Construction Chart Book

Chart Book (6th edition): Fatal and Nonfatal Injuries – Fatal Injuries from Falls to a Lower Level in Construction

by | Mar 27, 2018

44. Fatal Injuries from Falls to a Lower Level in Construction

Falls are the number one cause of fatal injuries in construction (see page 43). In 2015, 96% of deaths related to falls (including slips and trips) were attributed to falls to a lower level.1 Deaths of this type increased 36% from 260 deaths in 2011 to 353 deaths in 2015 (chart 44a). The rate of such deaths also increased from 3.0 to 3.6 deaths per 100,000 full-time equivalent workers (FTEs; see Glossary) during the same period. Overall, falls to a lower level killed 4,439 construction workers between 2003 and 2015, about 341 deaths annually.

While working at a height of 30 feet or above is very dangerous, 38% of fatal falls to a lower level in construction that occurred between 2011 and 2015 were from a height of 15 feet or less (chart 44b). The primary cause of fall fatalities in construction was falling from roofs, accounting for one-third of all fatal falls to a lower level (chart 44c), followed by falls from ladders.

Between 2011 and 2015, over 60% of fatal falls to a lower level in construction occurred in establishments with ten or fewer employees (chart 44d). This was disproportionately high given that less than 30% of construction workers were employed in establishments of this size (see page 2).

The risk of fatal falls to a lower level varies among construction occupations. Between 2011 and 2015, the rate of such deaths among roofers was 34.2 per 100,000 FTEs, more than ten times that of all construction workers on average (3.3 per 100,000 FTEs; chart 44e). Ironworkers had the second highest rate at 19.9 per 100,000 FTEs.

By major construction subsector, 1,058 fatal falls to a lower level occurred among Specialty Trade Contractors (NAICS 238; see page 1 for industry classifications and codes) from 2011 to 2015, accounting for 69% of such fatalities in construction during that time.1 In the residential roofing industry (NAICS 238161), 80% of fatalities were from falls.2 Workers who were older than 55 years and foreign-born Hispanics also had higher proportions of fatal falls.2

Effective fall protection is crucial to reduce fall injuries. OSHA requires employers to provide fall protection before any work that necessitates the use of fall protection begins.3 However, a study based on NIOSH Fatality Assessment and Control Evaluation (FACE) reports indicates that a large number of construction workers killed by falls did not have access to personal fall arrest systems (PFAS) when the incident occurred.4

In response to the staggering number of fall-related injuries and fatalities, the National Occupational Research Agenda (NORA) Construction Sector Council, NIOSH, and OSHA launched the National Fall Prevention Campaign in 2012. The National Safety Stand-Down, a major annual event of the campaign, reached more than five million workers across the United States between 2014 and 2016.5,6


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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,

1. U.S. Bureau of Labor Statistics. 2011-2015 Census of Fatal Occupational Injuries, (Accessed November 2017).

2. Dong XS, Wang X, Largay JA, Platner JW, Stafford E, Cain CT, Choi SD. 2014. Fatal falls in the U.S. residential construction industry. American Journal of Industrial Medicine, 57(9): 992-1000.

3. Occupational Safety and Health Administration. 1995. Subpart M – Fall Protection: Duty to have fall protection, (Accessed June 2017).

4. Dong XS, Largay JA, Choi SD, Wang X, Cain CT, Romano N. 2017. Fatal falls and PFAS use in the construction industry: Findings from the NIOSH FACE reports. Accident Analysis & Prevention, 102: 136-143.

5. Bunting J. 2017. The national campaign to prevent falls in construction final report on the 2016 Safety Stand-Down: A follow-up report to the final report on the 2014 & 2015 Safety Stand-Downs: A quantitative and qualitative analysis on data collected from OSHA’s Stand-Down Certificate of Participation database, (Accessed June 2017).

6. Dong XS, Wang X, Katz R, West G, Bunting J. 2017. Fall injuries and prevention in the construction industry, /publications/first-quarter-fall-injuries-and-prevention-construction-industry (Accessed August 2017).



Chart 44b –There were 239 deaths excluded due to lack of height information.

Charts 44b, 44c, and 44d – Totals may not add to 100% due to rounding.

Chart 44c – Other includes parts and materials, building, confined spaces, and other sources with numbers that do not meet BLS publication criteria.

Chart 44d – Deaths of self-employed workers and those without information on establishment size were excluded.


Charts 44a, 44b, 44c, and 44e – Fatality numbers were obtained from the BLS through special requests. The views expressed here do not necessarily reflect the views of the BLS. Numbers of full-time equivalents (FTEs) were estimated from the Current Population Survey. Calculations by the CPWR Data Center.        

Chart 44d – Fatality numbers were estimated from the Census of Fatal Occupational Injuries. This research was conducted with restricted access to the BLS data. The views expressed here do not necessarily reflect the views of the BLS.