Envisioning the Future of Construction: Challenges and Opportunities for Occupational Safety and Health

February 2, 2021 by Melissa Edmondson, MS, CIH, CPH, and Scott Earnest, PhD, PE, CSP

Introduction

Today’s construction industry is quite different than what existed just a few decades ago. These days, it is much less common to see workers hauling around rolls of hand drawn blueprints, punching numbers into printing calculators, or fiddling with slide rules. Records and plans are now created and stored digitally; workers use new, more efficient tools; and many on the construction site are equipped with various types of smart devices and handheld technologies. The workforce demographic makeup looks different, too. Immigrants are an increasingly sizeable part of the construction labor force. Although the gender gap remains quite large—with women making up only 10% of the industry (Bureau of Labor Statistics, 2020)—it might begin to shrink as companies embrace more inclusivity and diversity. As the industry continues to evolve, there could be unintended factors that impact the nature of the work, and the safety, health, and well-being of the construction workforce. Rapid technological advances, job displacement, changes in work arrangements, an aging workforce, extreme weather conditions, and the ongoing COVID-19 pandemic have already changed the way construction work is conducted. While it is difficult to forecast precisely how the future will unfold, it is necessary to try to anticipate and prepare for what lies ahead.

Emerging technologies, Automation, and Robotics in Construction

Construction sites of the future will likely increase the use of advanced technologies such as drones, exoskeletons, autonomous vehicles, remotely controlled mobile equipment, 3-D printing, and building information modeling (BIM). These technologies are expected to increase productivity and quality while reducing the cost of construction projects. In addition, the new technologies can improve safety of workers for certain tasks. For instance, exoskeletons have been used in reducing worker shoulder strain during overhead jobs. Wearable devices and sensor technologies also have been used to monitor workplace hazard exposures. However, the benefit of new technologies could come with a potential risk as well. Injury incidents can happen when operators are not familiar with the technologies, especially during non-routine operating conditions. Unanticipated hazards and consequences associated with the use of robots in construction could be particularly significant because of the characteristics of traditional construction projects: ever-changing work environments, the need for multiple skilled craftspeople working on a project, multiple employers sharing a common worksite, and the interactions among many pieces of automated equipment. Another potential issue is the impact of autonomous vehicles on highway work zone safety and struck-by incidents, which has not been well researched yet. Employers should consider these types of issues and potential hazards when integrating new technologies into the workplace. The NIOSH Center for Occupational Robotics Research is working to evaluate robotics technologies, provide guidance on robotic safety, identify research needs, and support the development and adoption of safety standards.

Engineered Construction Materials

Building materials such as concrete, steel, wood, and masonry have traditionally been used on construction projects for many applications based upon their cost and effectiveness. More recently, the materials used to build our homes, roadways, and other structures have shifted away from natural elements to some combination of natural and person-made materials. Recycled, reclaimed, and engineered construction materials are often more widely available, cost efficient, and easier to install and maintain. Engineered construction materials can contain resins, stabilizers, flame retardants, adhesives, heavy metals, nanoparticles, and other additives that improve the materials’ properties, but might pose a risk to workers’ safety and health. Construction materials of the future will continue to contain potentially hazardous constituents, especially as researchers explore the various uses of nanoparticles and other material technologies in construction. Cutting, drilling, and sanding these new materials can release hazardous particles, leading to increased exposure potential. Research is needed to improve our understanding of how these materials could lead to toxic exposure among workers, and what types of interventions or controls are appropriate to ensure worker safety.

COVID-19 and Other Infectious Diseases

During the COVID-19 pandemic, construction has been deemed essential, but it has raised questions about what risks construction workers might face as a result of ongoing community disease transmission. Construction workers could have an increased risk of exposure to COVID-19, influenza, and other infectious diseases, particularly when work tasks require them to enter homes or occupied worksites where they might come into close contact with other workers, clients, visitors, or members of the public. In some situations, workers might also commute together to the job site. In addition to the risk of exposure, CPWR – The Center for Construction Research and Training estimates that nearly 60% of the construction labor force is at higher risk for severe illness from COVID-19 based on age, underlying medical conditions, or other factors (CPWR, 2020). A recent study estimated the risk of COVID-19-related hospitalization among construction workers in Austin, TX to be 4.5 times the per capita risk of the general public (Pasco et al., 2020). The CDC has developed guidance for construction workers to protect themselves and slow the spread of COVID-19, including general mitigation steps like wearing masks, social distancing, avoiding crowds and poorly ventilated indoor spaces, and hand hygiene. In addition to the health risks, other consequences of major disease outbreaks on construction jobsites include supply chain disruptions, cancelled projects, layoffs, and increased volatility in the industry. These after-effects can lead to important mental health concerns and, in some cases, substance use disorders among the construction workforce. As novel infectious diseases emerge, we must consider the impact and effective mitigation strategies for this critical industry.

Mental Health Disorders and Suicide

The nature of construction work can impact the mental health and well-being of the workforce. Employment in the construction industry is often unstable, with workers having periods of no work mixed with heavy work. These workers are often employed by multiple employers, both long-term and short-term. Construction work is also physically and mentally demanding, there is typically no fixed work site, and many workers travel great distances to live and work away from their families, sometimes in poor conditions. Due to financial incentives and shortages of skilled labor, there is also pressure to work long hours. The ongoing COVID-19 pandemic, economic uncertainty, and social unrest could be causing additional stress and mental health issues for construction workers. In turn, these conditions could impact job performance, worker engagement, and workers’ ability to cope and complete their work.

Suicide rates in the United States have been rising since 2008. While NIOSH, CPWR, North America’s Building Trades Unions (NABTU), the Occupational Safety and Health Administration (OSHA), and others in the construction industry have been addressing suicides in construction, this trend has continued, resulting in an alarmingly high rate of suicides among construction workers. Findings from a study in CDC’s Morbidity and Mortality Weekly Report (MMWR) showed that suicide rates among construction workers were among the highest of all industries. In 2016, men working in construction in 32 states had suicide rates 65% higher than rates for civilian working men 16–64 years old (Peterson et al., 2020). Preparing for the future of work in construction must include strategies to better understand mental health issues, suicide risk factors, substance use disorders, and to develop and implement prevention measures by addressing conditions of work and employment, work-related stressors, and other critical factors.

Alcohol and Substance Use

Excessive alcohol use is a serious yet preventable public health problem that continues to adversely impact the health of the construction workforce. In a 2020 study of binge drinking by occupation, construction and extraction workers had the highest prevalence of binge drinking when compared with other occupations (Shockey and Esser, 2020). Binge drinking is associated with several other health problems, including alcohol use disorder, chronic diseases like high blood pressure and stroke, and unintentional injuries such as car crashes. Construction workers are also at risk for other substance use disorders. A 2018 NIOSH study of overdose deaths by occupation found construction workers had the highest risk of heroin-related and prescription opioid-related overdose deaths compared to other occupations (Harduar Morano et al., 2018). Other studies have reported similar findings. As such, primary prevention of injury and management of opioid use disorder are both important topics in the construction sector. Cannabis use and misuse are also concerns in the construction industry due to the rapidly changing legal landscape. As more states adopt laws that increase access to cannabis, and as more workers consume cannabis products, there are many implications for construction workers and management (Howard and Osborne, 2020); these include impairment, hiring, health and well-being, and injury potential, to name a few.

Because mental health disorders, suicide, and substance use issues are often impacted by both home and work life, a Total Worker Health® approach is often needed. This approach focuses on how the workplace and work contribute, and can be modified, to improve workforce health outcomes. Total Worker Health® underscores the inextricable relationships that exist both on- and off-the-job—including those which involve workers’ families, communities, and society as a whole. One example includes using a critical set of activities and interventions to increase the development and use of peer support networks and programs in the construction industry.

Extreme Weather Conditions

Construction workers are impacted by weather conditions including extreme temperatures that may be augmented by a likely increase of extreme weather events in the future. In particular, construction workers are at-risk for heat-related illness, injury, death, and reduced productivity, especially given the physically demanding nature of the work and their high exposure to outdoor weather conditions (NIOSH, 2016). Outdoor work in construction often occurs in the summer months during the hottest times of the year, with sometimes dangerous outcomes. Although construction workers only comprise 6% of the total workforce, they accounted for 36% of all occupational heat-related deaths in the U.S. (285 fatalities) during 1992–2016 (Dong et al., 2019).

An emerging area of research suggests heat exposure might also cause adverse effects to the kidneys (Nerbass et al., 2017). Other research has explored the relationship between rising temperatures and traumatic injuries in the workplace. At least two studies have found a positive association between occupational heat exposure and traumatic injuries among construction workers (Xiang et al., 2014, Caulkins et al., 2019). These injuries can result from sweaty palms, fogged-up safety glasses, dizziness, dehydration, and reduced reasoning ability related to heat exposure (NIOSH, 2016). As the number of days with heat indices over 100^o F are projected to double in parts of the country by 2036 to 2065 (Dahl et al., 2019), heat exposure will continue to be a critical concern for the construction workforce.

In addition to heat stress, construction workers might also be exposed to extreme cold, poor air quality, allergens, vector borne diseases, and other hazards. Occupational research needs to further consider the impact of climate on construction workers’ safety and health. Interventions should consider strategies to protect workers and assist management, including evaluating existing mitigation strategies to ensure that workplace hazard controls are effective.

Changing Demographics in the Workforce

Demographics of the construction workforce are quickly changing, and safety and health programs must adjust to ensure that all workers are protected from illness and injury. An aging workforce, a growing number of foreign-born workers, and increased gender and sex diversity will require the construction industry to design construction sites and work tasks to accommodate the capabilities and limitations of the broadest cross-section of workers of all ages, genders, and ethnicities. As a result, research is needed to determine how to create work sites and structure tasks so they can be performed by this increasingly diverse workforce, without putting one group at increased risk. For example, the personal protective equipment and safety equipment of the future must be designed to accommodate women and men of various shapes and sizes to keep all workers safe (see related blog). The number of construction workers who self-identify as Hispanic is increasing substantially, growing from 9% to 29% of the construction workforce from 1990 to 2015 (CPWR 2018). As more Hispanic workers (especially immigrant workers) enter the construction workforce, policies, programs, and practices should address the health disparities, language barriers, and reduced access to health care that could be experienced by some workers.

Work Arrangement

The number of U.S. workers in non-standard work arrangements has recently increased, and is expected to continue to rise. According to CPWR, 30% of construction workers are already in non-standard work arrangements, the second highest proportion of non-standard work arrangements among major industry sectors (CPWR 2019). The construction sector consists of businesses and workplaces of varying sizes and missions that are not easily characterized. Workers in this sector have a spectrum of relationships with their employers, ranging from long-term employment with a single employer to multiple employment relationships or contracts (general and subs) lasting for just a few days or months. Non-standard work arrangements present several challenges to worker wellbeing, including job uncertainty; reduced earnings; lack of insurance, sick leave and other job benefits; differential training of employees; and legal concerns about who is responsible for job protections for workers (Howard 2017). As non-standard work arrangements become increasingly more common, there is a continued need for sound, evidence‐based recommendations and strategies on how to address these unique work organization issues to promote safety, health, and well‐being of the construction workforce.

NIOSH and the Future of Construction

Researchers, policy makers, employers, and practitioners need to anticipate and prepare for the introduction of new hazards and the amplification of existing hazards that result from modernization of the workplace and other changes in the construction industry. The future of construction presents tremendous opportunities for innovative solutions to address these concerns and improve worker safety, health, and wellbeing. Through the Future of Work Initiative and other efforts, NIOSH is poised to take a proactive approach that addresses these issues by compiling, featuring, and promoting research on the future of work; identifying partnership opportunities; and applying practical approaches to improve safety, health, and well-being outcomes. The NIOSH Office of Construction Safety and Health is working across disciplines to ensure that the construction industry is prepared for the multi-faceted challenges of the future, while promoting innovative solutions. What are you doing to prepare for these changes? Share your ideas and concerns in the comment section below.

Melissa Edmondson, MS, CIH, CPH, is an Industrial Hygienist in the Science Applications Branch in the NIOSH Division of Science Integration.

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

References

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