Psychosocial Hazards Often Overlooked in Construction Industry

Why Do Psychosocial Factors of Work Matter?

The construction industry has considerable safety and health hazards that result in high rates of injury, illness, and fatality. Common hazards include noise, fall, electrical, and chemical hazards. Approximately 60% of all construction fatalities each year can be attributed to the ‘focus four’ hazards of falls, struck-by, caught in and between, and electrocutions.¹ Construction occupational safety and health (OSH) has traditionally focused on eliminating, mitigating, and managing those hazards that are common in many construction workplaces.

Other critical threats to construction workers that may be overlooked are psychosocial factors of work. Psychosocial factors are the social, organizational, and managerial features of a job that affect the worker’s feelings, attitudes, behaviors, and physiology. Psychosocial factors can result in physical or mental health impacts in the workplace.^2,3 Even though psychosocial factors are often not as easy to observe as physical hazards, and may be more abstract in concept, they are important and should not be dismissed. It is well documented that work affects mental health and vice versa.⁴ The combined impacts of physical and mental health have been in the spotlight since the beginning of the COVID-19 pandemic.

Working conditions such as high demands, low control over work tasks, lack of support from a supervisor or coworkers, and job dissatisfaction are all examples of negative psychosocial factors that can cause adverse health effects. These health effects can include heightened stress^2,3; poor safety outcomes (e.g., higher injury rates, more frequent incidents)^5–7; greater risk for cardiovascular disease; and higher susceptibility to musculoskeletal disorders, sleep disorders, and gastrointestinal issues.³ To ensure the health, safety, and well-being of the construction workforce, it is important for owners, contractors, and supervisors to also consider and address adverse psychosocial factors in their workplace.

Psychosocial Factors of Work in Construction

How do psychosocial factors affect worker risks in construction? As an example, construction workers are particularly prone to developing musculoskeletal disorders (MSDs) due to the nature of their work—manual lifting and material handling, repetitive motions, vibrations, frequent heavy exertion, and variable working conditions. MSDs contribute to one in five nonfatal injuries in the construction industry.⁸  While MSDs are the outcomes from physical exposures of construction work, extensive literature has shown that psychosocial factors contribute to the development of MSDs as well.^9–13 Stress and adverse psychosocial factors can make workers more prone to injury and negatively impact the functioning of multiple organ systems.¹⁴ Research focused on psychosocial factors and the construction industry has found strong evidence that low job satisfaction, high perceived job stress and unrealistic job goals or expectations, and perceived lack of control over the work environment resulted in greater lower back and neck or shoulder pain among construction workers.^9–11 To prevent MSDs, it is important to consider contributing factors beyond the physical demands.

Additionally, there is growing evidence that workplace psychosocial factors may contribute to mental health disorders, suicidal ideation, and harmful substance use among construction workers. Each of these issues are serious problems in the construction industry today. In a study of young Australian construction workers, job stress, workplace bullying, and perceived lack of social support contributed to a worker’s level of psychological stress which, in turn, was linked to illicit drug use (e.g., methamphetamines, cannabis).¹⁵ In other construction studies, low job control (perceived lack of control over the work environment) was found to be related to illicit drug use in the workplace.^16,17

Suggestions for Construction Owners, Contractors, and Supervisors

For owners, contractors, and supervisors to address psychosocial factors in the workplace, these factors must first be characterized. There are many existing questionnaires available to measure psychosocial factors of work, including the short-version of the effort-reward imbalance scale and Job Content Questionnaire (JCQ).  Research has shown that workplace safety climate can influence safety behaviors, injuries, and health outcomes in the construction industry.^7,18 A useful tool to help construction workplaces characterize and improve safety climate is the Center for Construction Research and Training’s (CPWR) Safety Climate Assessment Tool (also available in a version for small contractors).

After identifying the contributing psychosocial hazards, leadership can determine which factors can be feasibly addressed. This may require leadership to assess current practices and policies and address deficiencies. For example, if employers find that low job satisfaction is the most prevalent psychosocial factor, subsequent worker focus groups or one-on-one interviews can be conducted to find reasons contributing to low job satisfaction and develop solutions—both short-term (e.g., ask employees for feedback, celebrate successes) and long-term (e.g., improving wages, benefits and job security, and assessing managerial style).¹⁹

Psychosocial factors of work impact overall health, including mental health. Now more than ever, it is critical for employers to understand the importance of addressing mental health concerns when they arise and be able to direct their workers to mental health resources (e.g., employee assistance program, health insurance that covers mental health care). Additional resources include:

• OSHA’s resources on addressing Workplace Stress and “Supporting Mental health in the Workplace: Getting Started Guide for Senior Mangers”
• NIOSH’s training and resources for health workers and mental health that can be adapted for Construction
• The National Institute of Environmental Health Sciences Worker Training Program’s “Initiatives to Prevent Opioid Misuse and Promote Recovery Friendly Workplace Programs” and training resources
• CPWR’s information repository on mental health and substance use disorders

In the comment section below, please share your experience with psychosocial factors on construction jobs and any programs that you are familiar with to positively impact the physical and mental health of construction workers.

Aurora Le, PhD, MPH, CSP, CPH, is the John G. Searle Assistant Professor of Environmental Health Sciences at the University of Michigan School of Public Health.

 Douglas Trout, MD, MHS, is Deputy Director for the Office of Construction Safety and Health.

 Ann Marie Dale, PhD is with the Division of General Medical Sciences, Washington University School of Medicine in St. Louis, Missouri.

 Scott Earnest, PhD, PE, CSP, is the Associate Director for the NIOSH Office of Construction Safety and Health.

Resources & Tools Related to Positively Addressing Psychosocial Factors in Construction

CPWR | Mental Health & Addiction

CPWR | Opioid Awareness Training Program

Home | SC-SMIS (scsmis.com)

CPWR | Foundations For Safety Leadership

Job Strain, Long Work Hours, and Suicidal Thoughts | Blogs | CDC

Partnering to Prevent Suicide in the Construction Industry – Building Hope and a Road to Recovery | Blogs | CDC

Work Flexibility and Worker Well-being: Evidence from the United States

Addressing the Opioid Overdose Epidemic in Construction: Minimize Work Factors that Cause Injury and Pain | Blogs | CDC

Recovery-Ready Workplace Resource Hub | U.S. Department of Labor (dol.gov)

References

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