By Michael C. McReynolds RN/EMT
Injury Prevention Educator
University of Michigan Trauma Burn Center

While there are many injuries and health risks associated with all occupations, the highest risk of injury and illness occurs to construction workers.

The occupational environment associated with construction exacerbates this hazard. Construction workers erect, renovate and demolish buildings. There is an extensive range of job descriptions, everything from automated activities to physical labor. Work is performed in extreme temperatures, under enforced timelines and in unfamiliar work environments.

Fifty percent of new construction workers will have some kind of traumatic injury within their first 30 days of hire. The annual work-related death rate for construction workers is rarely surpassed by other occupational groups. On average, three construction workers die in the U.S. every day as a result of traumatic injury at the job site.

In 1999 Michigan had 87 occupational related deaths. The construction industry, while representing only 6% of the work force, accounted for 31 of the 87 recorded fatalities. At least 29 of these fatalities were a result of trauma. The traumatic injuries that account for the most fatalities are recorded under the categories of "struck by, falls, electrocutions, & caught between."

Other common occupational traumatic injuries include:

Degloving injuries - occurs when skin and soft tissues are stripped away from the body. This usually takes place when clothing or jewelry becomes caught in a machine, pulling a victim into the machinery.

Traumatic amputations - can occur from saws, cutting instruments and other types of machinery.

Long bone fractures - can result from many mechanisms including falls, crush and penetrating injuries.

Trauma is the leading cause of death and disability for people ages 1 through 44. Approximately 39.6 million people are treated in hospital emergency departments and 2.6 million Americans are hospitalized each year for traumatic injuries. Experts claim, even with these large numbers, that most injuries are not reported. Trauma is one of the most pressing public health problems in the U.S. today. One in four American workers is affected by traumatic injury, yet this problem is largely unrecognized. Occupational trauma awareness must be promoted.

Traumatic injury accounts for more lost years of life than heart disease and cancer combined. While some deaths related to cancer and heart disease can be prevented with lifestyle changes, trauma is truly preventable. The term "accident" is a misnomer when discussing traumatic injury. The word accident refers to an unexpected, unforeseen and unpreventable event. In reality, most traumatic injuries are preventable with only a small amount of planning. An injury is a definable, correctable event, with a specific risk for occurrence. It is the consequence of many interactions that arrive together at a particular split second.

The economical impact of trauma is staggering. Not only in terms of physical injuries and property damage, but also to the profitability of the company. Accidents create non-recoverable overhead cost such as downtime, failure to complete the job on time, damaged equipment, lawsuits and assessed fines, customer dissatisfaction, loss of future jobs, and increased insurance costs.

According to the American Trauma Society, fatal and nonfatal unintentional injuries amounted to $478.3 billion during 1997. This figure includes wage and productivity losses, administrative expenses, medical expenses, motor vehicle damage, employer costs, and fire losses.

Adequate knowledge of treatment and arrival at an appropriate medical facility will provide the best possible outcome after injury and have a significant influence on construction safety. Trauma centers have long been the principal provider of care following major injury.

While effective in dramatically improving treatment and implementing sophisticated trauma care, until recently trauma care has not been directly involved in occupational injury prevention programs. With respect to this, The University of Michigan Trauma Burn Center has developed an occupational injury prevention program. The purpose of the program will be to educate workers on such issues as the initial management and the consequences of occupational injury. Researching occupational trauma is also key to the program.

Trauma injury prevention is vital in the building trades. Programs that raise injury awareness and increase knowledge that change attitudes are needed to make a positive contribution in the war against trauma.

Current job site emergency response systems are poor; having a minimum of one qualified person on a job site trained in CPR and First Aid is not adequate. Designing a successful trauma injury prevention program requires legislation, education and economical incentives, as well as penalties. Evaluating and tracking an injury prevention program's effectiveness is essential. Financial benefits must also be included in the evaluation process.

While substantial research has been conducted defining the magnitude of the injury problems, addressing injuries at the local level is still more the exception than the rule.