Completed Research

Fall Prevention Training Among Residential Carpenters (Completed – 2004-2009)

Bradley A. Evanoff, MD, MPH

Washington University
St. Louis, MO
Ph: (314) 454-8638
[email protected]

Research Team

Vicki Kaskutas, OTD, Washington University School of Medicine, Program in Occupational Therapy; Ann Marie Dale, PhD, Washington University School of Medicine, Division of General Medical Sciences; Hester Lipscomb, PhD, Duke University; John Gaal, EdD, Carpenters’ District Council of Greater St. Louis and Vicinity; Mark Fuchs, BS, St. Louis Carpenters’ Joint Apprenticeship Program.

Falls from heights account for 35 percent of all construction deaths. The percentage is even higher in residential construction, where falls account for nearly half of work-related deaths. For the past five years, Dr. Bradley Evanoff and his research team at Washington University have worked with the Carpenters Joint Apprenticeship Program (CJAP) in St. Louis to reverse this trend, through improved fall prevention training programs for apprentice residential carpenters. Their early research uncovered some stark findings:

  • More than half of surveyed apprentices knew a co-worker who had fallen from a height in the previous year.
  • 16 percent had themselves fallen from a height in the past year.
  • The most common source of falls was ladders, which were involved in 29 percent of falls.
  • Carpenters think ladders are safe!
Dr. Evanoff and the research team began the project by assessing the fall prevention training needs of apprentices through focus groups, worksite audits by retired skilled carpenters, and a survey of more than 1,000 apprentices. They found that apprentices prefer to learn by doing and like to hear real-world stories from experienced carpenters. The team then worked with the CJAP instructors to revise the curriculum. The new program provided more hands-on practice and group discussion. As part of the new training, appren-tices built sections of a “model home,” rating the tasks from least to most hazardous. In one segment, the apprentices identified hazards and preventive measures as they worked on pulling up a floor. Throughout the project, the team also worked closely with leadership from the Carpenters District Council and the Home Builders Association of Greater St. Louis.

In 2009, the researchers evaluated the revised fall prevention training. They surveyed newly trained apprentices about their safety behaviors, and arranged to have retired skilled carpenters conduct audits at sites where the apprentices worked. In all, nearly 1,000 apprentices were surveyed and about 200 work-site audits were conducted.


  • Apprentices reported feeling more confident in their ability both to perform work tasks at heights and to prevent falls from heights, as a result of the training.
  • Apprentices’ self-reported safe use of ladders increased by about 50 percent.
  • The worksite auditors observed drastic improvements in priority training areas, such as avoiding work on the top plate of the ladder, use of warning lines to alert workers to unprotected edges, and truss setting.
  • The audit data evaluated so far show that apprentices increased their overall compliance with measured safety behaviors from 59 percent to 75 percent.

Despite a decrease in the number of active appren-tices due to the downturn in the construction industry, 78 revised training courses have been delivered to a total of 1,038 apprentices in 2009. Still, apprentices continue to report barriers to implementing safe behaviors at the worksite, such as the specific work situa-tion, time, and lack of equipment. The work has led to a one-year funded project from the Heartland Center for Occupational Health and Safety to measure the effectiveness of fall prevention technology at residential worksites.

Original Project Abstract:

Falls are a leading cause of morbidity and mortality in the construction trades despite considerable knowledge of risk factors and prevention strategies. Though construction apprentices receive training in fall prevention, it is not known how effectively this training changes knowledge, attitudes, and safety behaviors- even when effective, safety behaviors learning in training may not persist at the jobsite. The overall goal of this proposal is to evaluate the effectiveness of fall protection training methods among apprentice carpenters. Our proposal has three specific aims: 1. Conduct a comprehensive needs assessment including a careful assessment of the content and process of the current fall protection training. 2. Develop and implement changes in fall protection training based on the needs assessment. 3. Evaluate the effectiveness of the modified training. The project will follow the conceptual framework described by NIOSH for evaluation of strategies to prevent work injuries, moving through organizational and development phases prior to intervention, collection of outcome measures, analyses, and reporting. We will collect both quantitative and qualitative data to assess the effectiveness of current fall protection training and gaps in current training prior to planning our curricular changes. Baseline and follow-up measures will include three major types of data: questionnaires of apprentices, observations of work behaviors, and focus groups. The primary site of the proposed work will be the St. Louis Carpenters’ Joint Apprenticeship Program for Greater St. Louis and Vicinity. This four-year training program has 2400 actively enrolled apprentice carpenters in a program jointly operated by a building contractors association and the Carpenters District Council (CDC) of Greater St. Louis and Vicinity, the nation’s largest unionized residential carpenter workforce in a single geographic area.


Presentation delivered at the 20th Anniversary of the Construction Safety Conference and Exposition, Rosemont, IL,. 2010:

Outcomes of a Revised Apprentice Carpenter Fall Prevention Training Curriculum

Vicki Kaskutas, presenter