Factors Influencing Risk of Falls: A Review of Evidence in Construction
Kun Hu, Hazhir Rahmandad, Tonya Smith-Jackson, Woodrow W. Winchester Grado Department of Industrial and Systems Engineering Virginia Polytechnic Institute and State University Abstract
Falls are the second most common mechanism of fatal unintended injuryin the US  and the leading cause of nonfatal and fatal injuries among construction workers. Fall accidents also lead to significant financial costs, project delays, and reputational damage. In this paper, we surveyed the available literature on different factors contributing to the risk of falls. Over 250 empirical and theoretical papers were reviewed. We identified major causes of falls atmultiple levels of analysis, from workplace design factors to cultural, organizational, and incentives related to safety measures. On the basis of this assessment, we found that the homogeneity of the literature is not appropriate for conducting a structured meta-analysis. In response, we aggregated the current knowledge in a causal structural model. These findings are expected to contribute tobetter design of data collection and modeling studies, support engineering prevention efforts, organize the knowledge base, and inform policy and intervention design to reduce the risk of falls in the construction industry.
Risk of falls, injuries, construction safety, literature review.
The construction industry faces many occupational safety risks, making it bothunique and challenging to study. Construction is always risky because of outdoor operations, working at heights and in complex on-site environments, and equipment operation coupled with varied worker attitudes and behaviors towards safety. In theory, most construction site accidents can either be prevented or controlled. Unfortunately, achieving this goal has been very slow in practice. The poorsafety performance of the construction industry continues to be a cause of concern worldwide and competes for the worst safety record among different occupations. In addition to loss of life or reduction in the quality of life, construction accidents often lead to project delays, increased project costs, and yield significant side-effects to the society. Chen, Fisher, & Krishnamurthy  indicated thataccidents in the construction industry account for billions of dollars in economic loss every year. Often the cost of an accident is much more than what is measured directly; indirect costs of accidents have been known to be as much as six times or more of the direct costs. Among all the construction accidents, falls are the most costly problem in the workplace in terms of deaths, lost work time,and financial costs among others . Construction safety has been a persistent and worldwide problem. In the United States, the construction industry accounted for 20% of all occupational fatalities, while making up only 5% of the United States’ work force. Buckley, Sestito, and Hunting  calculates that 24% fatalities are caused by falls in the landscape and horticultural service industry.Major injury rates in Great Britain for construction have risen over recent years . In Kuwait, construction accidents account for 42% of all occupational fatalities ; and they account for more than one-third of all industrial accidents over the last 10 years in Hong Kong, with similar records in China [7-9]. Furthermore, falls represent a significant portion of occupational injuries toconstruction workers . Studies from many countries show that preventing falls from heights in construction is necessary to prevent fatal injuries. Fall risks are the leading cause of nonfatal and fatal construction injuries of occupational workers.
A wide range of circumstances is relevant to understanding the factors contributing to construction falls and translating that...