The 'Fatal Four’ Construction Hazards That Lead to 80% of Serious Injuries and Fatalities

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Despite construction workers representing roughly six percent of the private workforce, this industry accounted for an alarming 20.5% of worker fatalities in 2014. Even more alarming, these numbers are on the rise. The latest report from the Occupational Safety & Health Administration (OSHA) indicated that overall fatalities rose two percent from the previous year to 4,679 (source).

To help combat this growing trend, OSHA has renewed its efforts to spread awareness about the “fatal four” construction hazards that accounted for over half (58.1%) of construction-related fatalities in 2014. OSHA estimates that eliminating these four hazards – falls, struck by object, caught in/between, and electrocution – would save 508 workers’ lives in America every year (source).

Construction business owners should create and maintain an effective safety and hazard prevention program that addresses the risks posed by these “fatal four” hazards.

Fall Hazards

Slips, trips, and falls are the leading cause of construction fatalities, and account for almost 40% of all fatal occupational injuries (source). A fall hazard is anything on or at a worksite that could lead to a worker losing his or her balance that could lead to a fall. According to OSHA, falls from heights are the leading cause of fatalities in the construction injury, while falls from the same level are the leading cause of injuries.

OSHA has created a dedicated fall prevention campaign to help employers and employees prevent these injuries from occurring.

Common Causes:

  1. Roofing – Roughly 1/3 of all fall injuries and deaths are related to roofing. This can include falling from the roof or a leading edge, but can also happen due to holes or openings in the roof such as skylights. You can find more information on preventing roofing-related accidents here
  2. Scaffolding – Scaffolding injuries account for 18% of all fall related injuries. This can be caused by improper setup or workers not using proper protective equipment. You can find more resources on preventing scaffolding injuries here
  3. Ladders – Ladders are a common sight at a construction worksite, but improper use and selection of the appropriate ladder can lead to serious injury. Ladder-related injuries account for 16% of all fall injuries. OSHA has a wealth of resources on maintaining proper ladder safety. A good starting point can be found here.
  4. Structural Steel – Exposed structural steel, such as rebar, can pose a serious hazard to workers. Incidents involving injuries caused by exposed rebar account for roughly 8% of all fall-related injuries. Protuding ends of steel rebar should be guarded with caps, or bent such that the exposed ends are no longer upright to reduce the chance of puncture injuries.

How you can help prevent fall injuries:

  1. Wear personal fall arrest systems when working from elevated heights
  2. Install and properly maintain perimeter protection systems around leading edges
  3. Cover, secure, and properly label floor opening covers
  4. Use proper caution when on ladders and scaffolds


In 2014, electrocutions were the second-leading cause of construction worker fatalities (8.5%). Causes can range from unintended contact with power lines to improper grounding procedures. Electrical hazards are defined as any workplace occurrence that could expose workers to the following dangers:

  • Electrocution
  • Shock
  • Arc Flash/Arc Blast
  • Fire/Burns
  • Explosions

Common Causes:

  1. Contact with power lines – The most common electrical hazard prevents itself when working with or around overhead power lines. This can not only cause electrocution, but the resulting shock could also lead to falling from elevations as a result. Workers who operate on or near cranes, scaffolding, scissor lifts, and ladders are at higher risk than others.
  2. Contact with Energized Circuits – Workers are often exposed to incomplete or exposed wiring during the construction process. If the power supply is not properly grounded, current can travel through a workers body and lead to severe electrical burns or electrocution. These risks caused by these conditions can be mitigated by implementing ground-fault circuit interrupters (GFCI’s) or an assured grounding program to protect workers.
  3. Improper Use of Extension Cords – Extensions cords can become a hazard when not properly used or maintained. Fraying or damaged cords can expose workers to hazardous electrical energy, and use in outdoor environments where moisture may be present can increase these risks.

How you can help prevent electrocution injuries:

  1. Locate and identify all utilities before beginning work
  2. Understand and maintain safe distance requirements from power lines
  3. Look out for overhead power lines when operating heavy equipment
  4. Use GFCI’s as a protective measure
  5. Be aware of potential electrical hazards when working with ladders, scaffolds, or other platforms

Caught In/Between

Caught in/between hazards present themselves when workers are at risk of being crushed, pinched, rolled over, or involved in a cave-in. These hazards make up roughly 1.5% of fatal injuries (source).

Common Causes:

  1. Trench Cave-ins – Nearly 75% of all caught in/between injuries are a result of trench or excavation collapses, where the worker is crushed or buried during an unexpected cave-in.
  2. Equipment Rollover – Another significant cause of worker injury in this category is rollover, which occurs when an operator is unable to maintain control of a machine. These types of injuries can be reduced by properly training operators and avoiding steep grades, embankments, and unstable soil

How you can help prevent caught in/between injuries:

  1. Never enter a trench 5’ or deeper without an adequate protection system in place; some trenches under 5’ feet deep may also require such a system
  2. Trenches and excavations should be protected by one of the following:
    • Sloping
    • Shoring
    • Benching
    • Trench shield system
  3. Properly train employees and workers on proper safety precautions when working around heavy machinery and equipment


Struck by injuries occur when workers suffer physical impact from contact with equipment, or are struck by a falling object. These are the third leading cause of construction fatalities, accounting for roughly 8.4% of all deaths (source).

Common Causes:

  1. Heavy Equipment – Approximately 75% of all struck-by injuries involve heavy equipment, with one in four struck-by-vehicle deaths involving construction workers
  2. Falling Objects – Construction workers can also be at risk of being struck by falling objects. These situations can occur when working under or around cranes, scaffolds, or multi-level buildings. These dangers can be mitigated by installing sufficient safety systems including debris nets and/or catch platforms around elevated platforms
  3. Flying Objects/Debris – Workers can also be struck from flying objects caused by power tools such as grinders and saws. Ensure all workers are properly trained on the use of power tools and always wear proper protective equipment including hardhats and eye protection

How you can help prevent struck-by injuries:

  1. Never position yourself between moving and fixed objects
  2. Wear high visibility clothes near equipment and vehicles
  3. Develop a traffic control plan including barriers and warning signs while working near vehicles or on roadways
  4. Install safety netting or canopies near elevated platforms to prevent workers from being hit by falling objects
  5. Train all workers on the proper operation of power tools, and ensure that proper machine guarding systems are in place to prevent flying objects from striking a worker

You can help prevent serious injuries with a dedicated inspection program:

Due to the continually high numbers of serious injuries and fatalities among construction workers today, OSHA has made a renewed effort to increase awareness about these dangerous hazards. You can find a wealth of resources on OSHA’s Outreach Training Program here. Many of these hazards present themselves due to carelessness, improper training, or lack of oversight. Implementing a dedicated inspection program can help identify potentially dangerous situations quickly, and ensure that issues get resolved in a timely manner. This not only reduces your chances of a worker sustaining an onsite injury, it also helps you finish your jobs efficiently and on budget.

With Mobile Inspection, you can create your own checklists and inspections, schedule and manage inspections from the internet, and download custom PDF reports including pictures and GPS locations for your records. Interested in learning more? Contact us to learn how Mobile Inspection can help you prevent the ‘Fatal Four’ from happening to you.