Occupational Injuries among US Construction Workers Treated at the George Washington University Emergency Department, 1990-97

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Organization(s):

CPWR - The Center for Construction Research and Training , George Washington University , Washington Hospital Center

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Summary Statement

This report profiles injury tracking of emergency room visits to George Washington University Hospital, from 1990 through 1997. Includes information on trade, demographics, cause of injury, diagnosis, and injured body part.
Jan 2004

This research was made possible by funding from CPWR – Center for Construction Research and Training (CPWR) to the George Washington University and, more recently, to the Washington Hospital Center. The funding was part of a CPWR research agreement with the National Institute for Occupational Safety and Health (NIOSH) under NIOSH Cooperative Agreements CCU306169, CCU312014, and CCU317202. The research is solely the responsibility of the authors and does not necessarily represent the official views of NIOSH. CPWR – the research, development, and training arm of the Building and Construction Trades Department, AFL-CIO – is uniquely situated to serve workers, contractors, and the scientific community. CPWR’s goal is to improve safety and health in the U.S. construction industry.

© 2004, CPWR – Center for Construction Research and Training. All rights reserved. Copies of this report may be obtained from Publications, CPWR – Center for Construction Research and Training, Suite 1000, 8484 Georgia Ave., Silver Spring, MD, 20910, www.cpwr.com, 301-578-8500. For permission to reproduce this document or for bulk copies, contact CPWR.

Acknowledgments

Over the years, a number of George Washington University staff members have assisted with the collection and evaluation of data for this project. They include Natalie Aloyets, Remy Esquenet, Laura Kolb, Sandra Jacob, Mona Mahmood, Abla Mawudeku, Lisa Nessel-Stephens, Sandra Sanford, and James L. Weeks. Without their involvement, this project would not have been possible. The authors also appreciate the gracious assistance of the many individuals from the Department of Emergency Medicine.

Abbreviations

BLS	U.S.Bureau of Labor Statistics
GWU	George Washington University
NOS	Not otherwise specified
OSHA	U.S.Occupational Safety and Health Administration
SOC	Standard Occupational Classification

Summary

TO LEARN more about the causes of nonfatal injuries affecting construction workers, and in order to identify injury patterns for further investigations and prevention programs, an injury tracking program was established in 1990. The program was motivated, in part, by the high rate of nonfatal injuries in the construction industry and a lack of specific information that describes the causes of these injuries.

Each week from November 1990 through December 1998, a member of the research team reviewed all of the hospital registration forms at the George Washington University (GWU) Emergency Department in Washington, D.C. The demographic and injury information for patients listing a construction occupation was copied onto a standardized form. All personal information was kept confidential.

This report profiles the first seven years of injury tracking, from November 1, 1990 through October 31, 1997. During this period, 2,637 construction workers visited the emergency room a total of 2,916 times. Each injured worker was categorized into one of 16 groups by trade (occupation). The information on demographics, cause of injury, diagnosis, and injured body part was grouped into categories in order to examine injury patterns. Although 279 workers visited the emergency room more than once in the seven years studied, the focus of this report is on each injury case. Thus, this report refers to “2,916 injured “workers.”

The introductory section of this chart book details the background and methods of this research project. Along with charts that provide an overview of demographics and injuries of the inured workers, charts cover the 105 workers who were admitted to the hospital and their injuries. Trade-specific charts follow, with accompanying text that draws attention to any trade-specific injury trends and recommends ways to reduce injuries in each trade. The inside back cover provides a guide to interpreting the charts.

The results of follow-up with injured workers and their families to determine short- and long-term effects of the injuries are reported elsewhere.

Contents

Summary
Background and Methods
Comparison to Other Construction Injury Research
References
Injury Profiles for All Construction Workers

Injury Profiles for All Construction Workers (continued)
Chart 1-N – Percentage of injured workers in selected trades struck by a falling object
Chart 1-O – Percentage of injured workers in selected trades injured by electrical current
Chart 1-P – Percentage of injured workers in selected trades treated for eye injuries
Chart 1-Q – Percentage of injured workers in selected trades treated for burns
Chart 1-R – Percentage of injured workers in selected trades treated for toxic liquid/gas/dust exposure
Chart 1-S – Percentage of injured workers in selected trades treated for amputations/crushes/fractures to their fingers/hands

Injury Profiles for Individual Construction Trades, Listed in Order of Number of Injured Workers
Laborers (Summary report accompanied by Charts 2-A – 2-G)
Carpenters and Carpet Layers (Summary report accompanied by Charts 3-A – 3-F)
Electricians (Summary report accompanied by Charts 4-A – 4-F)
Pipe Trades: Plumbers and Sprinkler Fitters (Summary report accompanied by Charts 5-A – 5-E)
Supervisors and Foremen (Summary report accompanied by Charts 6-A – 6-E)
Ironworkers (Summary report accompanied by Charts 7-A – 7-E)
Painters and Glaziers(Summary report accompanied by Charts 8-A – 8-E)
rick, Stone, and Concrete Masons (Summary report accompanied by Charts 9-A – 9-E)
Sheet Metal Workers (Summary report accompanied by Charts 10-A – 10-E)
Exhibit Technicians (Summary report accompanied by Charts 11-A – 11-E)
Drywall Workers and Plasterers (Summary report accompanied by Charts 12-A – 12-C)
Asbestos and Insulation Workers (Summary report accompanied by Charts 13-A – 13-C)
Roofers and Waterproofers (Summary report accompanied by Charts 14-A – 14-C)
Heavy-Equipment Operators (Summary report accompanied by Charts 15-A – 15-C)
Welders (Summary report accompanied by Charts 16-A – 16-C)
Elevator Constructors and Mechanics (Summary report accompanied by Charts 17-A – 17-C)

Guide to Reading the Bar Charts

Background and Methods

CONSTRUCTION is a dangerous industry, with high rates of fatal and nonfatal injuries. In order to learn more about the causes of nonfatal injuries affecting construction workers and to identify injury trends for further investigations and prevention programs, an emergency department-based injury tracking program was established in 1990. The program was motivated, in part, by the high rate of nonfatal injuries in the construction industry and a lack of specific information about the causes of the injuries. This report profiles construction workers’ injuries that were identified on hospital registration forms at the George Washington University Emergency Department in Washington, D.C., from November 1, 1990 through October 31, 1997.

Each week, a member of the research team reviewed all of the hospital registration forms to identify injured workers in all construction occupations. Included was any worker whose job title was coded by the 1980 Standard Occupational Code (U.S. Department of Commerce) as “construction trades,” “construction laborers,” “construction helpers,” “construction managers,” “construction supervisors,” “construction inspectors,” “sheet metal workers,” or “elevator installers and repairers.” Thus, the list included construction tradespeople employed by non-construction-industry employers, such as maintenance painters, carpenters, electricians, and plumbers employed primarily by government agencies, educational institutions, and museums or theaters. Finally, some other job titles, such as, “welders” and “material moving equipment operators,” were included if they appeared (from the employer name) to be engaged in construction work ( table 1).

Table 1.Standard Occupational Classification (SOC)criteria for including and grouping job titles

SOC code	SOC category description	Trade group for analysis
121	General managers and top executives	Supervisors
133	* Construction managers [see note a]	Supervisors
1472	* Construction inspectors	Supervisors
161	Architects	Supervisors
162-3	Engineers	Supervisors
616	Heating, air conditioning, and refrigeration mechanics	Sheet Metal Workers
6176	* Elevator installers and repairers	Elevator Constructors & Mechanics
6179	Mechanics and repairers, NEC (only sprinkler fitters)	Plumbers & Sprinkler Fitters
631x	* Supervisors, construction	Supervisors
641x	* Brick masons, stone masons, and hard tile setters	Brick, Stone, & Concrete Masons
6422	* Carpenters [ note b]	Carpenters & Carpet Layers OR Exhibit Technicians
6424	* Drywall installers	Drywall & Plaster Workers
6432	* Electricians	Electricians
6433	* Electrical power installers and repairers	Electricians
6442	* Painters	Painters & Glaziers
6443	* Paperhangers	Painters & Glaziers
6444	* Plasters	Drywall & Plaster Workers
645	* Plumbers, pipefitters and steamfitters	Plumbers & Sprinkler Fitters
6462	* Carpet and soft tile installers	Carpenters & Carpet Layers
6463	* Concrete and terrazzo finishers	Brick, Stone, & Concrete Masons
6464	* Glaziers	Painters & Glaziers
6465	* Insulation workers	Asbestos & Insulation Workers
6466	* Paving, surfacing, and tamping equipment operators	Heavy Equipment Operators
6468	* Roofers	Roofers & Waterproofers
6472	* Sheetmetal duct installers	Sheet Metal Workers
6473	* Structural metal workers	Ironworkers
6474	* Drillers, earth	Heavy Equipment Operators
6475	* Air hammer operators	Laborers
6476	* Pile driving operators	Heavy Equipment Operators
6479	* Construction trades, not elsewhere classified	Laborers
6814	Boilermakers	Welders & Boilermakers
6824	* Sheet metal workers	Sheet Metal Workers
6832	Cabinet makers and bench carpenters	Carpenters & Carpet Layers
7633	Sawing machine operators and tenders	Carpenters & Carpet Layers
7714	Welders and cutters	Welders & Boilermakers
821	Motor vehicle operators	Heavy Equipment Operators
831	Material moving equipment operators	Heavy Equipment Operators
864	* Helpers, construction trades	With Respective Trade
871	* Construction laborers	Laborers
872	Freight, stock, and material movers – hand	Laborers
other	Non-construction trades injured on construction sites [ note c ]	Laborers

* Category includes every injured worker, whether or not employer was a construction company; other categories included only injured workers whose employer was engaged in construction work.
a. “Construction managers” include 9 self employed contractors with no trade specified; self-employed managers who specified a trade were coded with that trade.
b. Carpenters and technicians who did exhibit work (for conventions) were sometimes identified as such by their job titles. We also identified workers as exhibit technicians by referencing a complete list of contractors who do trade show/exhibit work in the area.
c. Non-construction trades workers injured on construction sites included 1 emergency medical technician, 2 security guards, and 3 elevator operators.

Injuries were determined to be work-related based on a combination of data in the medical record: the patient’s initial complaint, indication that the payment was to be through workers’ compensati on insurance, notes made by any treating health care worker about the circumstances of the injury, or the physician’s check in a box labeled “work-related.”

During the seven years of data collection reported here, 2,916 visits to the Emergency Department were made by 2,637 injured construction workers, and 3,207 diagnoses were recorded among those visits for this study. Three workers were fatally injured. Although some workers visited the emergency room more than once in the seven years studied, this report focuses on each injury case. Thus this report refers to the total set of cases as “2,916 injured workers.”

The following data were collected from the medical chart of each construction worker with a work-related condition (if available): medical record number, name, address, state and zip code of residence, phone number, gender, date of birth, social security number, ethnicity, employer name, city and state, occupation, up to two diagnoses, circumstances of injury, and physician’s recommendation for time off work or light duty. If a patient was admitted to the hospital, the discharge date was also noted. The George Washington University Committee on Human Research approved this project and all personal information has been kept confidential. Occupation was coded according to 1980 Standard Occupational Classification (SOC) codes. Diagnosis codes and cause-of-injury codes (E-codes) were assigned according to the International Classification of Diseases, 9 th Revision (ICD-9).

Data collection was continuous except for July through December 1994, when only two groups of injuries were recorded: those from one large local construction project, and those serious injuries that required the services of the emergency department trauma team. During the 6 months of partial data collection, about 200 cases were probably missed.

In 1994 at the midpoint of this project, approximately 9,000 construction workers were employed in the District of Columbia and about 113,000 were employed in the area (including surrounding Maryland, Virginia, and West Virginia counties). ( a Bureau of Labor Statistics website, Non-Farm Wage and Salary Employment.) However, it is not known how many of these people work downtown and, if injured, would be treated at a downtown hospital such as George Washington University (GWU). Furthermore, cannot be calculated and the analyses are based on the percentage or proportion of construction injuries that were treated at GWU. pattern of work and injuries for each trade or all construction.

For the trades that are represented by fewer than 70 injured workers (an average of fewer than 10 each year), selected injury causes, diagnoses, and injured body parts are profiled on a single chart (chart A in each section). Among these trades, some injuries or GWU’s emergency department is only one of several emergency departments in downtown Washington. Because of this, injury rates njuries treated at the emergency department – reflects the Similarly, it is not known types of construction work done near GWU – or i

Data collection was continuous except for July through December 1994, when only two groups of injuries were recorded: those from one large local construction project, and those serious injuries that required the services of the emergency department trauma team. During the 6 months of partial data collection, about 200 cases were probably missed.

In 1994 at the midpoint of this project, approximately 9,000 construction workers were employed in the District of Columbia and about 113,000 were employed in the area (including surrounding Maryland, Virginia, and West Virginia counties). ( a Bureau of Labor Statistics website, Non-Farm Wage and Salary Employment.) However, it is not known how many of these people work downtown and, if injured, would be treated at a downtown hospital such as George Washington University (GWU). Furthermore, GWU’s emergency department is only one of several emergency departments in downtown Washington. Because of this, injury rates cannot be calculated and the analyses are based on the percentage or proportion of construction injuries that were treated at GWU. Similarly, it is not known types of construction work done near GWU – or injuries treated at the emergency department – reflects the pattern of work and injuries for each trade or all construction.

For the trades that are represented by fewer than 70 injured workers (an average of fewer than 10 each year), selected injury causes, diagnoses, and injured body parts are profiled on a single chart (chart A in each section). Among these trades, some injuries or diagnoses were infrequent, and it is not possible to present a reliable percentage; those outcomes are not displayed. The accompanying list of injury causes (chart B) and diagnoses (chart C) is comprehensive.

Comparison to Other Construction Injury Research

This injury tracking project is based at the George Washington University Emergency Department, which is a large hospital in Washington, D.C. Because the data come from one location, and because they are based on emergency room visits, the information presented here will look different from reports based on other data sets and other data collection methods. When comparing different sources of construction injury data, it is important to consider whether the types of construction projects and the data sources are similar.

Construction near the hospital is mainly new commercial construction, commercial renovation, and commercial maintenance. Much of the commercial construction is high-rise office and apartment buildings. There is also some road and bridge repair work, but very little residential construction. The types of construction projects influence the mix of trade specialties working downtown. The mix of tasks and trades, in turn, influences injury risk.

Injury profiles vary, depending on where the data come from and how “injury” is defined. In some cases, emergency department medical reports include the injuries of workers who wouldn’t show up in other sources of injury data. For example, this project includes workers who didn’t lose time from work as a result of their injuries, these same workers might not qualify for workers’ compensation or show up in reports that count only lost-time injuries. On the other hand, emergency department data might not capture workers with less-urgent injuries, such as low-back pain and other sprains and strains. Different sources of information will describe different pieces of the pie, in terms of the proportion of construction workers who are injured on the job and the types of injuries they suffer. For example, a worker might go to a family doctor for a knee that won’t stop aching, but he or she will go the emergency department for an amputated finger. Despite this limitation, emergency department medical records are a rich resource for identifying nonfatal injuries and are likely to capture virtually all injuries that require immediate medical attention.

As one might expect, a smaller proportion of the construction workers who were identified in these emergency department data were treated for sprains and strains, as compared to other reports that were based on workers’ compensation data or employers’ injury logs (Hunting and others 1999; also see Welch and Hunting 2003).

The information sources that researchers have commonly used to describe nonfatal work-related injuries and illnesses include annual employer survey data published by the Bureau of Labor Statistics (BLS), workers’ compensation data, emergency department medical records, and employer injury logs ( the BLS website; Culver, Marshall, and Connolly 1992; and Brown and Connolly 1992). The Construction Chart Book profiles construction injuries using these and other sources (CPWR 2002).

In this report, injuries have been grouped by their causes into one of 10 general categories such as “falls,” “struck by object,” and “machinery related.” These cause of injury categories are based on “E-codes” that are part of the International Classification of Diseases and are commonly used to describe injuries and diseases in medical settings such as emergency departments. More-detailed categories are also used for grouping injuries by cause, diagnosis, and injured body part. The reader should be aware that other coding systems exist. For example, the Bureau of Labor Statistics has its own system. When interpreting the results of a study, it is important to know which coding system was used.

Although many previous reports have described construction worker injuries, very few have provided detailed data by trade. An important exception is a 1995 injury atlas from the Construction Safety Association of Ontario, Canada, which described lost-time construction injuries for each trade in detail. The atlas has been updated; see . This chart book has in many ways been modeled on the Ontario report; our hope is that it will be as valuable for establishing trade-specific prevention priorities.

References

Anderson, Judith TL, Katherine L Hunting, and Laura S Welch. 2000. Injury and Employment Patterns Among Hispanic Construction Workers. Journal of Occupational and Environmental Medicine , 42(2): 176-86, February.

Brown, Anthony D., and Constance A. Connolly. 1992. Construction Lost-Time Injuries:The U.S.Army Corps of Engineers Data Base,1984-1988.Washington, D.C.: U.S. Department of Labor, December

Bureau of Labor Statistics. Data on Workplace Injuries and Illnesses, 1989-1999. ( )

–––. Non-farm Wage and Salary Employment. ( ), accessed 5/07/01, follow links for both DC and DC MSA, then for Construction, then for 10-year history.

CPWR, CPWR – Center for Construction Research and Training. 2002 The Construction Chart Book: The U.S.Construction Industry and Its Workers, Third Edition . CPWR – Center for Construction Research and Training, Silver Spring Maryland. .

CSAO, Construction Safety Association of Ontario. 2003. Injury Atlas, Ontario Construction: Based on WCB Injury Reports from 1997 to 1999. Construction Safety Association of Ontario, Toronto, Ontario, Canada.

Culver, Charles, Michael Marshall, and Constance Connolly. 1992. Construction Accidents:The Workers ’ Compensation Database, 1985-1988.Washington, D.C., U.S. Department of Labor, OSHA, April.

Hunting, Katherine L , Laura S Welch, Lisa Nessel-Stephens, Judith TL Anderson, and H Abla Mawudeku. 1999. Surveillance of Construction Worker Injuries: The Utility of Trade-Specific Analysis. Applied Occupational and Environmental Hygiene,14(7): 458-69, July.

Lipscomb, Hester J., John M Dement, Vernon McDougall, and John Kalat. 1999. Work-Related Eye Injuries Among Union Carpenters. Applied Occupational and Environmental Hygiene,14(10): 665-76, October.

Lipscomb, Hester J., John Kalat, and John M Dement. 1996. Workers’ Compensation Claims of Union Carpenters 1989-1992: Washington State. Applied Occupational and Environmental Hygiene,11(1): 56-63, January. [Also see related letter, Applied Occupational and Environmental Hygiene , 12(8): 507-509, August 1997.]

Nessel-Stephens, Lisa, Laura S Welch, James S Weeks, Katherine L Hunting, and Jose Cardenas-Amaya. 1995. Carbon Monoxide Poisoning from Use of Gasoline-Fueled Power Washers in an Underground Parking Garage – District of Columbia, 1994. Morbidity and Mortality Weekly Report,44(18): 356-57, 363-64, May 12th.

Ore, Timothy, and Nancy A Stout. 1997. Risk Differences in Fatal Occupational Injuries Among Construction Laborers in the United States, 1980-1992. Journal of Occupational and Environmental Medicine,39(9): 832-43, September Pollack, Earl S., Matthew Griffin, Knut Ringen, and James L Weeks. 1996. Fatalities in the Construction Industry in the United States, 1992 and 1993. American Journal of Industrial Medicine,30(3): 325-330, September.

Welch, Laura S., and Katherine Hunting. 2003. Injury Surveillance in Construction: What Is an “Injury”, Anyway? American Journal of Industrial Medicine,44(2): 191-96, August.

Welch, Laura S., Katherine L Hunting, and Judith TL Anderson. 2000. Injury Surveillance in Construction: Injuries to Laborers. Journal of Occupational and Environmental Medicine,42(9): 898-905, September.

Welch, Laura S., Katherine L Hunting, Abla Mawudeku. 2001. Injury Surveillance in Construction: Eye Injuries. Applied Occupational and Environmental Hygiene,16(7): 755-62, July.

Injury Profiles for All Construction Workers

IN SEVEN YEARS,information was collected on a total of 2,916 visits by construction workers to the emergency department for work-related injuries. Two hundred and seventy-nine of the visits were made by workers who were treated more than once on different occasions for different injuries. In this report, each hospital visit is counted as a separate injury case and, for simplicity, the total set of cases is referred to as “2,916 injured workers.” An overview of the injuries and injured is presented in charts 1-A through 1-Q.

Demographic characteristics (charts 1-A through 1-C): The injured workers were generally young; two of every three workers were under the age of 40. Just over half of the injured workers were members of ethnic minorities. The hospital categorized each worker as Hispanic (which includes black and white), non-Hispanic black, and non-Hispanic white. Only 3% of the injured workers were female. For statistical analysis, construction workers who didn’t specify a trade were grouped with laborers, with the result making up the largest group – 29% of injured workers. Some trades that pe rform similar work were grouped together for analysis. For instance, maintenance carpenters, electricians, plumbers, and painters were grouped with their construction counterparts. Exhibit technicians were assigned to their own group because their tasks were considered to be unique.

Causes of injury (charts 1-D and 1-E): The leading cause of injury was contact with cutting or piercing objects – most often pieces of metal, razors and knives, power tools, and nails.

Injury diagnoses and body parts (charts 1-F through 1-H): About 10% of the workers had two injury diagnoses, sometimes to different parts of the body; for instance, a worker might have been treated for a bruised arm and a strained shoulder following a fall. Because of this, some workers are counted in more than one category and the percentages add to more than 100.

About one in three workers was treated for a laceration (cut). Of the workers treated for strains, sprains, or musculoskeletal pain, almost 40% had a back injury.

Hospital admissions (charts 1-I through 1-L): Over this seven-year period, 105 workers had injuries that were serious enough to require inpatient admission to the hospital – 3.6% of all visits. Three workers died from their injuries; these cases are included here. While about 60% of the workers admitted to the hospital had short stays of one or two days, the remaining workers had lengthy stays – several longer than a month. The percentage of injuries admitte d to the hospital varied substantially among trades and by ethnicity or race.

The large proportion of Hispanic workers admitted to the hospital might be because that group is over-represented in the more basic trades, which are often considered to be more dangerous, or may otherwise be assigned more hazardous work. Alternatively, perhaps injured Hispanic workers are more reluctant to seek treatment for some of their less-serious injuries because of immigration status or other issues (s Anderson, Hunting, and Welch 2000).

Selected injuries and circumstances by trade (charts 1M through 1S): The injury patterns reflect the job tasks and hazards and provide a starting place for deciding how to make the job safer. More detail for each of these types of injury can be found in the trade-specific injury profiles. Except on charts 1-M, 1-N, and 1-P, the injuries that are highlighted are fairly uncommon within most trades. Thus these analyses are based on small numbers of injuries, and should be interpreted cautiously.

Of the 498 construction falls that were treated at the GWU Emergency Department, 352 were falls from a height. These falls from a height are highlighted because of their potentially serious consequences. The remaining 146 workers had either fallen from the same level or had fallen in unspecified circumstances; they are excluded from this chart. The nature of the falls, along with possible prevention strategies, are described in the injury profiles for each trade ( Gillen, Faucett, Beaumont, and McLoughlin 1997).

Injuries caused by a falling object are highlighted, largely because of the serious potential outcomes. One-tenth of the 2,916 construction workers were struck by a falling object.

Injuries caused by electrical current are highlighted because of the potential for a worker to be killed and because such a high proportion of these workers was admitted to the hospital. There were striking differences among the trades in the proportion of injuries that were caused by exposure to electrical current.

Eye injuries are highlighted because they are largely preventable by implementing and enforcing straightforward eye protection policies. Developing eye injury prevention programs should be a priority (Lipscomb, Dement, McDougall, and Kalat 1999, and Welch, Hunting, and Mawudeku 2001).

Burns are highlighted because they can be serious and there were dramatic differences in the proportions of burn injuries among the trades. Also, the causes of burns differ substantially by trade. For instance, roofers are often splashed with hot tar, while electricians and supervisors are frequently burned by electrical current.

Toxic exposures are highlighted because, like electrical exposures, they can be fatal. Work-related health effects from toxic exposures – including poisoning, skin rashes, skin burns from caustic a nd corrosive materials, and breathing problems – are relatively uncommon compared to work-related injuries. The proportion of workers treated for toxic exposures varied substantially by trade. Carbon monoxide was the most common exposure and occurred when workers used gas-powered jet washers, concrete saws, forklifts, and other combustion equipment in inadequately ventilated spaces (see Nessel-Stephens and others 1995). Many construction workers with these types of problems will not seek emergency treatment and may, instead, visit their family doctor or not seek treatment at all.

Severe finger and hand injuries are highlighted because they can be disabling. Fingers and hands are the body parts most often injured among these construction workers, accounting for one-third of cases treated in the emergency room during this study. Approximately 15% of these finger and hand injuries were amputations, partial amputations, crushes, and fractures. (Because of small numbers, the information for elevator mechanics and heavy equipment operators should, however, be interpreted cautiously.)

Chart 1-E

2,916 injured construction workers
Detailed causes of injury,rank 1-3

RANK #1	26%
SHARP OBJECT	762
metal/sheetmetal/duct	170
razor/knife	128
power tool, incl. saw (25), drill (18), screw gun (17), nail gun (13)	92
nail/screw	78
hand tool, incl. hacksaw (12), chisel (8)	48
metal stud	40
cable/wire	36
glass	34
light fixture	21
wood/splinter	17
saw (unspecified type)	13
ceramic/ceiling tile	10
metal bar/rebar	9
pipe	9
metal ceiling frame	8
other	32
not specified	17

RANK #2	20%
STRUCK BY/AGAINST OBJECT (INCL.FALLING OBJECT)	580
pipe	52
board/wood	46
beam	44
metal/sheetmetal/duct	39
hammer/sledge	33
metal object/plate	36
scaffold	26
ceiling/wall	25
rebar/metal bar	24
cinder block/brick/stone	17
granite/marble/stone	16
hand tool, other than hammer	15
door	14
concrete/cement	13
drill	13
drywall/plaster	13
box/crate/toolbox	12
power tool, other than drill	12
wire/cable	11
light fixture	7
cart/dolly	6
door jamb/doorway	5
truck	5
table	4
other	64
not specified	28

RANK #3	17%
FALL	498
from ladder	135
slip/trip/stumble	99
from scaffold	80
from another level	59
from stairs	30
out of a building/structure	26
into a hole	21
not specified	48

GWU Emergency Department injury data, 11/90 – 10/97
Note:Only the more common causes of injury are listed.

Chart 1-E,continued

2,916 injured construction workers
Detailed causes of injury,rank 4-6

RANK #4	12%
OVEREXERTION / STRENUOUS MOVEMENT	355
lifting/carrying	193
pushing/pulling	32
stepping on/off, walking	24
bending over	10
while drilling	9
using hammer/sledge	7
stopping a fall/falling object	6
overhead	4
using jackhammer	4
other	36
not specified	30

RANK #5	8%
OBJECT IN EYE	239
concrete/cement (dust or wet)	53
metal dust	39
chemical	25
dirt/dust/debris	24
drywall/plaster	12
paint (dust or wet)	11
wood dust	10
insulation	9
rock/stone/gravel	6
ceiling tile	5
other	11
not specified	34

RANK #6	5%
MACHINERY RELATED	142
power saw (woodworking)	32
grinder	18
welder/solderer	17
crane	13
forklift	10
bobcat/front-end loader	8
air compressor	7
elevator	5
other: lifting machine	9
woodworking machine	6
metalworking machine	4
miscellaneous	7
not specified	6

Chart 1-H

2,916 injured construction workers treated for 3,207 diagnoses
Injured body parts for selected diagnoses*

RANK #1	37%
LACERATION	1,079
finger/thumb	408
hand/wrist	226
face/head	195
elbow/forearm	125
ankle/foot	63
knee/leg/hip	55
shoulder/upper arm	4
trunk	4

RANK #2	22%
SPRAIN,STRAIN,PAIN	649
low/upper back 252
ankle/foot	93
knee/leg/hip	77
neck	61
shoulder/upper arm	56
hand/wrist	54
elbow/forearm	27
trunk	27
finger/thumb	22
not specified	4

RANK #3	15%
CONTUSION,ABRASION, FOREIGN OBJECT (excl.eye)	446
knee/leg/hip	92
ankle/foot	61
hand/wrist	56
finger/thumb	51
trunk	46
face/head	43
back	35
shoulder/upper arm	31
elbow/forearm	30
multiple	18
neck	7
not specified	2

RANK #4	11%
EYE INJURY	314

RANK #5	9%
FRACTURE	253
finger/thumb	73
ankle/foot	59
hand/wrist	44
elbow/forearm	21
trunk	21
knee/leg/hip	16
shoulder/upper arm	14
face/head	13
multiple	4

* Percentages are out of 2,916 injured workers. Some injured workers have more than one diagnosis/ injured body part.