Construction Chart Book

Chart Book (6th edition): Fatal and Nonfatal Injuries – Musculoskeletal Disorders in Construction and Other Industries

48. Musculoskeletal Disorders in Construction and Other Industries

Work-related musculoskeletal disorders (WMSDs, see MSDs in Glossary) in construction decreased dramatically in the past decades, similar to the overall injury trend (see page 38). Both the number and rate of WMSDs resulting in days away from work (DAFW) dropped to a record low in 2014, even lower than the recession-related dip in 2010 (chart 48a). Although WMSDs in construction slightly increased in 2015, the number of cases (20,510) was less than 40% of the level in 1992, and the rate (34.6 per 10,000 full-time equivalent workers; see FTEs in Glossary) was 25% of the 1992 level. Despite the reduction, the rate of WMSDs in construction was still 16% higher than the rate of 29.8 per 10,000 FTEs for all industries combined in 2015.1 These numbers may be underestimated due to a variety of factors (see pages 40 and 41).2

The back remains the primary body part affected by WMSDs in construction, although its proportion of the WMSD cases decreased modestly from 48% in 2011 to 43% in 2015 (chart 48b). WMSDs from shoulder injuries increased marginally from 12% to 16% over the same period.

Overexertion (see Glossary) is not only a major cause of WMSDs, but also a leading cause of overall nonfatal injuries in construction (see page 43). In 2015, overexertion from lifting and lowering caused 30% of the WMSDs among construction workers (chart 48c). Other types of overexertion involving pushing, pulling, holding, carrying, and catching caused an additional 37% of WMSDs.

The rate of injuries from overexertion in lifting was 10.6 per 10,000 FTEs in construction, higher than all industries on average (chart 48d). By construction subsector, the rate of overexertion injuries among Finish Carpentry Contractors (NAICS 23835) and Tile and Terrazzo Contractors (NAICS 23834) was 52% higher than that for all construction (56.1 versus 37.0 per 10,000 FTEs; chart 48e). Residential Building Construction (NAICS 2361) also had a high rate of overexertion injuries at 47.1 per 10,000 FTEs.

About 65% of WMSDs in construction were related to sprains, strains, and tears (chart 48f). Such injuries may develop into chronic conditions and permanent disabilities.3,4 Task-specific ergonomic innovations to reduce physical workload are important to mitigate the risk of WMSDs and to facilitate sustained employment,.3-6 such as the revised NIOSH Lifting Equation (RNLE).6 Information on ergonomic solutions and ideas are also available at the Construction Solutions database, CPWR Ergonomics Handouts, and CPWR Ergonomics Toolbox Talks.

Many available tools and technologies can reduce the risk of WMSDs, but barriers to adoption exist such as costs, uncertain return on investment, solutions not suitable for small jobs, lack of related knowledge, etc.7 Factors that would improve the adoption of ergonomic interventions include the involvement and appropriate training of all affected stakeholders, changes in work systems and design, and safety culture.7


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Musculoskeletal disorders (MSDs) – From the U.S. Bureau of Labor Statistics (2011 onward): in the category of Nature, MSDs include an injury or illness from pinched nerve; herniated disc; meniscus tear; sprains, strains, and tears; hernia (traumatic and non-traumatic); pain, swelling, and numbness; carpal or tarsal tunnel syndrome; Raynaud’s syndrome or phenomenon; and musculoskeletal system and con­nective tissue diseases and disorders. In the category of Event or exposure, MSDs include an injury or illness due to overexertion and bodily reaction; over­exertion involving outside sources; repetitive motion involving microtasks; other and multiple exertions or bodily reactions; and being rubbed, abraded, or jarred by vibration;

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,

Overexertion – Cases of injury or illness that occur when excessive physical effort (such as lifting or carrying) is exerted on an outside source (such as a heavy container).


1. U.S. Bureau of Labor Statistics. 2015 Survey of Occupational Injuries and Illnesses, (Accessed July 2017).

2. Wang X, Dong XS, Choi S, Dement J. 2017. Work-related musculoskeletal disorders among construction workers in the United States from 1992 to 2014. Occupational and Environmental Medicine, 74(5): 374-380.

3. West GH, Dawson J, Teitelbaum C, Novello R, Hunting K, Welch LS. 2016. An analysis of permanent work disability among construction sheet metal workers. American Journal of Industrial Medicine, 59(3): 186-195.

4. Marcum J, Adams D. 2017. Work-related musculoskeletal disorder surveillance using the Washington state workers’ compensation system: Recent declines and patters by industry, 1999-2013. American Journal of Industrial Medicine, 60(5): 457-471.

5. Kumar P, Agrawal S, Kumari P. 2016. Ergonomics methods to improve safety in construction industry. International Research Journal of Engineering and Technology, 3(8): 680-683.

6. National Institute for Occupational Safety and Health (NIOSH). Musculoskeletal Health Program. Success story: Revised NIOSH lifting equation, (Accessed July 2017).

7. Dale AM, Jaegers L, Welch L, Barnidge E, Weaver N, Evanoff BA. 2017. Facilitators and barriers to the adoption of ergonomic solutions in construction. American Journal of Industrial Medicine, 60(3): 295-305.



All charts – Data cover private wage-and-salary workers only.

Chart 48c – Totals may not add to 100% due to rounding. Other includes multiple types of overexertions and bodily reactions, and not elsewhere classified overexertion, bodily reaction, and exertion.

Chart 48e – An asterisk (*) represents four-digit NAICS codes; the remaining are five-digit NAICS codes.

Chart 48f – Other includes carpal tunnel syndrome, tendonitis, and other nature with numbers that do not meet BLS publication criteria.


Charts 48a, 48b, 48c, and 48f – U.S. Bureau of Labor Statistics. Survey of Occupational Injuries and Illnesses. Data were obtained from the BLS by special requests (e-mail: [email protected]). Calculations by the CPWR Data Center.

Charts 48d and 48e – U.S. Bureau of Labor Statistics. 2015 Survey of Occupational Injuries and Illnesses, (Accessed July 2017).