The construction industry is one of the most hazardous sectors in the United States. According to the Bureau of Labor Statistics (BLS), construction accounts for nearly 1 in 5 workplace fatalities annually1. To address the most common and deadly risks, OSHA has identified the “Fatal Four” hazards: Falls, Struck-By, Caught-In/Between, and Electrocutions. These four categories alone are responsible for over 60% of construction-related deaths each year2.
1. Falls: The Leading Cause of Death
Falls are the most frequent cause of fatalities in construction, accounting for 38.5% of all construction deaths in 20231. Common causes include:
- Unprotected edges
- Improper scaffolding
- Lack of personal fall arrest systems (PFAS)
OSHA’s Fall Protection Standard (29 CFR 1926 Subpart M) requires that fall protection be provided at elevations of six feet or more. Employers must install guardrails, safety nets, or PFAS and ensure workers are trained in their proper use2.
The CDC’s National Campaign to Prevent Falls in Construction emphasizes that falls from elevation are the leading cause of construction fatalities, and that training and planning are key to prevention3.
2. Struck-By Incidents
Struck-by hazards occur when workers are hit by moving vehicles, falling tools, or flying debris. These incidents are the second leading cause of construction fatalities. OSHA recommends:
- Wearing high-visibility clothing
- Using hard hats and face shields
- Maintaining safe distances from equipment
- Implementing traffic control plans on job sites2
Proper signage, equipment maintenance, and situational awareness are essential to reducing struck-by risks.
3. Caught-In/Between Hazards
Caught-in/between incidents involve workers being crushed between equipment, materials, or collapsing structures. These hazards often occur in trenching, excavation, and heavy equipment operations.
To prevent these incidents, OSHA requires:
- Protective systems for trenches deeper than 5 feet (e.g., shoring, shielding, or sloping)
- Guarding of moving machinery
- Lockout/tagout procedures during maintenance2.
Employers must ensure that workers never enter unprotected trenches and that excavation sites are inspected daily by a competent person.
4. Electrocutions
Electrocutions result from contact with overhead power lines, exposed wiring, or improperly grounded equipment. In 2023, electrocutions remained a significant contributor to construction fatalities1.
OSHA’s Electrical Standards (29 CFR 1926 Subpart K) require:
- Identification and marking of utilities
- Use of Ground-Fault Circuit Interrupters (GFCIs)
- Proper grounding or double insulation of tools
- Lockout/tagout procedures for energized equipment2
Training is critical to ensure workers understand how to recognize and avoid electrical hazards.
The Role of Training and Supervision
Training is one of the most effective tools for reducing workplace injuries and fatalities. A systematic review by NIOSH found that occupational safety and health training significantly reduces risk factors for injury and death, especially when combined with strong management commitment4.
Supervisors and safety managers play a vital role in:
- Enforcing safety protocols
- Conducting daily inspections
- Leading toolbox talks
- Modeling safe behavior
Creating a culture of safety starts with leadership and is sustained through continuous education and accountability.
Recommended OSHA Training Course(s):
Visit https://gbts.learnshare.com to view a full list of courses including the online OSHA 30-Hour construction course in both English and Spanish.
OSHA Outreach courses are provided in partnership with UL PureSafety, an OSHA-authorized online outreach provider. Meets OSHA and NYC Department of Buildings guidelines when actively proctored.
Contact Gallagher Bassett Technical Services at GBTSNYCinfo@gbtpa.com with any questions.
Sources
1: Bureau of Labor Statistics. (2025). Fatal falls in the construction industry in 2023. U.S. Department of Labor. https://www.bls.gov/opub/ted/2025/fatal-falls-in-the-construction-industry-in-2023.htm
2: Occupational Safety and Health Administration. (n.d.). Construction Focus Four Training. U.S. Department of Labor. https://www.osha.gov/training/outreach/construction/focus-four
3: Centers for Disease Control and Prevention. (2024). National Campaign to Prevent Falls in Construction. https://www.cdc.gov/niosh/construction/falls-prevention-campaign/index.html
4: Robson, L. S., Stephenson, C. M., Schulte, P. A., et al. (2010). A systematic review of the effectiveness of training & education for the protection of workers. National Institute for Occupational Safety and Health. https://www.cdc.gov/niosh/docs/2010-127/pdfs/2010-127.pdf
