49. Back Injuries in Construction and Other Industries
Workers in many construction occupations frequently perform activities that can lead to back problems (see page 33) and work-related musculoskeletal disorders (see page 48). In 2015, back injuries alone accounted for almost 17% of nonfatal injuries resulting in days away from work (DAFW) in construction according to data collected by the U.S. Bureau of Labor Statistics (BLS; chart 49a).1
The number of reported back injuries has declined considerably over the past two decades. In 2003, there were about 31,560 back injuries among construction workers reported to the BLS, but just over 13,000 such cases in 2015 – a 58% decrease (chart 49b). The rate of back injuries has also declined over time, dropping 58% between 2003 and 2015, from 52.7 injuries per 10,000 full-time equivalent workers (FTEs, see Glossary) to a rate of 22.3 injuries per 10,000 FTEs. Even so, construction workers still had a higher rate of back injuries in 2015 than in all industries combined (22.3 versus 16.2 per 10,000 FTEs); and the fourth highest rate among major industry groups (chart 49c).
The risk of back injuries varies among construction subsectors. Tile and terrazzo contractors reported the highest rate of back injuries (54.9 per 10,000 FTEs; chart 49d) in 2015, followed by roofing contractors (42.8 per 10,000 FTEs). This may be a result of their exposure to lifting and carrying materials, bending and twisting of the body, and making repetitive motions in performing work tasks (see page 33).
Estimates based on self-reported data suggest that the true prevalence of back disorders may be significantly higher than the numbers reported by BLS. In a 2015 household survey, more than one-third of construction workers reported experiencing “back pain during the previous three months”, with the highest rate among those 55 years and older (chart 49e). While it is unclear whether such back problems were related to worker’s job according to this survey, a longitudinal study found that construction workers who were once injured at work were twice as likely to report back pain and joint pain compared to those who had never been injured in a ten-year follow-up.2 Research also shows that older construction workers who have severe low back pain are more likely than other workers to leave the industry due to disability.3
Back problems are costly. Low back and neck pain accounted for the third-highest amount of the personal health care spending total in the United States, with an estimate of $87.6 billion in 2013.4 Identified ergonomic solutions, such as increased use of mechanical handling devices and optimizing lifting height wherever possible, are the primary methods of reducing exposure to risk factors associated with back injuries and musculoskeletal disorders (see page 48).5,6
(Click on the image to enlarge or download PowerPoint or PDF versions below.)
Full-time equivalent workers (FTEs) – It is used to convert the hours worked by part-time employees into the hours worked by full-time employees for risk comparison. FTEs is determined by the hours worked per employee on a full-time basis assuming a full-time worker working 40 hours per week, 50 weeks per year, or 2,000 hours per year, https://www.bls.gov/iif/oshdef.htm.
1. U.S. Bureau of Labor Statistics. Occupational Injury and Illness Classification Manual, Section 2: Definitions, rules of selection, and titles and descriptions, https://www.bls.gov/iif/osh_oiics_2010_2.pdf. The BLS defines back injuries as related to the posterior part of the trunk that is bounded by the neck and pelvis. Includes: cartilage, muscles, nerves, and neuroglia of the spine and spinal cord (except cervical); tendons, veins, and arteries of the back; and vertebra (backbone) and discs (except cervical). Excludes: neck or cervical vertebrae (C1 – C7); and cervical spine and/or cervical discs.
2. Dong XS, Wang X, Largay JA, Sokas R. 2015. Long-term health outcomes of work-related injuries among construction workers—Findings from the National Longitudinal Survey of Youth. American Journal of Industrial Medicine, 58: 308–318.
3. West G, Dawson J, Teitelbaum C, Novello R, Hunting K, Welch L. 2016. An analysis of permanent work disability among construction sheet metal workers. American Journal of Industrial Medicine, 59(3): 186-195.
4. Dieleman JL, Baral R, Birger M, et al. 2016. U.S. spending on personal health care and public health, 1996-2013. JAMA, 316(24): 2627-2646.
5. Ngo B, Yazdani A, Carlan N, Wells R. 2017. Lifting height as the dominant risk factor for low-back pain and loading during manual materials handling: A scoping review. IISE Transactions on Occupational ergonomics and Human Factors, 5(3-4):158-71.
6. Kincl LD, Anton D, Hess JA, Weeks DL. 2016. Safety voice for ergonomics (SAVE) project: Protocol for a workplace cluster-randomized controlled trial to reduce musculoskeletal disorders in masonry apprentices. BMC Public Health, 16: 362.
Chart 49a – Total may not add to 100% due to rounding. Other includes neck, body system, and other parts with numbers that do not meet BLS publication criteria.
Chart 49b – OSHA revised the requirements for recording injuries and illnesses in 2002. Therefore, data prior to 2002 may not be directly comparable to data from 2002 forward.
Chart 49d – An asterisk (*) represents four-digit NAICS codes; the remaining are five-digit NAICS codes.
Chart 49a – U.S. Bureau of Labor Statistics. 2015 Survey of Occupational Injuries and Illnesses, Table R2, https://www.bls.gov/iif/oshwc/osh/case/ostb4754.pdf (Accessed July 2017).
Chart 49b – U.S. Bureau of Labor Statistics. 1992-2015 Survey of Occupational Injuries and Illnesses, http://www.bls.gov/data/#injuries (Accessed July 2017).
Charts 49c and 49d – U.S. Bureau of Labor Statistics. 2015 Survey of Occupational Injuries and Illnesses, Table R6, https://www.bls.gov/iif/oshwc/osh/case/ostb4758.pdf (Accessed July 2017).
Chart 49e – National Center for Health Statistics. 2015 National Health Interview Survey. Calculations by the CPWR Data Center.