October 31, 2011, Washington DC

Lifetime Risk of Occupational Injuries & Illnesses among Construction WorkersLifetime Risk of Occupational Injuries & Illnesses among Construction WorkersIllnesses among Construction WorkersIllnesses among Construction WorkersXiuwen Sue Dong, DrPH1

John Dement PhD2John Dement, PhDLaura Welch, MD1

Knut Ringen, DrPH1

1. CPWR - The Center for Construction Research and Training2. Duke University

Financial DisclosureFinancial DisclosureFinancial DisclosureFinancial Disclosure

This study was funded by the U.S. National Institute for Occupational Safety and Health (NIOSH) grant p y ( ) gU60OH009762.

The contents of this presentation are solely the ibilit f th th d d t ilresponsibility of the authors and do not necessarily

represent the official views of NIOSH.

PROFILE OF THE PROFILE OF THE CONSTRUCTION INDUSTRY CONSTRUCTION INDUSTRY

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

11 8

2 12.3 2.6 2.9 3.0

2.710.0

12.011.8

10.9

9.79.1

0.60.8

0.91.2

1.5 1.62.1

2.32.2

6.0

8.0

of e

mpl

oyee

s

7.0

6.4 6.7 7.1 7.4 7.9 7.8 8.0 8.5 8.6 8.7 8.9 8.3 7.4 6.94.0

Mill

ions

o

0.0

2.0

1992 1994 1996 1998 2000 2002 2003 2004 2005 2006 2007 2008 2009 2010Year

Non-Hispanic HispanicSource: 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 2010Occupational distribution in construction, Hispanic versus non Hispanic workers 2010Hispanic versus non-Hispanic workers, 2010Hispanic versus non-Hispanic workers, 2010

Hispanic

4 1%

Non-Hispanic

6.9%3.3%

3.4%

Management/ professional24.4%

4.1%

Service/ administrative

Construction/ extraction7.9%

86.5% Other production 63.6%

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

Construction establishments and employees, 2009 (With payroll)Construction establishments and employees, 2009 (With payroll)(With payroll)(With payroll)

Establishment size Number of % of all Total number % of all(Number of employees) establishments establishments of employees employees(Number of employees) establishments establishments of employees employees

1 to 9 589,106 82.6% 1,477,935 24.8%10 to 19 65,485 9.2% 877,756 15.1%20 t 99 51 611 7 2% 1 989 914 33 3%20 to 99 51,611 7.2% 1,989,914 33.3%100 to 499 6,327 0.9% 1,141,119 19.1%500 or more 448 0.1% 480,404 8.1%Total 712,977 100.00% 5,967,128 100.00%, , ,

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

Self-employed workers in construction, 2010Self-employed workers in construction, 2010p yp 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 1985-2010Average age of workers, construction versus all industries 1985-2010all industries, 1985-2010all industries, 1985-2010

41 541.842

43

Construction41.5

39

40

41

year

s)

All industries

37

38

39

Age

(in

35

36

37

1985 1990 1995 2000 2005 2010Year

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 Number of deaths from injuries in construction, Hispanic versus non-Hispanic workers, 1992-2010 p p ,(Private and public sectors)

p p ,(Private and public sectors)

215 317 321 360 317

1,200

1,400

1,077 1,0951,207 1,183 1,153 1,171

1,278 1,2431,297

1,239

1 016

108

116 137215

278 245 264321 317

250

222800

1,000

f dea

ths

780P

9631,016

879

855961 958 992

905 908 907 961 922 937 922766

657

176

400

600

Num

ber

o

657 604

0

200

1992 1994 1996 1998 2000 2002 2003 2004 2005 2006 2007 2008 2009 2010Year

Non-Hispanic HispanicP = Preliminary.Source: U.S. Bureau of Labor Statistics, 1992-2010 Census of Fatal Occupational Injuries.

Rates of fatal and nonfatal injuries in construction, Hispanic versus non-Hispanic Rates of fatal and nonfatal injuries in construction, Hispanic versus non-Hispanic , p pworkers, 1992-2009

, p pworkers, 1992-2009

400

500

40

50

kers

kers

Fatal: Hispanic

Fatal: Non-Hispanic

300

400

30

40

full-

time

wor

k

ull-t

ime

wor

k Nonfatal: Hispanic

Nonfatal: Non-Hispanic

20020

es p

er 1

0,00

0 f

per

100,

000

fu

0

100

0

10

Inju

rie

Dea

ths p

001992 1994 1996 1998 2000 2002 2004 2006 2008

Year2009

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

METHODSMETHODSMETHODSMETHODS

Methods for Injuries (1)Methods for Injuries (1)j ( )j ( )

• Data SourcesCensus of Fatal Occupational Injuries (CFOI)Survey of Occupational Injuries and Illnesses (SOII)Current Population Survey (CPS)

• MeasuresFatality - Number of deaths per 1,000 FTEsFatality Number of deaths per 1,000 FTEsNonfatal injuries - Number of injuries per 100 FTEs

(Adjusted assuming nonfatal injury rates are proportional to fatal injury rates in the same worker group)fatal injury rates in the same worker group)

FTE = Full-Time Equivalent

Methods for Injuries (2)E ti f C l ti R t E ti t *Methods for Injuries (2)E ti f C l ti R t E ti t *Equation for Cumulative Rate Estimate*Equation for Cumulative Rate Estimate*

• WLTR = [1 – (1 – R)У] * 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 a1 R probability of a worker not having a work related injury in a given year

– У = years of exposure to work-related injuryУ– (1 – R)У = probability of surviving У years without a work-related

injury

– 1 – (1 – R)У = probability of having a work-related injury over Уf lyears of employment

* References: OSHA, 1995; Fosbroke et al., 1997; Sygnatur, 1998; Drudi, 1998; Sasieni & Adams, 1999.

Methods for Injuries (3)A l t ti tMethods for Injuries (3)A l t ti tAnnual rate estimateAnnual rate estimate

400

450

45

50

ers

ers

Fatal: HispanicFatal: Non-HispanicNonfatal: Hispanic

250

300

350

30

35

40

ull-t

ime

wor

ke

ull-t

ime

wor

ke Nonfatal: Non-Hispanic

20072003

150

200

250

15

20

25

per

10,0

00 fu

per

100,

000

fu

0

50

100

0

5

10

Inju

ries

Dea

ths p

001992 1994 1996 1998 2000 2002 2004 2006 2008

Year

2009

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

Methods for Injuries (4)A l t ti tMethods for Injuries (4)A l t ti tAnnual rate estimateAnnual rate estimate

200 0

30.0

s

Fatal: Hispanic

Fatal: White, Non-Hispanic

Nonfatal: Hispanic

150.0

200.0

20.0

25.0

ime

wor

kers

time

wor

ker s

p

Nonfatal: White, Non-Hispanic

100.0

10 0

15.0

10,0

00 fu

ll-ti

100,

000

full-

50.05.0

10.0

Inju

ries

per

Dea

ths p

er

0.00.02003 2004 2005 2006 2007

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

Methods for Chronic Diseases (1)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)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)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 BTMEDA ifi i id E ti t d f• Age-specific incidence: Estimated from age-specific prevalence assuming:– Diseases are non-reversible after diagnosisDiseases are non reversible after diagnosis– Mortality risk for those with disease based on NIOSH

Life Table Analysis System ratesA d bili f di i id i– Assumed stability of disease incidence over time

LIFETIME RISK LIFETIME RISK ESTIMATESESTIMATES

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

pHispanic workers (45y)

6

7

s

4

5

er 1

,000

FT

E

2

3

fetim

e ri

sk p

e

0

1

White, non-Hispanic Hispanic All construction

Lif

Point estimate Upper 95% CL Lower 95% CL

Lifetime risk of work-related deaths from injuries in construction, Hispanic versus white, non-Lifetime risk of work-related deaths from injuries in construction, Hispanic versus white, non-pHispanic workers, by leading cause (45y)

pHispanic workers, by leading cause (45y)

1.342.24Falls

Lifetime risk per 1,000 FTEs

1.23

0.75

1.15

1.26

Contact with objects/equipment

Transportation accidents

0.62

0.13

0.75

Assaults and violent acts

Exposure to harmful substances/environments

j q p

Hispanic

White, non-Hispanic

0.11

0.13

0.11Fires and explosions

Assaults and violent acts

4.725.65All causes

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

40

45

50

s

25

30

35

per

1,00

0 FT

Es

10

15

20

Life

time

risk

0

5

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

25

30

s

15

20

per

1,00

0 FT

Es

10

15

Life

time

risk

0

5

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

Lifetime risk of work-related injuries resulting in days away from work in construction, Hispanic versus white non Hispanic workersHispanic versus white, non-Hispanic workers (45y)Hispanic versus white, non-Hispanic workers (45y)

80

90

100

s

50

60

70

80

per

100

FTE

s

30

40

50

Life

time

risk

p

0

10

20L

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

y y yleading cause (45y)

Overexertion

Contact with object/equipment

Fall on same level

Fall to lower level

Exposed to harmful substance

Transportation accidents

Estimated by SOII

Repetitive motion

Slip, trip, loss of balance--without fall Adjusted by CFOI

0 5 10 15 20 25 30 35 40 45Lifetime risk per 100 FTEs

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

y y yselected occupations (45y)

I l tLaborer

IronworkerSheet metal

Helper

PlumberRoofer

HeatingCarpenter

Truck DriverInsulator

Op EngineerBrickmason

WelderPower installer

ElectricianPlumber

Construction ManagerPainter

Machine OperatorForemanDrywall

Op. EngineerAdjusted by CFOI

0 20 40 60 80 100

Construction Manager

Lifetime risk per 100 FTEs

Lifetime risk of work-related MSDs in construction, Hispanic versus white, non-Lifetime risk of work-related MSDs in construction, Hispanic versus white, non-pHispanic workers (45y)

pHispanic workers (45y)

35

40

Es

20

25

30

k pe

r 10

0 FT

E

10

15

Life

time

risk

0

5

White, non-Hispanic Hispanic All Construction

Adjusted by CFOI Estimated by SOII

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

Overexertion

Bending, climbing, crawling, reaching, twisting

Lifting

Pulling/pushing

Holding/carrying

Estimated by SOII

Repetitive motion

Pulling/pushingAdjusted by CFOI

0 5 10 15 20Lifetime risk per 100 FTEs

COPD risk among construction k b

COPD risk among construction k bworkers by ageworkers by age

ConclusionConclusionConclusionConclusion

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 work-related 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 career45 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 parenchymalCOPD and a 11% likelihood of dust-related parenchymal chest x-ray changes

Strengths and LimitationsStrengths and LimitationsStrengths and LimitationsStrengths and Limitations

St th Strengths 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.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.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 Lifetime risk estimates for work-related deaths, injuries, and MSD did not take into account changes in the population at risk due to other causes of death.

Thank You!Thank You!Thank You!Thank You!Thank You!Thank You!Thank You!Thank You!

SD @SDong@cpwr.com8484 Georgia Avenue, Suite 1000Silver Spring, MD 20910Phone: (301) 578 8500Phone: (301) 578-8500Fax: (301) 578-8572http://www.cpwr.com