Prescription opioid use and associated factors among US construction workers.

BACKGROUND: Construction workers are among the segments of the US population that were hit hardest by the opioid prescription and overdose deaths in the past decades. Factors that underlie opioid use in construction workers have been compartmentalized and isolated in existing studies of opioid use and opioid overdose, but they ignore the overall context of their use. This study examines prescription opioid use and its association with a variety of occupational and nonoccupational factors in construction workers in the United States. METHODS: Data from the 2011-2017 Medical Expenditure Panel Survey (n = 7994) were analyzed. The prevalence of prescribed opioid use and the association with occupational and nonoccupational characteristics among construction workers were examined in four multiple logistic regression models. RESULTS: The odds of prescription opioid use for workers with occupational injuries was more than triple that of their noninjured counterparts when demographics and occupational factors were controlled (odds ratio = 3.38, 95% confidence interval: 2.38-4.81). Odds of prescription opioid use were higher in older construction workers, workers who were white, non-Hispanic, working part-time, and in poorer health, while Hispanic workers and those without health insurance were much less likely to report prescription opioid use. CONCLUSIONS: Prescription opioid use among construction workers encompasses both occupational and nonoccupational factors. As an insight into opioid use among construction workers becomes clearer, effectively responding to the opioid crisis remains a challenge.

Chronic back pain among older construction workers in the United States: a longitudinal study.

This study assessed chronic back pain among older construction workers in the United States by analyzing data from the 1992-2008 Health and Retirement Study (HRS), a large-scale longitudinal survey. Fixed-effects methods were applied in the multiple logistic regression model to explore the association between back pain and time-varying factors (e.g., employment, job characteristics, general health status) while controlling for stable variables (e.g., gender, race, ethnicity). Results showed that about 40% of older construction workers over the age of 50 suffered from persistent back pain or problems. Jobs involving a great deal of stress or physical effort significantly increased the risk of back disorders and longest-held jobs in construction increased the odds of back disorders by 32% (95% CI: 1·04-1·67). Furthermore, poor physical and mental health were strongly correlated with back problems. Enhanced interventions for construction workers are urgently needed given the aging workforce and high prevalence of back disorders in this industry.

Injury underreporting among small establishments in the construction industry.

BACKGROUND: There is convincing evidence that occupational injury and illness rates, particularly those reported by employers in the BLS' Survey of Occupational Injuries and Illnesses (SOII), substantially underestimate the true magnitude of injury and illness in the construction industry. METHODS: Fifteen years of data from five large nationally representative data sources were analyzed, including SOII, CFOI, CBP, CPS, and MEPS. Regression trends and ratio analyses were conducted, and stratified by establishment size and Hispanic ethnicity. RESULTS: Small construction establishments were most likely to underreport injuries. The SOII data only captured 25% of severe injuries among Hispanic workers, and 60% among white workers in small construction establishments. CONCLUSIONS: Underreporting is pervasive in the construction industry for small establishments and Hispanic workers. Given that small establishments are predominant in the U.S. construction industry, they should be the focus of a larger effort to identify the true extent of construction-related injuries.

Occupational injury costs and alternative employment in construction trades.

OBJECTIVE: To present the costs of fatal and non-fatal days-away-from-work injuries in 50 construction occupations. Our results also provide indirect evidence on the cost exposure of alternative construction workers such as independent contractors, on-call or day labor, contract workers, and temporary workers. METHODS: We combine data from the Bureau of Labor Statistics on average annual incidence from 2000 to 2002 with updated per-case costs from an existing cost model for occupational injuries. The Current Population Survey provides data on the percentage of alternative construction workers. RESULTS: Construction laborers and carpenters were the two costliest occupations, with 40% of the industry's injury costs. The 10 costliest construction occupations also have a high percentage of alternative workers. CONCLUSIONS: The construction industry has both a high rate of alternative employment and high costs of work injury. Alternative workers, often lacking workers' compensation, are especially exposed to injury costs.

Costs of occupational injuries in construction in the United States.

This paper presents costs of fatal and nonfatal injuries for the construction industry using 2002 national incidence data from the Bureau of Labor Statistics and a comprehensive cost model that includes direct medical costs, indirect losses in wage and household productivity, as well as an estimate of the quality of life costs due to injury. Costs are presented at the three-digit industry level, by worker characteristics, and by detailed source and event of injury. The total costs of fatal and nonfatal injuries in the construction industry were estimated at $11.5 billion in 2002, 15% of the costs for all private industry. The average cost per case of fatal or nonfatal injury is $27,000 in construction, almost double the per-case cost of $15,000 for all industry in 2002. Five industries accounted for over half the industry's total fatal and nonfatal injury costs. They were miscellaneous special trade contractors (SIC 179), followed by plumbing, heating and air-conditioning (SIC 171), electrical work (SIC 173), heavy construction except highway (SIC 162), and residential building construction (SIC 152), each with over $1 billion in costs.