Construction injuries

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International Journal of Occupational Safety and
Ergonomics
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Causes of Construction Injuries: Review
Getnet Engeda Birhane, Li Yang, Jichao Geng & Junqi Zhu
To cite this article: Getnet Engeda Birhane, Li Yang, Jichao Geng & Junqi Zhu (2020): Causes of
Construction Injuries: Review, International Journal of Occupational Safety and Ergonomics, DOI:
10.1080/10803548.2020.1761678
To link to this article: https://doi.org/10.1080/10803548.2020.1761678
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2. 1
Publisher: Taylor & Francis & Central Institute for Labour Protection – National Research Institute (CIOP-PIB)
Journal: International Journal of Occupational Safety and Ergonomics
DOI: 10.1080/10803548.2020.1761678
Causes of Construction Injuries: Review
Getnet Engeda Birhane, Li Yang, Jichao Geng, Junqi Zhu
E-mail: getnet1999@gmail.com, y321212@163.com, , gjcjsj@126.com, 276415876@qq.com
School of Economics and Management, Anhui University of Science and Technology, Huainan, Anhui 232001, PR
China
Acknowledgement
This study was supported by the National Natural Science Foundation of China under grant (No. 71971003); the
Major Program of Humanities and Social Sciences in Colleges and Universities of Anhui Province, China under grant
(No. SK2019ZD09); the MOE (Ministry of Education in China) Project of Humanities and Social Sciences under
grant (No.19YJCZH037); Key Research Fund for Young Teachers of Anhui University of Science and Technology
under grant (No. QNSK201801); Start-up fund for motivating young researchers of Anhui University of Science and
Technology, the Excellent Young Talents Program Project of Anhui Province in China under grant (No.
gxyq2017010).
Causes of Construction Injuries: Review
Getnet Engeda Birhane, Li Yang, Jichao Geng, Junqi Zhu
E-mail: getnet1999@gmail.com, y321212@163.com, , gjcjsj@126.com, 276415876@qq.com
School of Economics and Management, Anhui University of Science and Technology, Huainan, Anhui
232001, PR China

3. 2
Abstract
The aim of this paper is to identify the causes of construction injuries (CIs), to summarize them into
categories, to provide input in a concise form for reference and recommend possible solutions. A total of
967 peer-reviewed papers were retrieved and after identification, 42 papers were finally identified and
analyzed in detail. The causes of CIs were categorized into four major factors; management commitment
factors, behavioral factors, psychological factors, and demographic factors, then each reviewed separately.
The main finding of the study is that management commitment and behavioral factors are the main sources
of CIs. The finding regarding experience and age is the contribution of this paper. Thus, further joint
research needs to be conducted using mixed methods to provide a better and in-depth understanding of the
association between the empirical findings and accident causation theories to design effective safety
policies. Further, the public body responsible for safety implementation should design mass media
awareness advertisement to increase the general public’s awareness.
Key words: Work-Related Injuries, Construction Injury, Causes of Injury, Human Behavior
1. Introduction
The construction industry has played a significant role in the development of countries with 350 million
people around the world are directly involved in this sector, and the number is growing rapidly in the cities.
However, due to several occupational health risks, this sector has placed the top of the list in terms of
workplace accidents and injuries. Workers in this sector were exposed to several types of fatal occupational
health hazards daily [1].

4. 3
Construction work involves various activities such as working in confined spaces, working at heights,
manual handling, lifting operations, demolition works and ground works. These all activities involve risks
and are very hazardous in nature. So, the chances of accidents taking place on construction sites are high.
Conducting a thorough investigation that identifies the causes will help to prevent similar events from
happening again [2]. Construction sites were exposed to a wide range of accidents, it is very important to
identify the causes of these accidents to plan and implement a preventive safety system to avoid the same
type of accidents from happening and to decrease the probability of unexpected injuries [3].
Thus, the importance of identifying and understanding the causes of construction accidents is not an option
but the key factor for developing appropriate safety plan and reducing the occurrence of construction
occupational injuries. In order to achieve these objectives many researchers had conducted different studies
with different methodologies in different parts of the world and concluded different factors as the causes for
CIs. However, there is a lack of review studies to present a comprehensive review of the industry for
construction companies, safety managers and researchers. Thus, this paper provides a compressive review of
the causes of CIs.
The research objectives of the review are (1) to collect and identify papers related to causes of CIs; (2) to
examine and review the variables identified as causes; (3) to condense the variables into categories; (4) to
create factors and (5) to analyze each factor separately and to present comprehensive overview. Thus, after a
thorough assessment of peer-reviewed literatures; this paper identified and categorizes key variables under
four factors; management commitment, behavioral factors, psychological factors, and demographic factors
and developed a framework of causes of CIs.

5. 4
The study is arranged in the following order; methodology is presented in the second section, causes of CIs
were reviewed in depth in third section, and the fourth section contains the conclusion. The final section
contains recommendation.
2.
Methodolo
gy
2.1.
Literature
search and
inclusion criteria
The materials used in this review paper were studies on the prevalence of CIs obtained from Web of
science, Google search engine and Google scholar using search terms like ‘causes of injuries’, ‘CIs’, work-
related injuries, causes of injuries, and ‘human behavior’. Based on the search engines, yielded 969(nine
hundred sixty nine) of references from 2006-2019 were identified. We used Citespace version 5.6.R1 to
identify the important studies and 42 articles were downloaded in accordance to the inclusion criteria
specified in (table 1) below and reviewed in full. Studies were selected based on the following inclusion
criteria: (1) the study was published between January 2006 to November 2019, (2) the participants were
construction employees and accidents were work-related, (3) the study focus on identifying causes of
construction injuries, factors that influence the unsafe behaviors and accidents, (4) the study was published
in a refereed journal, and (5) the study was written in English (table 1). In total, 42 studies were included in
the final review to determine causes of CIs (Figure 1).
Insert table 1: Material selection Criteria
Description Inclusion Criteria

6. 5
Insert figure 1: Identification and framework development
2.2. Data Extraction
In all the reviewed papers the study design, study type, analytical method, sample size and findings were
identified in detail as shown in (table 2) below. Then the variables that were reported as cause or
contributory factors of CIs were analyzed based on their association with unsafe behaviors and accidents.
These variables were further condensed according to some common characteristics, which were later
grouped under four categories (or factors).
table 2: Causes of construction injuries identification
Publication period Studies Published from January 2006 to
November 2019
Participants of the Study construction employees and accidents were
work-related
Focus of the study causes of construction injuries, factors that
influence the unsafe behaviors and accidents
Type of Journal Studies published in a refereed journal
Language Studies written in English were used

7. 6
Reference &
Country
Study Design Analytical method Sample
size
Finding
[3] (Oman) Case Study Descriptive analysis 40 Poor instruction by supervisors, lack of training, lack of workers’ awareness, lack of
maintenance of equipment, underestimating dangers by workers, lack of
contractor awareness regarding health and safety, poor scaffolding, lack of health and
safety warning signs at the construction site and lack of safety considerations by site
supervisors.
[4] (Nigeria) Descriptive
Statistics
Descriptive Statistics
Analysis
70 Lack of attention from leaders and negligence were causes of construction accidents.
[5] (Hong Kong) Survey Descriptive Statistics
Analysis
292 The results suggest that future safety climate interventions should be more effective if
supervisors exhibit transformational leadership, encourage construction personnel to
voice safety concerns without fear of retaliation, and repeatedly remind them about
safety on the job.
[6] (Bhutan) Exploratory
Study
Descriptive Statistics
Analysis
54 Lack of safety regulations and standards, low priority of safety, lack of data on safety
at construction sites, lack of competent manpower, lack of safety training, lack of
safety promotion, and lack of documented and organized safety management systems.
[7] (Nigeria) Survey design Descriptive Analysis 50 Implementing a health and safety policy increases the cost of the projects. Lack of
safety orientation and training increases injuries.
[8]
(Thailand)
Cross-
Sectional
Multiple Logistic
Regression
248 Workers who worked as main jobs were 2.56 times more likely to get an accident
than those who did not. The workers who had the same posture repeatedly over 1
hour were 2.35 times more likely to get an accident than those whose posture was
repeatedly less than 1h. Workers who drank alcohol were 2.72 more likely to get an
accident than those who did not time.
[9] (Hong
Kong, China)
Qualitative Qualitative Analysis 12 Workers were involved in unsafe behavior because of: a lack of safety awareness; to
exhibit of being ‘tough guys’; work pressure; co-workers’ attitudes; and other
organizational, economic and psychological factors
[10]
(Palestine)
Mixed design Quantitative &
Qualitative analysis
34 Accident rates will decrease among subcontractors and their workers if new workers
were trained well in the work site and they were informed about dangerous places,
and if a workable safety plan is well preplanned. Accident rates increased among
subcontractors when using old, unsafe equipment and due to the complexity or
difficulty in the construction sites features.
[11] (Ethiopia) Cross-
Sectional
Study
Bivariate &
Multivariate
Logistic
Regression Analysis
809 Causes of injuries were job dissatisfaction, working for more than 48 h per week, lack
of vocational trainings, and not using of PPE.
[12] (Egypt) Cross-
sectional
Regression Analysis 107 Extended working hours, poor safety climate, short duration of work, job
dissatisfaction, young age, and job stress were significant risk factors of occupational
injuries.
[13] (Ethiopia) Cross-
sectional
Descriptive Statistics
Analysis
75 Cause of injury was lack of PPE.
[14] (Ethiopia) Institutional
based cross-
sectional
Descriptive Statistics,
Bivariate &
Multivariate
401 The causes of injuries were old age, job dissatisfaction, lack of vocational training
and working overtime.

8. 7
study Regression Analysis
[15] (Iran) Cross-
Sectional
Statistical Analysis 500 Demographic and organizational factors, factors related to work conditions and
equipment, unsafe actions and conditions, HSE training and control measures
[16] (Kenya) Mixed design Qualitative and
Quantitative Analysis
60 Reluctance to provide resources for safety, lack of staff training, lack of safety policy
and enforcement of safety regulations, poor safety consciousness among workers and
lack of strict operational procedures in construction sites.
[17] (Iran) Cross-
sectional
Regression Analysis 850 Causes of injuries were age, education, marriage, work experience, safety training
programs and number of workers in the workplace as well as employment status.
[18] (Egypt) Cross-
sectional
Qualitative Analysis 100 Cannabis usage was the cause of CIs.
[19] (U.S.A) Survey Chi-Square Analysis 300 Lack of training was the cause of CIs.
[20] (Malaysia) Survey Descriptive analysis 116 Causes of CIs were workers’ negligence, failure of workers to obey work procedures,
work at high elevation, operating equipment without safety devices, poor site
management, harsh work operation, low knowledge and skill level of workers, failure
to use PPE and poor workers attitude about safety.
[21] (Malaysia) Qualitative Regression analysis 30 The causes of the CIs were poor site management, failure to use PPE and unsafe
equipment use
[22] (U.S.A) Survey Correlation Analysis 500 Lack of management commitment was cause of injury and illness.
[23]
(Cambodia)
Survey Descriptive Analysis 114 Poor safety awareness of top management and insufficient promotion of safety
awareness, lack of experienced project managers and lack of PPE, provision of a safe
site environment and lack of technical guidance, ineffectiveness of current safety
policies & reckless operations.
[24] (Qatar) Survey Qualitative 28 Poor risk management practice.
[25] (Taiwan) Data mining Statistical Analysis 255 Young employees’ inexperience and carelessness, and improperly installed or
damaged equipment’s were the leading accident causes.
[26] (Thailand) Exploratory
Study
Descriptive Analysis 255 To establish appropriate safety policy, the environmental and ergonomic issues
(ventilation, light, equipment design, and site layout) should be considered.
[27] (Portugal) Survey Descriptive analysis 285 Performance pressure was the cause of CIs.
[28] (Singapore) Data
Analysis
Descriptive analysis Causes of CIs were negligence or mistakes happen due to the uncertain
circumstances.
[29] (Ethiopia) Cross-
sectional
Regression Analysis 544 Lack of safety awareness, PPE, work experience & khat chewing were causes of
injuries
[30] (Colombia) Case study Descriptive Analysis 117 Failures of control, personal factors, work related factors, unsafe acts and
unsafe conditions were the causes of CIs.
[31] (Uganda) Cross-
Sectional
Stepwise Analysis
Regression
365 Permanent employment and knowledge of safety measures were associated with
increased use of PPE.
[32] (Nigeria) Survey Quantitative
analysis
128 Inadequate engagement of safety managers on sites, lack of proper training about
effective use of safety wears and workers failure to adapt with safety practices as it
was against their traditional training.
[33] (Ireland) Survey Descriptive &
Physical examination
155 The reasons cited for non-wearing of eye protection in this study included poorly
fitting eyewear, habit, fogging of eyewear or non-availability of eyewear.
[34] (China) Survey Statistical Analysis 1260 Serious cigarette smoking, serious alcohol consumption, not having injury prevention
and safety education, and depressive symptoms were considered important factors for

9. 8
injuries.
[35](South
Africa)
Qualitative Qualitative 9 Use of drugs and alcohol as a coping mechanism for financial strains was cause of
injuries.
[36] (Tanzania) Thematic Thematic Data
analysis
70 Life style, coping technique and taboo were the main reasons for alcohol & drug
abuse on site, which in turn causes injuries.
[37] (Malaysia) Cross-section Descriptive analysis 323 There was strong association of CIs with organization’s interest in safety and health
training and safety equipment.
[38](Hong Kong,
China)
Qualitative Descriptive analysis 16 Organization factors (including safety supervision and inspection, safety culture,
social influence, and workplace condition) and individual factors (including attitude
towards risk, perception of risk, perceived behavioral control) were found to
influence construction worker risk-taking propensity.
[39] (Serbia) Data Mining Descriptive analysis 719 Young workers with less than 4 years of working experience make the highest risk
group of construction workers.
[40] (Australia) Data Mining Regression analysis 24764 Old and experienced employees were more injury prone
[41] (South
Korea)
Data Mining Regression Analysis 2663 Construction workers over 40 years of age suffered the most from occupational
injuries.
[42] (Denmark) Data Mining Quantitative analysis 23464 Young workers have at least twice the risk compared to older workers. Fluctuations in
work injury trends among workers under 30 years of age were significantly related to
the business cycle, where the risk of injuries was higher during economic booms than
during recessions.
[43] (Iran) Cross-
sectional
Regression Analysis 500 Individual and organizational factors (IOFs), HSE training factors (HTFs), and risk
management system factors (RMSFs) to be significantly associated with accident
severity rate (ASR).
[44] (Greece) Retrospective Descriptive Analysis The most frequently appearing variable/factor was age.

10. 9
The related variables in each study were identified by each author; similar variables were categorized into single
factor and analyzed. The selected variables and factors with the number of studies they were described in are shown
in the (table 3) below.

11. 10
Table 3: Causes of Construction Injuries with frequency in the studies
Contributory Factors and Variables Studies (Citation No.)
Management
Lack of safety orientation, training and supervision [3],[6],[7],[8], [9],[11],[12],[13],[14],[15],[16],[17],[18],[19]
Unsafe working environment [2],[6],[9],[12],[20],[21],[24],[25],[26]
Unsafe equipment uses [3],[4],[10],[15],[19],[20],[21]
Cost [6],[7],[16],[22],[23]
Performance Pressure [9],[10],[38]
Behavioral
PPE Use [3],[6],[8],[11],[12],[13],[14],[15],[16],[17],[20],[21],[26],[29],[30],[31],[32],[33]
Use of Alcohol & Drug [8],[18],[21],[29],[34],[35],[36]
Individual factors/Negligence [3],[4],[8],[11],[16],[21],[26],[28],[31],[36]
Psychological
Job dissatisfaction [12],[14]
Self esteem [9],[38]
Work experience [8],[9],[12],[15],[17],[23],[25],[29],[39],[40]
Demography
Age [12],[14],[15],[16],[30],[40],[41],[42],[43],[44]

12. 11
Finally, the variables and factors were used to develop the conceptual framework of the study as shown in (Figure-2)
below.
Insert figure 2: Conceptual Framework of the study
3. Results and Discussion
3.1. Management commitment
Management commitment as the leadership, vision, and resources needed to implement an effective safety
and health program. Management leadership means that business owners, managers, and supervisors: make
worker safety and health a core organizational value, were fully committed to eliminating hazards,
protecting workers, and continuously improving safety and health on job sites, provide sufficient resources
to implement and maintain the safety and health program, visibly demonstrate and communicate their safety
and health commitment to workers and others & set an example through their own actions [2].
Lack of attention from leaders and constant supervision to ensure safety on construction sites contribute to
construction injuries [4]. Transformational leadership has significant impact on safety climate and it in turn impacts
safety behavior through safety knowledge. Thus, the effectiveness of future safety climate is dependent on the level of
transformational supervisor’s exercise and if they encourage construction personnel to voice safety concerns without
fear of retaliation, and repeatedly reminds them about safety on the job [5]. The following variables were the causes
of CIs under this factor.
3.1.1. Lack of safety orientation, training and supervision
The occurrence of injury and its frequency in the construction sector were directly related to safety training.
Resources must be available for implementing and monitoring the safety management systems. The
construction industry is a dangerous environment. But health and safety training and its correct application
can reduce the frequency and severity of occupational accidents on construction sites [6 - 8]. The causes of
CIs that expose employees to occupational injuries in the construction industry were poor supervision, lack
of safety training and awareness [3, 9]. Owners and contractors have to stipulate in their contracts an

13. 12
amount that must be set aside for safety training, PPE, and other preventive measures [10]. This is because
training introduces workers to their work condition; the potential hazard involved in their work condition
and reduces accident. The contribution of lack of vocational training to work-related accidents is significant
[11]. Similarly, because of lack of training and orientation the CIs rate were high [12]. Lack of occupational
health and safety committee, and supervision has led workers without vocational training to encounter CIs
[13-16]. However, workers who do attend safety training programs have experienced a three-fold decrease
in work-related injury or illness compared with other workers [17]. Further, construction companies
operating out of major towns should train locally employed workers to decrease the occurrence of
occupational injuries [18]. Safety training has great impact in changing employees’ behavior towards safety
climate, but the employee’s active participation plays vital role in achieving overall safety in the
construction work [19]. Thus, training, safety plans, motivation, safety rules and regulations and the hiring
of safety officers were important elements for improving site safety [10].
3.1.2. Unsafe equipment
In the construction site among the potential hazards, unsafe equipment plays vital role in work-related
accidents [20]. The construction industry is riskier than other industries is because of the use of unsafe
equipment [21] Management failure to implement a system in which regular inspection and maintenance of
equipment were not put forth, the prevalence of injuries increases as workers were exposed to the potential
hazard [15]. Similarly, lack of maintenance of construction equipment’s and the use of old and unsafe
equipment’s contributes to CIs [3, 10]. Further, the importance of introducing employees to their work
environment and the risks involved with the use of unsafe equipment should not be neglected [19]. Lack of
management commitment in terms of providing safe equipment, implementing a regular system of
inspection and lack of disposal of unsafe and old equipment on construction projects contributed
significantly to employees’ injuries.
3.1.3. Cost factor

14. 13
Contractors should make safety consciousness major concern above their profits, with a ready mind to
invest in safety. It is important to invest in safety since workplace safety reduces the probability of injuries
thereby increasing the productivity of contractors and decreasing costs from absenteeism and lost work days
[22]. Construction companies view implementing occupational health and safety programs as an additional
cost rather than essential activity for increased productivity from reduced absenteeism and lost workdays.
Having a separate safety department would mean extra unwanted pressure on the already tight human and
financial resources of the company [6-7]. Majority of the construction companies allocate less than 1% of
the project budget to health and safety. This was because of the construction industry lack a clear policy on
accident prevention [16]. The key factor that affects safety performance was lack of sufficient budget
allocation for safety from the initial designing stage to the implementation of the construction works [23].
3.1.4. Unsafe working environment
One of the causes of CIs, illnesses, and incidents is the failure to identify or recognize hazards that were
present, or that could have been anticipated [2]. Creating a good working environment involves
implementing occupational safety and health program [24]. However, lack of a written safety policy and
poor safety awareness statistically significant [6, 9]. Similarly, unsafe acts, arising from failure to de-
energize electrical systems, failure to maintain safe distances, improper use of PPEs, and poor work
practices were the causes of fatalities [25]. Absence of good safety climate, first aid service and extended
working hour were causes of CIs [12]. Working without authority, failure to warn others of the danger,
missing platform guardrails, inadequate fire warning systems, excessive noise, and poor illumination, lack
of education, restricted training, poor quality, and control system contribute to CIs [21]. The causes of
construction injuries on average were mainly attributed to the management such as poor inspection
programs, poor safety policies, and unsafe method or incorrect work procedures [20]. Further, poor site
management was one of the causes of construction work-related injuries [26]. Thus, lack of proper safety
planning, poor management of the site, and lack of regular inspection, poor safety policies and poor
housekeeping significantly contributes to CIs.

15. 14
3.1.5. Performance pressure
Construction companies compete with time, which forces employees to work more hours without rest.
Sometimes employees have no enough time to wear safety protective equipment due to performance
pressure. Employees care more about completing their task through short-cut ways rather than following the
appropriate procedures which increase their vulnerability to CIs [9]. The acceleration of activities was the
cause of problems and unsafe work conditions that result in accidents [10]. Further, acceleration of
construction works requires proper strategies to prevent workplace injuries, while considering changes in
scheduling practices and health protection programs for people working in jobs involving overtime and
extended hours [27].
3.2. Behavioral Factors
CIs occurring in the construction largely attributed to behavioral factors. The importance of understanding
how behavior influences safety performance cannot be underestimated. A more important conception is that
by increasing concentration and effort placed on the influence of human behavior, accidents and injuries can
be significantly reduced in construction sites. Human behavior is the main cause of construction accidents;
negligence or mistakes can happen due to uncertain circumstances. Hence, unavoidable accidents have to be
expected in the construction industry. The commitment of all humans involved, from the project manager to
the laborer towards good practices would enhance the safety performance in construction sites [28].
3.2.1. Use of personal protective equipment (PPE)
There are several types of PPE and each of them has different functions, which includes; hearing protection,
eye protection, respiratory protection, protection of the skin, and general protection in the form of protective
clothing, and safety helmets, harnesses, and lifelines. In the construction industry, workers prefer working
without wearing PPE because they feel uncomfortable at work. However, the functionality of the PPE
should also be considered in order to avoid the likelihood of CIs [21]. The lack of and improper use of
PPE’s in the construction increases the employee’s tendency towards injuries [8, 11, 12]. The absence of the

16. 15
provision of PPEs use from the employer and workers lack of knowhow about the importance of different
PPEs causes CIs [3, 14, 15]. Operating equipment without safety devices, and lack of PPE usage increases
the odds of injuries in the construction site [17, 26, 29-30]. There was limited use of PPE among building
construction workers due to the absence of prior knowledge of safety measures. Essentially, ignorance and
inadequate health and safety information were dual factors that contribute substantially to poor safety
practices at construction sites [31]. Further, lack of PPE usage coupled with workers’ negligence hugely
contributed to the cause of accidents [20]. Adaptation to safety practices and its avoidance because of
traditional training, unethical practices, insufficient instructions, religious assertions, inadequate and
ineffective supervision were causes for not wearing PPE [6, 16, 32]. Similarly, CIs occur because of the
lack of protective devices in the workplace, and lack of practicality of safety rules [13]. The most common
reason cited for non-wearing of eye protection include; perceived unavailability of eye protection, lack of
safety awareness, citing discomfort or fogging as the primary reason for non-wearing, and habit of non-
usage [33].
3.2.2. Use of drug and alcohol
Male construction workers who do smoke cigarettes and took alcohol had a significant higher risk of work-
related injuries [34]. Drinking alcohol or taking drugs may decrease awareness and cause serious accidents
[21]. Similarly, drinking alcohol certainly results in memory loss, nervous system, blood pressure, and
uncontrolled body conditions, which causes accidents at work [35]. Construction workers who drank
alcohol encounter CIs [8]. Construction employee’s addiction to khat chewing and cannabis abuse was
cause of CIs. This is because of the fact that abuse of mind-altering substances, like khat, and cannabis is
likely to cause a change in the behavior and impair workers concentration and performance. A high blood
level of such substances while at work will endanger both safety and efficiency, and be the cause of
increased likelihood of mistakes, poor decision making and errors in judgment [18, 29]. Further, lack of
inspection procedures; testing procedures to uncover the presence of alcohol intoxication or illicit drugs

17. 16
possession on many constructions’ sites have contributed much in allowing workers to abuse alcohol in
their workplaces [36].
3.2.3. Individual Factors
Employees failure to abide to the safety rules and regulation or negligence as well as safety procedures,
results in fatal injuries [26]. Construction workers with little knowledge of the construction work-related
potential hazards underestimate or become negligent and exposed to work-related accidents [3]. The human
element factor of unsafe act such as failure to use or wear PPE, use of unsafe equipment and poor site
management (unsafe condition) were categorized as primary causes of CIs [8, 11, 16, 21]. Employees’
perception regarding safety was directly related to work-related injuries in construction site [37]. Some of
the means of reducing the act of negligence on construction sites is through constant reminder of employees
to adhere to safety rules and measures with strict punishment on defaulters that were negligent. Further,
through regular supervision and inspection of health and safety executives, supervisors and head of
foreman, architects, and engineers on site [3, 32].
3.3. Psychological factors
Psychological and social (psychosocial) factors inherent in work design, organization and management were
contributory factors to work-related accidents and ill health.
3.3.1. Job Dissatisfaction
Job dissatisfaction is the psychological condition of an employee brought about by the unraveled conditions
at work. Job dissatisfaction happens due to several reasons some of them were work load, lack of control,
unfairness, value conflict and insufficient reward. Job dissatisfaction increases the occurrence of injuries in
the construction works. Dissatisfied employees dislike their job which led to low motivation, and low
productivity. These in turn led them to lose concentration and focus, increasing their vulnerability to
occupational injuries [12]. The risk of work-related injury decreases with job satisfaction, as workers

18. 17
dissatisfy with their job, they couldn’t experience meaningfulness, greater responsibility, and better use of
their knowledge and skills in their job. And such a situation leads to decreased safety in their work and
increased occupational injuries [14].
3.3.2. Self-esteem
Self-esteem refers to individual’s perception or subjective appraisal of one’s own self-worth, one’s feelings
of self-respect and self-confidence and the extent to which the individual holds positive or negative views
about self. Employee’s wanted to prove they are ‘tough guys’ through breaching safety rules. They don’t
scare getting hurt or injured. More experienced workers don’t feel comfortable following safety procedures.
Workers perform risky jobs to exhibit their self-esteem and co-workers also encourage them. Further, they
don’t use PPE to avoid being teased by their co-workers [9]. Workers see the co-workers and follow the
same unsafe behavior. In some instances, workers see other workers and feel that if they don’t perform the
same way co-workers perform the work, they feared being teased. Thus, co-worker’s breach safety rules and
procedures and undertake the work in an unsafe procedure, which led them to CIs [38].
3.3.3. Experience
Inexperienced young employees were more prone to accidents, while with the passage of time workers get
more experience and aware of the safety requirements. The best-trained construction workers ‘learned by
doing’ or by gaining experience [9, 25]. More experienced workers accustomed to the safety rules, and the
probability of them being injured decreases. Inexperienced employees were more exposed to the causality
of potential hazards due to lack of experience [12, 39]. Further, project managers’ lack of experience on
safety contributes to CIs [23]. In general, the occurrence of injuries among inexperienced construction
workers was very high [8, 15, 17].

19. 18
However, some studies come up with a report in disagreement with the above studies. More experienced
employees could be accustomed to the work environment and developed false consciousness of safety,
which drives them not to comply with safety precautions including proper use of PPE [29, 40].
3.4. Demographic Factors
The frequency of the occurrence and severity of construction injuries were largely dependent on the
employee’s age. Old construction workers were more injury prone. This might be due to the fact that
reduced physical capabilities like strength, balance, and processing speed further increases the risk of
injuries with age [14]. The highest proportions of serious, severe and critical injuries occur in older
employees [40-41].
However, some studies reported in disagreement to the abovementioned results, that more injury prone was
young employees. Accident cases were more frequently present in the younger population due to lack of
experience and awareness of the dangers and risks present in the work [12, 15, 30]. Young workers were
more prone to work-related injuries or had at least twice the risk compared to older workers [16, 42].
Further, inexperienced, and skilled workers were more prone to occupational injuries [43-44].
3.5. Limitations of the study
The study doesn’t deployed content analysis software.
4. Conclusions and Recommendations
4.1. Conclusions
The most important causes of CI’s were management commitment and behavioral factors. Avoiding or
reducing CIs requires allocating appropriate budgets, training employee, housekeeping, supervision and
corrective actions. However, the deviations in experience and age in different studies regarding to the
occurrence of injuries should be studied in the future. Thus, further joint research needs to be conducted
using mixed methods to provide a better and in-depth understanding of the association between the
empirical findings and accident causation theories to design effective safety policies. The conceptual
framework of occupational injury developed in this study can also be used in future studies.

20. 19
4.2. Recommendations
 Construction sites must have safety officers and safety committee to identify project risks.
 Construction companies need to provide funding for health and safety and provide workers with the
necessary PPE.
 All employees from top management should undergo proper job related health and safety training.
 In order to improve safety in the construction industry, health and safety should be included right
from preparation of contract documents.
 The public bodies responsible for the implementation of safety policies and regulation should
regularly conduct construction sites supervision and take serious measures on contractors breaching
the policies. They should also design mass media awareness advertisement to increase the general
public’s awareness.
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26. 25
Screening Studies or Studies
found by search engines
(N=969)
(N=883) irrelevant studies
were excluded from the titles
(N=44) were excluded after
reviewing abstracts
Reviewing full text (N=42)
Extracting Variables
(N=90)
Condensing
variables to
categories (N=12)
Creating Factors
(N=4)
Developing
framework
Content Analysis Framework
Development
Identification

27. 26
Unsafe
working
environment
Lack
of
training
&
Supervision
Unsafe
equipment
use
Cost
Performance
Pressure
Management Commitment
PPE
Use
Use
of
alcohol
and
drug
Individual
factors/Negligen
ce
Behavioral factors
Demographic
factor
Age
Psychological
factors
Job
dissatisfaction
Self esteem
Work experience
Construction
Injuries