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The other fatal 4: report warns of less-considered major construction health hazards | Dump Trucks Charlotte NC

Ask anyone familiar with construction hazards, and you'll likely hear about those on OSHA's Top 10 Safety Violations annual list or the agency's Fatal Four — falls, struck-by incidents, electrocutions and caught-in-between accidents.


The danger of falls, in particular, has garnered the industry's attention as the most common cause of accidental construction injuries and deaths. And the agency has shown its commitment to enforcement in this area, as often the most-cited violations are related to OSHA's fall protection standard. 

However, the American Industrial Hygiene Association, in its “Focus Four for Health: An Initiative to Address Four Major Construction Health Hazards,” is trying to make the industry aware of other site conditions that also pose a major threat to construction workers. They are:

Manual material handling

The AIHA publication says that the handling of construction materials can result in overexertion due to the lifting, pulling, pushing and carrying associated with this common task. These physical movements while handling materials are the top cause of work-related musculoskeletal disorders, which make up more than 30% of all work-related construction injuries and approximately half of all workers’ compensation costs.


High noise levels are linked to myriad conditions including hearing loss, tinnitus — a chronic ringing in the ears — sleep disturbances, cardiovascular disease, hypertension, depression and balance impairment. The AIHA said that, according to its research, almost 75% of construction workers likely have been exposed to noise levels above the recommended exposure limits set by the National Institute for Occupational Safety and Health.

Air contaminants

Asthma, irritation to chronic obstructive pulmonary disease, nervous system problems, kidney damage and cancer are just some of the short-term and long-term conditions that can be caused or exacerbated by dust, fume, vapor and gas exposure on a jobsite.  

More than 50% of construction workers have reported that they are regularly exposed to these substances twice a week or more on the job. This could be one of the reasons, the AIHA said, that the risk for developing an occupation-related disease is two to six times higher for career construction workers than it is for those who have spent most of their working years in other industries. 

High temperatures

Exposure to high temperatures on the jobsite can lead to a variety of heat-related conditions — heat exhaustion, heat syncope, heat cramps, heat rash — but heat stroke is the most serious. Heat stroke can cause death or permanent disability if ignored. Those who are new on the job are particularly vulnerable to heat illness. 

While OSHA has no specific standard for heat, the agency recommends that employers train their employees on how to recognize the signs of a heat-related condition in themselves and others, as well as provide shade, water and frequent breaks to those workers exposed to high temperatures.​

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