OSHA’s “Fatal Four” In Construction: Leading Causes of Fatalities in Construction



OSHA Fatal Four Image


In this article, we'll be talking about workplace fatalities. Workplace fatalities in the construction industry, to be more specific. And to be even more specific, about the four hazards that OSHA calls "The Fatal Four" in construction because of how many construction workplace fatalities involve these hazards.

Before we do, it's worth getting some perspective. According to OSHA, just a little over 21% of worker fatalities in private industry in a recent year (2018) occurred in the construction industry. So we're talking about an industry with a significant amount of fatalities.

In this article, we'll let you know what the Fatal Course hazards are, link you to relevant resources and OSHA standards, and provide some safety training tips for each as well.

And since the larger focus of this article is about workplace fatalities and preventing them, you might also find our Preventing Workplace Fatalities and Using Risk-Based Approaches to Reduce Serious Injuries and Fatalities (SIFs) articles of interest.

The Significance of Construction's "Fatal Four"

As mentioned earlier, about 21% of the workplace fatalities in the US occur in the construction industry. And nearly 60% of those construction industry fatalities are related to the "Fatal Four" hazards in construction.

So reducing fatalities related to just these four hazards would reduce a significant percentage of the overall workplace fatalities in the US in any given year.

What Are the "Fatal Four" Hazards in Construction?

We've listed the "Fatal Four" hazards below--in order from top-to-bottom based on percentage of fatalities they contributed to in 2018:

  • Falls (33%)
  • Struck-by-object (11%)
  • Electrocutions (8-9%)
  • Caught-in and/or caught-between (5-6%)

See this OSHA Quick Card on the Construction "Fatal Four" for even more.

Now let's take a closer look at each of the "Fatal Four" hazards.

"Fatal Four" Hazard 1: Falls

Falls contribute to more fatalities in construction than all the other "Fatal Four" hazards combined. Remember that falls can occur in many ways in the construction industry--from a roof or a ladder, yes, but also through floor openings to a lower level and even off scaffolds and stairs.

Fall hazards in construction include but are not limited to:

  • Leading edges
  • Overhead bricklaying
  • Roofing work
  • Residential construction activities
  • Walking and working surfaces
  • Hoist areas
  • Holes
  • Ramps & runways
  • Excavations
  • Equipment
  • Wall openings

Hazard controls include but are not limited to:

  • Guard rail systems
  • Safety net systems
  • Personal fall arrest systems
  • Positioning device systems
  • Fall restraint systems
  • Warning line systems
  • Controlled access zones
  • Safety monitoring systems
  • Toeboards
  • Canopies

As a first step in to reduce fall-related fatalities, check out OSHA's 29 CFR 1926 Subpart M, Fall Protection.

Additionally, OSHA offers a very helpful Fall Protection/Prevention Safety and Health Topic webpage that's full of helpful resources you can use to reduce the risk of falls in your organization.

PLUS, this 48-page Fall Protection in Construction publication from OSHA (OSHA 3146, published in 2015) is quite comprehensive.

And on top of all that, there's OSHA's National Safety Stand Down for Fall Prevention in Construction that happens every year and this Fall Prevention Toolbox Talk Checklist we created for the Stand Down last year and that you can download for free.

"Fatal Four" Hazard 2: Struck-by-Object

Let's start this section with OSHA's definition of a struck-by hazard:

Struck-by injuries are produced by forcible contact or impact between the injured person and an object or piece of equipment.

Furthermore, OSHA notes there's a distinction between "struck-by" and "caught-in" or "caught-between. Here's how they explain the difference:

...it is important to point out that in construction, struck-by hazards can resemble caught-in or caught-between hazards. There is a distinction which is best explained by looking at the key factor in making a determination between a "caught" event and a "struck" event, ask: Was it the impact of the object alone that caused the injury? When the impact alone creates teh injury, the event is considered as "struck." On the other hand, when the injury is created more as a result of crushing injuries between objects, the event is considered as "caught."

OSHA goes on to explain that struck-by hazards can be categorized into four different types:

  • Struck-by flying object
  • Struck-by falling object
  • Struck-by swinging object
  • Struck-by rolling object

Here are some examples of struck-by hazards, again borrowed from OSHA:

  • Worker hit from above when bricks being hosted to the top of a building fall out of a bucket and strike the worker in the head.
  • Workers installing a sign on a highway struck by passing truck that left the road and hit the workers.
  • Workers attempting to lift an exterior wall into place struck by the wall when they lost control of it and the wall falls.
  • Inspector struck by an end loader while crossing an equipment vehicle route at an interstate highway.
  • Worker struck by counterweight and revolving superstructure of an excavator.
  • Worker struck by pipe he and other workers were lifting out of a hole.
  • Worker struck and killed when a heavy metal plate separates from the lift camp of an overhead crane and falls onto the worker

This OSHA Struck-By eTool may help you better prepare your workplace to avoid struck-by incidents, injuries, and fatalities.

"Fatal Four" Hazard 3: Electrocution

Electrocution causes the third-most fatalities among the "Fatal Four" hazards in construction. Here's how OSHA defines electrocution:

Electrocution results when a person is exposed to a lethal amount of electrical energy. An electrical hazard can be defined as a serious workplace hazard that exposes workers to the following: burns, electrocution, shock, arc flash/arc blast, fire, and/or explosions.

OSHA goes on to identify each of those last items this way:

Burns: Damage to the skin and other body parts. Burns from electricity are of three types: electrical, arc/flash, or thermal. Electrical burns result from heat generated by the flow of electric current through the body. Arc/flash burns are high-temperature burns caused by an electric arc or explosion. Thermal contact burns occur when skin comes in contact with overheated electrical quipment.

Electrocution: When a person is exposed to a lethal amount of electrical energy (note that electrocution is by definition fatal)

Shock: When a person's body becomes part of the electrical circuit; electrical current enters the body at one point and leaves at another point.

Arc Flash/Arc Blast: An arc flash is the sudden release of electrical energy through teh air when a high-voltage gap exists and there is a breakdown between conductors. An arc flash gives off thermal radiation (heat--recorded as high as 35,000 degrees F) and bright, intense light that can cause burns. High-voltage arcs can also produce considerable pressure waves by rapidly heating the air and creating a blast. An arc flash can be spontaneous or result from inadvertently bridging electrical contacts with a conducting object. Other causes may include dropped tools or the buildup of conductive dust or corrosion. For more information on arc flash and arc flash refer to NFPA 70E: Standard for Electrical Safety in the Workplace.

Fire: Most electrical distribution fires result from problems with fixed wiring such as faulty electrical outlets and old wiring. Problems with cords, such as extension and appliance cords, plus, receptacles, and switches also cause electrical fires.

Explosions: Explosions can occur when electricity ignites an explosive mixture of material in the air.

OSHA lists the following as major electrocution hazards in construction:

  • Contact with power lines
  • Contact with energized sources
  • Improper use of extension and flexible cords

And OSHA suggests the following for reducing the risk of electrocution hazards in construction:

  • Maintaining a safe distance from overhead power lines
  • Using ground-fault circuit interrupters (GFCI)
  • Inspecting portable tools and extension cords
  • Using power tools and equipment as designed
  • Developing and following lockout/tagout procedures

As a first step in to reduce fall-related fatalities, check out OSHA's 29 CFR 1926 Subpart K Electrical.

Additionally, OSHA offers a very helpful Electrical Safety and Health Topic webpage that's full of helpful resources you can use to reduce the risk of electrocutions and electrical fatalities in your organization

PLUS, this Why Are So Many Construction Workers Being Electrocuted? webpage by the Electronic Library of Construction Occupational Safety and Health has lots of great ideas for reducing electrical hazards and incidents.

Finally, check out this OSHA publication, Controlling Electrical Hazards.

"Fatal Four" Hazard 4: Caught-in or Caught-between

The final "Fatal Four" construction hazard is caught-in or caught-between.

Let's start this section with OSHA's definition of a "caught" hazard:

According to OSHA, caught-in or caught-between hazards are defined as: injuries resulting from a person being squeezed, caught, crushed, pinched, or compressed between two or more objects, or between parts o fan object. This includes individuals who get caught or crushed in operating equipment, between other mashing objects, between a moving and stationary object, or between two or more moving objects.

As you may remember, OSHA notes there's a distinction between "struck-by" and "caught-in" or "caught-between. Here's how they explain the difference:

The key factor in making a determination between a "caught" event and a "struck" event is whether the impact of the object alone caused the injury. When the impact alone creates the injury, the event should be recorded as Struck. When the injury is created more as a result of crushing injuries between objects, the event should be recorded as "caught."

According to OSHA, here are some examples of incidents that should be considered "caught":

  • Cave-in while trenching
  • Being pulled into or caught in machinery and equipment
  • Strangulation when clothing is caught up in moving equipment
  • Being compressed or crushed between rolling, sliding, or shifting objects such as semi-trailers and a dock wall, or between a truck frame and a hydraulic bed that is lowering

OSHA lists the following as common types of caught-in or caught-between hazards in construction:

  • Machinery with unguarded moving parts
  • Being buried in or buried by
  • Between pinned between

OSHA mentions the following as controls that can help reduce the risk of caught incidents, injuries & fatalities:

  • Properly guarding hazardous machines and machine parts
  • Ensuring that machinery is supported, secured, or otherwise made safe
  • Protecting yourself from being pinned between equipment
  • Protecting yourself on excavation sites
  • Training

This OSHA document includes much more information on "caught" hazards as well as links to many other helpful resources to assist you in creating a safer workplace.

Hazard Identification and The "Fatal Four"

Avoiding and reducing or eliminating hazards begins with identifying hazards.

This article should help you identify hazards at a construction site more effectively due to the information we've covered. So that's a start.

In addition, you might want to practice with OSHA's Hazard ID eTool. 

Likewise, you can download the EXAMiner hazard ID tool from NIOSH Mining and place your own images in it to improve your current hazard identification skills and also to use as part of employee hazard identification training programs (listen to our extended interview with NIOSH Mining to learn more about this).

Additionally, this Recognition and Control of Construction Workplace Hazards by Electronic Library of Construction Occupational Safety and Health has lots of specific information for the construction industry.

And finally, you may enjoy our own Hazard Identification Training article as a nice starting point.

Hazard Control, the Hierarchy of Controls, and the "Fatal Four"

Always remember to use the hierarchy of controls when considering controls for hazard elimination, reduction, and/or mitigation. And for those "fall-related" hazards, check out our article on the Fall Prevention Hierarchy of Controls.

Training for the "Fatal Four" in Construction

OSHA offers this helpful Outreach Training Program--Construction Focus Four Training webpage with lots of helpful resources. Check that out and see if there's something that's helpful for you.

Want to Know More?

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