Construction workers are five times as likely to be hospitalized with the coronavirus as workers in other occupations

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Construction workers have a much higher risk of becoming hospitalized with the novel coronavirus than non-construction workers, according to a new study from researchers with The University of Texas at Austin COVID-19 Modeling Consortium.

Analyzing data from mid-March to mid-August on hospitalizations in Austin, Texas, the researchers found that construction workers there were five times as likely to be hospitalized with the coronavirus as workers in other occupations. The finding closely matches forecasts the team made in April.

The current study is, to the authors’ knowledge, the first to compare COVID-19 hospitalizations of construction workers to non-construction workers. An earlier study by the CDC reported that the construction sector was ranked number two in frequency of workplace outbreaks in Utah.

According to the researchers, the higher vulnerability for construction workers probably stems from the continuation of construction work throughout the pandemic, even during stay-home orders and other community-wide mitigation measures.

The nature of the work exacerbated the risks due to close contact with others, practices by employers and demographic factors.

“It doesn’t necessarily mean we need to stop construction work,” said Lauren Ancel Meyers, a professor of integrative biology and director of the consortium. “It means we need to go to great lengths to ensure the health and safety of workers when they do go to work.”

Encouraging basic precautions such as mask wearing and physical distancing on the work site would help, the authors note, as would having governments or employers offer workers paid sick leave and other incentives to stay home when they have a known exposure or have mild symptoms, to help mitigate risk.

In addition, regular work site-based surveillance COVID-19 testing (with effective tracing and isolation of detected cases) can help prevent spread.

In central Texas, construction workers are disproportionately Hispanic, and many of them are uninsured or in close contact with people who have limited access to health care.

Compared with the general population, they also experience more underlying health conditions linked to severe cases of COVID-19, are more likely to have more people in the home and may feel pressured to work even when they don’t feel well due to socioeconomic pressures.

In Texas, COVID-19 has disproportionately affected Hispanics, who account for about 40% of the state’s population but 56% of its COVID-19 fatalities, according to the latest data from the Texas Department of State Health Services.

“These workers face many overlapping risks and are being exposed at a time when less vulnerable populations are able to stay home,” Meyers said.

Across the U.S., construction workers are disproportionately Hispanic: 17.6% of all workers are Hispanic or Latino, yet 30% of construction workers are Hispanic or Latino, according to the U.S. Bureau of Labor Statistics.

The study’s other authors are Remy Pasco, graduate student in the Meyers lab; Spencer Fox, the consortium’s associate director; Clay Johnston, dean of the Dell Medical School and vice president of medical affairs at UT Austin; and Michael Pignone, chair of the Department of Internal Medicine and interim chair of the Department of Population Health at Dell Med.

The results are published in the peer-reviewed journal JAMA Network Open.

In their earlier study delivered in the spring, at the request of the City of Austin, the team analyzed the risks of allowing construction work to continue during the pandemic. (On March 31, Texas Gov. Greg Abbott declared all construction essential and permissible statewide, overriding earlier local restrictions.) At the time, the team projected that construction workers would have a 4 to 5 times higher rate of hospitalization than non-construction workers—a prediction the new paper bears out.

“From mid-March to mid-August, the elevated risk of COVID hospitalization among construction workers matched our model predictions almost to a T,” Pasco said.

“The rise in COVID-19 hospitalizations among construction workers suggest that the virus has been spreading at work sites, and more should be done to protect the health and safety of the workers.”

Their model also predicted that continued construction work would increase the rates of hospitalizations among the general public because of increased transmission from construction workers, but with current levels of contact tracing, that is much harder to measure and validate, Meyers noted.


The workforce management’s literature in construction is discussed in this study in the context of two main groups, studying the workforce as a resource that can be planned, forecasted and optimized (e.g., Fard Fini et al., 2018, Sing et al., 2016, Sing et al., 2012a, Sing et al., 2012b); and a second group of studies understanding challenges faced by the workforce in the construction site, such as safety, wage differentials, and workers turnover (e.g., Ayodele et al., 2020, Goodrum, 2004, Shen et al., 2015).

The workforce as a resource

The construction workforce is one of the most variable resources involved in construction projects (Halpin et al., 2017, Sing et al., 2016). One of the main challenges that the construction industry and its companies face in this regard is the shortage of skilled labor (Karimi et al., 2018), as such, multiple models and techniques have been proposed to improve the accuracy and certainty of the workforce supply and demand for construction companies.

Srour et al. (2006) proposed a model to optimize the strategic investment in the workforce’s training and allocation on multiple construction projects. Specifically, Srour et al. (2006) proposed a model capable of account for a strategy to train the construction workforce, hire new workers when needed, and allocate them across different construction projects.

This model allowed the workforce’s optimization to human resource professionals from a strategic standpoint (Srour et al., 2006). Similarly, Gomar et al. (2002) studied multiskilled workforce’s optimal allocation in construction projects.

The authors found that although projects benefit from having multiskilled workers, the benefits are marginal beyond having 20% of the multiskilled workforce (Gomar et al., 2002).

Models have also been proposed specifically to understand the workforce supply and demand to find an equilibrium point. Interestingly the variables used to develop these models greatly differ. While models focused on the supply side were based on workforce attributes—e.g., age and skills (Sing et al., 2012a)— the models focused on the demand for the construction workforce were based on the economic conditions around the forecasting process (Sing et al., 2012b).

More recently, Sing et al. (2016) argued that due to the large variety of factors influencing workforce forecasting needs for construction, a dynamic approach is required to improve the accuracy of workforce forecasts.

Namely, Sing et al. (2016) proposed a system dynamics model to forecast the construction workforce supply and demand, and the effect of training policies on the workforce equilibrium. More recently, the literature has begun to discuss the need to incorporate workers’ career plans on workforce planning (Shahbazi et al., 2019).

Some studies have claimed that including workers’ career plans may improve project performance (Lim and Loosemore, 2017, Loosemore and Lim, 2017). Shahbazi et al. (2019) proposed a model to maximize productivity and construction workers’ career opportunities; however, maximizing workers’ career opportunities came with a small productivity loss.

In summary, existing studies have emphasized the important role of planning/forecasting the construction workforce for the successful development of construction projects. As such, given the current pandemic that project managers and the workforce have faced and will face in the foreseeable future, it is necessary to understand how the potential spread of COVID-19 among construction workers may influence workforce planning.

Challenges faced by the construction workforce

The shortage of skilled construction workers represents one of the main problems of the construction industry (Azeez et al., 2019, Goodrum, 2004). Multiple researchers have explored challenges that construction workers face while working on a construction project that may disincentivize a productive project performance, such as safety environment (Shen et al., 2015), language barriers (Oswald et al., 2019), and turnover (Ayodele et al., 2020).

In this literature review, we discuss some of the challenges related to cultural aspects; nonetheless, the focus is on the safety challenges as these may provide insights about how to manage the workforce in the current pandemic context.

Studies regarding cultural challenges faced by the workforce have included differences in wages based on ethnicity (Goodrum, 2004), language barriers (Oswald et al., 2019), and absenteeism (Ahn et al., 2013).

For example, Goodrum (2004) found that Hispanic construction workers were paid lower wages compared with non-Hispanic workers. Additionally, Goodrum and Dai (2005) found that Hispanic workers were related to more hazardous construction occupations, which led to more injuries and fatalities.

When it comes to construction workers’ absenteeism, it has been found that the social norms and interactions among workers play a key role in decreasing absenteeism among workers (Ahn et al., 2013).

Interestingly, the cultural challenges faced by workers also influence the safety of workers. Oswald et al. (2019) found that the interpretation of safety instruction can be negatively impacted when safety videos are translated from its original language.

The construction sector has long been recognized as one of the most dangerous activities for the workers involved (Alwasel et al., 2017); thus, in recent decades, safety-related workforce challenges have been largely studied in the literature (Mohammadi et al., 2018).

Interestingly, the conditions faced by the workforce have been identified as one of the main factors influencing the safety performance of construction projects (Mohammadi et al., 2018). The way construction workers perceive their environment influences how safely they interact and how safely they behave (Abbas et al., 2018, Shen et al., 2015).

Notably, when workers understand and perceive construction activities as too risky or leading to frequent injuries, workers can simply decide to leave the workforce, as it has been found with masonry workers (Alwasel et al., 2017). The quantification of hazard exposure to workers can help project managers minimize activities perceived by the workforce as insecure or too risky (Luo et al., 2016).

The existing literature underscores that the conditions in which construction workers do their job highly influence their performance in construction projects. Consequently, given the current pandemic context faced by the construction sector, it is fundamental to understand the potential impact that COVID-19 may have among construction workers interacting during a construction project. As the pandemic has continued to spread all over the world some studies have researched how to improve safety aspects due to the spread of COVID-19 (de Bruin et al., 2020, Varotsos and Krapivin, 2020); however, we also need to understand the potential influence of COVID-19 on construction workers while interacting during a construction project.

reference link : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7522627/


More information: JAMA Network Open (2020). DOI: 10.1001/jamanetworkopen.2020.26373

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