is set too shallowly, the bottom can slide out.

NIOSH has a smartphone application, available at, to help workers safely position ladders.

The NIOSH Ladder Safety phone app has an angle of inclination indicator which uses visual and audible signals, making it easier for workers and other users to set an extension ladder at the proper angle of 75.5 degrees.

Researchers at NIOSH are also examining improved harness sizing designs aimed at better protecting workers against falls due to poor fit or improper size selection; along with a worker support bracket and safety rail assembly that provide a guardrail system to protect workers against falls.

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Check out this fall protection compliance center to manage a number of issues surrounding workplace slips, trips and falls.


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