As one of the most injury-prone occupations in America, construction workers face numerous hazards and health risks in their day-to-day work. They work around heavy machinery, atop high and narrow ledges, in the vicinity of hazardous materials and in just about any other threatening situation imaginable. Adequate safeguards and regulations substantially mitigate the actual number of injuries and accidents that do happen. But the most common injuries in the construction industry are those that progress over a long period of time. They seem minor at first, but can develop into medical conditions that negatively impact not only a worker's productivity on the job, but also their overall quality of life.
"The incidence of RSIs has risen sharply in recent years."
Repetitive stress injuries, also known as cumulative trauma disorders, are what OSHA describes as "one of the fastest growing workplace injuries." A study by the Bureau of Labor and Statistics that analyzed nonfatal injury data in construction from 1991 to 2009 found that the incidence of musculoskeletal disorders, which include most RSIs as well as back injuries, has been rising sharply in recent years. According to the Connecticut Department of Public Health, RSIs and related issues are "the largest cause of occupational disease in the United States." They not only strain productivity, but also account for a third of all worker's compensation annually, according to OSHA, with a total insurance bill of $20 billion. All told, indirect costs from these injuries are estimated to cost employers more than five times that amount.
Clearly, RSIs are a serious problem in the construction industry, but their continued prevalence suggests that little is being done to minimize this all too common health risk in the working population. Fortunately, recent studies have shown that the incidence of these common injuries could be reduced through technology, safety engineering and better planning. When it comes down to it, implementing plans to reduce injuries on the job just makes sense. Construction managers and professionals have a vested interest in utilizing modern construction safety systems to see these efforts come to fruition, not only to save money on insurance costs, but also to provide a safer work environment for their employees.
Many names, one cause
The causes and symptoms of RSIs are varied, with over 100 distinct diagnoses falling under the umbrella term. The common denominator of all these is how they are inflicted. The Connecticut Department of Health classifies injuries as RSIs if they "are caused by over use as a result of stressful work over a period of time." All RSIs result in pain that makes use of the affected area, as well as normal movement and function, very difficult. Due to their nature, RSIs can impact just about any muscle in the body, although a few specific injuries stand out in construction work:
- Tendonitis is perhaps the most common injury, and is caused by the repeated incidence of "micro-tears" to the tendons that connect bone to muscles. A type of tendonitis frequently seen in construction workers affects the rotator cuff in the shoulder. Continued use of the arms in raised positions without frequent rest or adequate conditioning leads to rotator cuff tendonitis. This causes pain and discomfort, as well as stiffness and decreased mobility of the affected joint in some cases.
- Carpal tunnel syndrome is another of the most common RSIs. This inflicts pain and discomfort when the muscles in the hand, wrist or fingers become swollen from repeated use, causing nerve compression that can feel like a tingling or burning sensation throughout the entire arm or hand. A similar condition, thoracic outlet syndrome, can present the same symptoms of carpal tunnel syndrome, but is caused by a blood vessel obstruction in the back and results from repeated overhead lifting.
- Raynaud's syndrome is perhaps most unique to construction work. Also known as "vibration white finger," this injury results from prolonged gripping of vibrating hand tools like power drills, power saws or other motorized equipment. Raynaud's syndrome can cause sustained tingling or numbness in the fingers and hands, even progressing to total loss of sensation in these areas. The problem is often exacerbated in cold temperatures.
As the Connecticut DPH notes in its report on RSIs, the activities that lead to these injuries cannot be eliminated from construction work. Instead, action can be taken to reduce the incidence of these stresses, which will in turn increase overall productivity.
In training materials, OSHA stresses the importance of the principles of ergonomics in order to reduce the incidence of RSIs. Ergonomics is the study of the relationship between the human body and the performance of a physical task, and usually focuses on optimizing that performance to be as safe and effective as possible. OSHA summarizes the goals of ergonomics succinctly: "The word is used to describe the science of fitting the job to the worker, not the worker to the job," it explains in a training presentation. "[Musculoskeletal disorders] are the problem and ergonomics is the solution."
"Workers are encouraged to adopt a stretching routine to reduce injury."
Some issues that ergonomic studies tend to pinpoint are the prevalence of awkward postures, repetition and poorly designed tools on a jobsite, as well as generally poor work organization. Workers should select hand and power tools that fit well in their own grip and can adequately complete the desired task without using excessive force or strain. Posture and body movement play a major role in the prevention (or onset) of RSIs. Tasks that require bending down at the waist, like rebar tying and concrete screeding, can be improved with tools that allow for upright posture. Overhead drilling is a frequent cause of rotator cuff injuries, among many others. OSHA recommends the use of an overhead drill press to reach elevated areas without excessive strain. To promote general fitness, workers are encouraged to adopt a stretching routine before and after working. A team-wide stretch for just a few minutes each day can prepare muscles for exertion, as well as foster a sense of camaraderie among workers.
A number of construction safety products exist to manage time effectively and ensure workers are taking adequate breaks and not working for too long. Better organization from supervisors can help prevent the repetition and excess work that frequently leads to RSIs. Keeping this knowledge about some of the most common injuries faced by construction workers is the best way to prevent them, and see an overall happier, healthier group achieving their goals.