Safety
Workforce

Preventable Absences Are Possible in Construction

Employers can minimize absences by focusing on five specific medical conditions.
By Mark S. Williams
November 11, 2021
Topics
Safety
Workforce

It’s no secret that construction work is physically demanding and taxing on the body. While this type of labor can at times lead to workers sidelined with injuries, employers may be pleasantly surprised to learn how they can minimize their workers’ missed workdays—and keep employees safe and healthy. In fact, The Hartford has identified five medical conditions that construction companies should consider to prevent absences based on an analysis of hundreds of thousands of its combined workers’ compensation and disability claims.

Meniscal Tear

Considered one of the most common injuries causing workplace absences, particularly in the construction industry, a meniscal tear occurs more frequently in men, with nearly 35% of this work-related knee injury happening within the first year of employment according to The Hartford’s data. A specialized piece of cartilage between the tibia and femur in the knee, the meniscus is particularly vulnerable to activities involving deep squatting and especially torquing of the knee.

Construction companies may want to consider work modifications to deep squatting and pivoting in order to minimize high pressures and torquing on the knee joint, and reduce the need for these actions, whenever possible. For example, with stationary jobs, employers may want to provide a chair or stool to reduce squatting, and for lifting-related squatting, contractors should pre-plan mechanical lifting methods when possible. Mechanical lifting devices may include large equipment such as cranes or forklifts or smaller equipment such as roustabouts, jacks or pulley/winch systems. In addition, workers should consider using workbenches to place items to be lifted at a desirable height prior to lifting.

To reduce pivoting-related injuries, contractors should plan logistically for lifting events, asking themselves if items can be placed in designated areas to reduce the number of lifts or the number of turns, as well as take the time to reposition lifted items and workers when pivoting is required.

The key to these methods is systematic pre-planning of work that includes front line employees that can provide realistic feedback on how work is done and project managers that can approve cost-effective solutions that can be purchased ahead of time. Training should also be given early in employment to educate workers on how to plan ahead for work functions, what is the procedure for voicing concerns and requesting help, and proper lifting techniques. In addition, employers should contemplate offering a time and place for construction workers to stretch and warm up before a shift.

Rotator Cuff Syndrome

Rotator cuff syndrome occurs when the rotator cuff, a group of four muscles attaching the arm to the shoulder, becomes irritated or damaged, resulting in pain, weakness and a reduced range of motion. Improper reaching and frequent overhead work are particularly linked to this condition. Nearly 70% of people over the age of 50 are affected by rotator cuff syndrome, according to The Hartford’s claims analysis.

Employers can help mitigate rotator cuff syndrome by implementing lifting programs and encouraging movement, as well as providing assistive lifting wearables for work that involves high amounts of overhead activities. Planning to use mechanical lifting devices is by far the best way to mitigate rotator cuff syndrome. This includes pre-plan work platforms such as scaffolds or scissor lifts to get workers to heights where overhead work is not necessary or reduced. Prefabrication of overhead components will also help. Building components into a more complete product at ground level and then lifting them into place all in one piece will greatly reduce overhead reaching.

Contractors should also consider tools with extensions so that the workers' hands can remain at or below shoulder height. And while exoskeletons that take pressure off the body are now being introduced in the construction industry, this technology is very new and not widespread. It will take a little longer for this tech to be more readily available, but once that happens, it will be extremely beneficial to reducing rotator cuff injuries.

Lumbar Sprain

Lumbar sprain is an injury to the lower back resulting in damaged tendons and muscles that can spasm and hurt. This injury can occur suddenly or gradually due to overuse. The Hartford’s data shows 84% of lumbar sprains occurring in medium- to heavy-duty occupations.

Employers can reduce the incidence of lumbar sprain significantly by utilizing programs that teach workers lifting techniques, as well as consider using assistive lifting technologies when construction workers’ duties are in the medium to heavy range. Similar to rotator cuff syndrome, developing a pre-plan of activities that use mechanical lifting devices as opposed to manual labor is key to helping reduce lumbar sprain injuries.

Contractors would also be wise to teach workers proper lifting techniques and coach laborers to ask for help when lifting. It would be beneficial for construction companies to designate a proper number of workers to a lifting scenario and evaluate the task on an ongoing basis to ensure it is the adequate number.

Carpal Tunnel Syndrome

Described as numbness, tingling or weakness in the hand due to pressure on the median nerve, carpal tunnel syndrome is often difficult to properly diagnose. Research shows that construction and manufacturing workers have a significantly higher incidence of this injury compared with office workers.

While many factors can cause carpal tunnel syndrome, a big factor is forceful gripping and grasping combined with repetitive motion activities. This includes manual labor that requires lifting and forceful wrist motions, as well as exposure to vibration force in the work function through use of tools for hammering and drilling. If a worker is already working in an awkward posture, e.g. bent over at the waist drilling into concrete, and then combines that with the vibration force from a power tool such as a rotary hammer drill, then these risk factors could potentially have a compounding effect on the musculoskeletal injury.

Carpal tunnel syndrome can also be exacerbated when workers have minimal rest between work-related events and hobbies such as golfing, gardening, playing video games and riding motorcycles that involve forceful gripping and grasping techniques. Prevention is key. Workers should improve body mechanics to allow wrists to maintain neutral postures and minimize exposure to vibration magnitudes by rotating on and off vibrating tools and jobs that require excessive wrist motion.

Assistive devices are helpful. This can include anti-vibration gloves, adjustable desks and chairs, as well as tools that are designed to allow for neutral postures to be adopted. In addition, when workers are selecting a tool for the job, they should consider the ability of the tool’s handle and user’s wrist posture to fit the type of work it will be performing. When contractors are purchasing heavy power tools, they should consider features that allow the tool to be held with both hands. Workers would also be wise to take advantage of features that allow for greater control of the tool and less fatigue when operating heavy tools.

Employers could also consider job modifications for work that requires repetitive forceful gripping and grasping. This could alleviate the propensity for work-related carpal tunnel syndrome from occurring on the job.

Hernias

A hernia is the abnormal exit of tissue or an organ through the wall of the cavity in which it normally resides. Number seven on the overall list, this injury can be a result of improper lifting. If someone has had a hernia, it is more likely to happen again. Men have 98% of work-related hernias, according to The Hartford’s data.

To mitigate hernias, employers may want to consider implementing a fit-for-duty program that includes ergonomics training and wellness programs. Smoking cessation and weight management programs can be important because research shows a strong connection between smoking and poor tissue strength. In addition, a post-offer physical examination may be helpful in minimizing future injuries and absences because it may detect a previous hernia or a family history of abdominal hernias.

Partnering in Prevention

Injury prevention should be a partnership between employers and employees. Employers can normalize stretching or warm-ups to prepare for periods of increased physical demand, as well as leverage post-offer evaluation testing (POET) of employees, which can provide a detailed history and physical examination that may identify risks or confirm that they have a proper level of physical health that fits the job demands. Employees, in turn, can practice pre-workday stretching and warm-ups and take the need to be in good physical condition seriously. It’s important for these “industrial athletes” to remain fit and show up well rested to accomplish the day’s work demands—and to stay safe.

by Mark S. Williams
Dr. Mark S. Williams is a chiropractic physician and medical director with The Hartford. He received his Doctor of Chiropractic from Logan College of Chiropractic, his MBA from the University of Southern Maine, and a bachelor’s degree in Human Biology from Logan College of Chiropractic. He is board certified in occupational health and applied ergonomics. The Hartford offers middle and large commercial contractors injury prevention services (IPS), which includes onsite and virtual services.

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