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The 'Fatal Four' and Your Worksite


By Michael Halliwell

I recently took the time to look at the U.S. Occupational Safety and Health Administration website for some of the commonly used statistics. To be perfectly blunt, the statistics were eye-opening.

Stats may cause people’s eyes to glaze over in record time, but when you get beyond the percentages and get to the human toll they represent, it’s frightening.

Across the U.S., there were more than 13 worker deaths per day in 2014 (4,386 total), with one in five of private industry deaths being construction related (899 deaths).

occupational hazard warning
© / Feverpitched

OSHA says that in 2014 one in five of private industry deaths were construction related; it attributes 60 percent of those construction worker deaths to what it calls the “Fatal Four.”

OSHA refers to the top four leading causes of death in construction as the “Fatal Four,” and they accounted for more than 60 percent of construction worker deaths (545 out of that 899 number) in 2014.

Think about that for a moment … that’s three deaths every two days from four common causes.

Although I do not do a significant amount of work with coatings, the construction environment is one I deal with on a regular basis—building construction, demolition, bridge rehabilitations and abatement jobs are frequently linked to the environmental work that is my forte.

In looking at where I have encountered those working in the coatings industry, I can see where our paths would cross with these “Fatal Four.”

So, what are they and how can we reduce the associated body count?


The biggest and baddest of the Fatal Four is falls, which totalled 39.9 percent of construction deaths in 2014 (359 out of 899 deaths).

We all know the mantra: 100 percent tie-off, every time. We know that if we’re working at height, we’re supposed to tie off. So why is this the leading killer of construction workers?

I think we all know why: The “it’ll just be a moment, it’s fine” thought process turns into a slip or trip, then ends with a fatal fall. Or there’s always the “it’s not that high, I’ll be fine” mindset, too.

In lift
Photos by Michael Halliwell unless otherwise noted

Statistics suggest that a worker is more likely to be seriously injured or even killed when working at heights over 2 meters/6 feet. Many companies require tie-off at those heights and higher.

Although my local OHS Code allows for up to 3 meters (about 10 feet) before requiring tie-off, many local companies use a 2-meter (about 6-foot) cut-off. Why? Because the research and statistics have shown that once you get above 2 meters/6 feet you’re more likely to be seriously injured or killed, with the latter becoming the more common result the higher you go.

But it’s not just falling from a bridge or building that can generate the forces involved. In a recent company safety meeting, we were made aware of a near miss involving a fall potential.

In this case, two workers went to access a location where an excavation had left a narrow path with a 3-meter (or more) drop on either side. There were no guardrails or places to tie off, and there was a bit of a gusty wind. It hadn’t even crossed their minds that there was a fall hazard there—in their minds, they were walking on the ground surface.


OK, so 74 construction workers were electrocuted in 2014—what’s that got to do with coatings work, right?

If you’re water blasting, do you know if that cord going through the work area is connected to a proper Ground Fault Interrupter (GFI) circuit? What about the circuit in that conduit that’s being stripped—is it de-energized?

Gearing up

The Fatal Four can be present on most job sites, even in the coatings industry. I encourage you to
take a fresh look around and see if one of the Fatal Four could be lurking at your job site.

I’ve had the unpleasant experience of discovering a fence was energized to keep livestock in. Even at as little as 40 joules (with a fence running at 8,000 volts and a contact of 0.1 second, it means a current of only about 50 mA), getting jolted was an unpleasant experience.

Most circuits on a construction site are 10 amp or more; the same 0.1-second contact on a 120-volt line yields 120 joules of energy—that’s as much as the output of a modern automated external defibrillator (AED)!

It doesn’t take much of a hit with that sort of energy to stop someone’s heart.

Struck by Object

Right behind electrocutions in the Fatal Four is being struck by an object.

It doesn’t matter whether something is dropped, launched or swings around—if it hits you, it can be fatal.

Take for example, a crew working on a water tower. What happens if a tool slips and falls to the ground below? If the work area was properly secured and the area below is clear of workers, then the tool falls to the ground and probably breaks.

If someone is standing below, well, that could have a far more tragic outcome.

And don’t just think you need heights for this one. A skid-steer loader or zoom-boom running around a site can hit workers with a load just as easily.

Caught In/Between

The last of the Fatal Four could be referred to as a crushing injury from some form of pinch point. It involves someone being caught between something moving and something not, or between two moving things.

Struck-by hazard

Construction equipment in motion has the potential to hit workers by itself or with a load, or to pin and crush a person on a work site.

It doesn’t matter whether it is getting run over by the skid-steer (a skid-steer moves; the ground doesn’t), having a trench collapse, having someone back their truck up and pin you between it and the building, or having a scaffolding fail and come down on you—they all work on the body the same way.

The hazard is real and you need to be aware of where you’re working and what you might come between or what might come and trap you.

Where Do We Go from Here?

The Fatal Four can be present on most job sites, even in the coatings industry. So how do we keep them from claiming our lives or the lives of our co-workers?

Ultimately, I think it comes down to being diligent; avoiding complacency; and, as another blogger recently put it, trying to get past the “normalization of deviance” or just doing things “how we’ve always done it.”

Falls can be mitigated with the proper training, the correct PPE being used properly all the time, and prompt action to prevent suspension trauma if someone falls.

Electrocutions can be avoided by having proper lockout/tagout training and other procedures in place and, if in doubt, testing circuits before starting work.

Struck-by and caught-in hazards can be a little more challenging, as they involve changing circumstances. The easiest way to avoid them is to be aware of your circumstances or surroundings and, if needed, get clear before a potential issue becomes a deadly problem.

I know that my audience here understands the hazards and risks involved with the specific jobs we each do—but there are four big causes to workplace fatalities in construction. I’d encourage you to take a fresh look around and see if one of the Fatal Four could be lurking at your job site.


Michael Halliwell

Michael Halliwell, M.Eng., CESA, EP, P.Eng., is an Associate and Environmental Engineer for Thurber Engineering Ltd. in Edmonton, Alberta, Canada. During his 17-plus years with the company, he has been involved with environmental site assessment, remediation, construction inspection and supervision, and project management. He also performs hazardous building material assessments for asbestos and lead paint.



Tagged categories: Engineers; Environmental Controls; Environmental Protection; Project Management; Thurber Engineering Ltd.; Fall protection; Hazards; Health & Safety; Health and safety; North America; OSHA; Regulations; Safety; Safety equipment

Comment from Bob Dahlstrom, (11/22/2016, 8:33 AM)

Great article Michael. The Occupational Safety and Health Administration (OSHA) maintains that the hierarchy of fall protection starts with completely eliminating the hazards and risks of falling by engineering them out and away from the workplace. If that is not a reasonable possibility, then preventing falls from happening is to be considered next. And if that is also not a suitable solution, then implementing a fall protection program and a rescue plan is a must. Be safe everyone!

Comment from M. Halliwell, (11/23/2016, 11:04 AM)

Bob, thank you for the compliment and you are quite right...I believe most jurisdictions have a similar hierarchy for any form of hazard: eliminate it by design or substitution, permanently engineer it out, administrate it out (training, scheduling or procedures) and last line of defense: PPE. When it comes to construction and coatings, though, we're often left with the last line of defense when it comes to falls...and we see far too many examples in Paint Square articles where a poor choice by a worker, supervisor or company has lead to another tragic loss of life. I agree 100% with your last comment: stay safe out there everyone!

Comment from Mike Harsant, (3/29/2021, 7:51 AM)

This is a nice article. It is really important that we apply OSHA properly when doing concrete construction.

Comment from Paul Palmer, (6/8/2022, 4:03 PM)

Great Article and final point, We should always be open to new ways and improved technique and equipment, getting past that stage of comfort and thinking this is how we've always done it and it should be good enough. Those fatality stats in the beginning of the article should highlight the need for an open mind in how we approach safety in the workplace. As a Painting Contractor I always have safety meetings and keep it on the front of my crews minds while at work. We continually look for improved equipment and trainings. Thank again!

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