On Oct. 9, driver Brian Anderson's dump truck knocked down and crushed James Lee Causey, a 60-year-old working for Moran Environmental Recovery, which was repairing a collapsed culvert at a former municipal dump in Gainesville, Fla. "The driver feels [that] the victim knew the truck was there," a city police officer told a local reporter. The accident was a fragment of local news, a humdrum industrial accident worth only a few paragraphs in the Gainesville, Fla., Sun.

When construction closes the books on 2002, there will be another 1,200 or so James Lee Causeys and the cumulative loss of life and treasure will be more apparent. The industry had 1,225 fatalities in 2001, according to the U.S. Labor Dept., an all-time high. Very few of the deaths receive much public notice. That is because death is an unobtrusive predator on U.S. construction sites, striking in maddeningly routine mishaps, disguising itself in the numbing repetitions of the day, coiling inside the steel and trucks and backhoes used to do the work. Unlike the more spectacular structural collapses that draw attention from reporters and often appear in the pages of ENR, most of the 1,200 workers die in run-of-the-mill disasters that cause what medical personnel describe as "trauma." The deaths come from the rupturing pressure of a rotating crane cab that catches a worker against a wall, from the impact of a short fall following a slip, or from being in the blind spot of a backing truck--like James Lee Causey.

The blind spot in which the hazards hide is vividly described every year in research reports prepared by the National Institute for Occupational Safety and Health as part of its 20-year-old Fatality Assessment and Control Evaluation program. FACE investigators from NIOSH or from state health or labor departments send researchers to find out what happened at about 80 accidents each year, many of them at construction sites. In exchange for the anonymity of the deceased and employer, the investigators are given relatively unguarded accounts of what occurred. Employers cooperate because NIOSH, a unit of the Dept. of Health and Human Services, isn't the Occupational Safety and Health Administration, a unit of the Labor Dept. whose enforcement mission and penalties often are controversial.

The reports culminate in a series of recommendations that often refer to regulations in a predictable way, but occasionally go beyond that to comment on deeper causes and solutions not covered by regulations.

Of course, the clinical scope of FACE reports stop far short of the broader ramifications of fatal accidents, which have risen steadily since 1992, when the total was 889, according to the U.S. Labor Dept. In addition to the grief and loss felt by those connected to the victim, fatal accidents for a long time haunt co-workers and family members who are present when the accidents occur. Many are traumatized to the point where they suffer from depression or need to rebuild their shattered sense of security.

Before this year, ironworker Matthew Abate had seen two co-workers killed. One was Gary Fitzpatrick, who died five years ago at U.S. Steel's Ambridge Works near Pittsburgh when a load of rail slipped from a trolley and fell on him. Abate tries to remain stoic. "Such is life," he says resignedly. "Buildings go up, and you've got a job to do."

Last Feb. 12, Abate was working at Pittsburgh's convention center expansion when a truss collapsed and killed his friend, ironworker Paul Corsi Jr. Abate suffered a shoulder injury and still has nightmares about the accident and is seeing a psychiatrist. He has worked only part time since then. "Co-workers pay a terrible price and it goes unrecognized and unmanaged," says James T. Patterson, vice president of safety for broker HRH Insurance, Denver.

There are several recurring scenarios in the "routine" accidents described by FACE investigators and safety experts. One danger is when older, experienced workers grow overly familiar with their surroundings and become inured to the hazards around them. "Have you every driven your car with something else on your mind?" asks Selwyn "Sol" Carter, regional safety director for Howard S. Wright Construction Co., Seattle. "That's what happens all too frequently. They are not focused."

At the other end of the experience spectrum, new workers trying to make a showing by finishing work quickly can lose track of their surroundings, too. Energetic young workers often are picked to do dirty and dangerous jobs. "Those are the kinds of guys that go in the hole," says Wayne Johnson, a FACE investigator who researches fatalities in Iowa.

To keep older workers alert, Howard S. Wright makes taking breaks "something we do steadfastly," says Carter. And a steady stream of reminders delivered throughout the day, without nagging, can wake up workers from complacency, suggests Paul H. Moore, a safety engineer who is a member of NIOSH's FACE team based in Morgantown, W. Va., home of the program.

Another big problem is cookie-cutter, half-hearted safety training–such as a Monday-morning toolbox talk that is nothing more than a foreman giving a dreary reading from a manual. That kind of lackadaisical effort often fails to identify relevant hazards or motivate workers. Without daily early morning hazard checks and more compelling presentations geared to the projects' changing menu of danger, workers won't get information that they need. "The reality is, conditions do change," says Hank Cierpich, FACE's southern California investigator.

In addition to the falls and electrocutions that plague construction, improperly used or poorly maintained equipment and vehicles are behind many of the most exasperating mishaps that kill. FACE reports (www.cdc.gov/niosh/face/faceweb.html) include rollovers, tipovers and sudden equipment activations.

Improperly used skid-steers proved to be a problem in Nebraska, according to Bill Hetzler, labor law and occupational fatality manager in the state's office of safety and labor standards. In one case, the skid-steer's seatbelt interlock mechanism, which requires the operator to be locked in the cab before operating the bucket pedals, didn't work. The boss ordered a young man who had never operated the equipment to get in and use it. The man later got out of the cab and went to depress the bucket pedal with his hand to see if it would move, Hetzler says. The bucket came down and crushed his head.

Improperly used aerial lifts can be dangerous, too, says Michael McCann, director of safety and ergonomics at the Center to Protect Workers' Rights, a union-funded safety advocate. In one FACE investigation of an accident in New Jersey, a scissor lift designed for indoor use with a narrow base was used outside on soft ground by an electrician who also sat up on the guardrail. When the lift fell over, the electrician was thrown off and died of head injuries and trauma.

Many employers fail to train their workers to use specific equipment models, says McCann. "There is no standardization of controls" on various types of lifts and elevated platforms, notes McCann.

Few accident types dismay safety experts more than those involving backing construction vehicles. Even properly functioning signals and high-visibility garments sometimes fail to stop this kind of accident. Careful contractors set up internal traffic plans for their projects, but the practice is hardly standard. NIOSH is developing a program to evaluate them, says epidemiologist Stephanie Pratt. The goal is to eliminate hazards like the one that killed Florida's James Lee Causey and make the tragedy of his and other deaths less than routine.

FACE report #2000-12: Overloaded Bucket Hits Ohio Carpenter

It was 8:30 in the morning on Oct. 13, 1999, when the 50-year-old carpenter finished his break and returned to the roof of an Ohio library addition. He began removing forms from a recently completed wall while a concrete crew poured ready-mix nearby. A crane on the ground had been hoisting the concrete in a 1-cu-yd bucket with the help of a radio spotter. The concrete crew groomed the wet ready-mix and then waited as the empty bucket was refilled.

On one lift, the crane began to wobble as the bucket moved toward the concrete crew. Realizing what was happening, the operator, who had 26 years of experience, radioed the spotter to clear the site. He shouted and the concrete crew fled to safety and the carpenter, working alone 25 ft away, started to scramble. As the 180-ft-tall crane began to tip over, the 5,110-lb bucket--overloaded by 1,490 lb, investigators learne--swung out of control, hitting the carpenter in the head and shoulder. He was pronounced dead at the scene minutes later.

The accident had many causes but they start with the overloaded crane. As sections of the work were completed, the concrete finishing crew moved to new locations on the roof, extending the crane's drop-off distance, the FACE investigator noted. The FACE report says that cranes must be operated within lifting capacities, monitoring instruments must be calibrated, workers near landing loads notified and safety procedures taken before loads are hoisted.

Why the carpenter could not escape is less clear. The lift already was in progress when he arrived back from his break and it is possible that he did not notice that a load was in the air. Being at a loud, kinetic jobsite is nothing new to veteran workers, and events on the periphery sometimes go out of focus. "People get used to working around machinery and they don't concentrate on their surroundings," says Ian Scotty Paterson, president of the Construction Management Institute, Palo Alto, Calif. The carpenter "was probably just focusing on his work." Full report:

Ohio FACE report #990H022: A Crew Member Steps on a Seemingly Safe Panel--and Falls

The small Ohio roofing sub-contractor had been in business five years and had not put a safety program in place or performed any safety training for its six employees. Until May 31, 1999, when the contractor was at work constructing the roof of a warehouse, none of its workers had been killed. The lucky streak was about to end and the FACE report shows exactly what happened.

SUDDEN DROP Part of roof appeared to be done, but panel was unsecured. (Photo courtesy of NIOSH)

The 32-year-old laborer had met with his fellow workers on May 26, 1999, at 7 a.m. It was Wednesday, halfway through the work week, and the roofing materials to be used that day already had been laid out. The laborer began work by walking across what appeared to be a completed portion of the warehouse's metal roof deck panels. There was no pitch or incline. His five co-workers began by placing 50-ft sections of insulation.

The laborer approached a lift foreman and voiced his concern that the materials had been improperly arranged. As he was crossing back to his work location, he stepped onto an unsecured and unmarked roof panel--and into space. He fell, possibly head first, 30 ft to the hard gravel ground below.

An ambulance arrived at 8:27 a.m., soon after the accident was reported, and paramedics saw injuries to the laborer's head, neck and chest. The victim was unconscious and breathing for a while, but he went into cardiac arrest. The paramedics restored a weak pulse, but at the hospital he was pronounced dead.

The FACE investigator found much that should have been done. A safety net could have been suspended beneath the area where workers could fall. And the hazards to which the workers were exposed should have been analyzed by the contractor.

Small employers that fail to protect their workers expose them to terrible hazards. Some owners think they will be protected by luck until they can afford to pay for safety procedures and protective equipment. But it only takes one accident to produce a tragedy. "In construction, because of the high impact of the work, a fatality can happen on the first slip-up and you have to be diligent," says John A. Gleichman, safety director for Barton Mallow Co., a big contractor based in Southfield, Mich. If someone is not sure a place is safe, "every worker has to be able to have the right to stop work," he says. Full report: www.cdc.gov/niosh/face/stateface/oh/99oh022.html-#photoA


California FACE report #01CA013: A Cell Phone Call, a Bucket Swing, a Death

Start and stop, scoop and wait. Running a backhoe/loader can feel like a long drive home in heavy traffic. An operator's peripheral vision may gauze over with the numbing repetition, and that is when trouble strikes. It is not clear how many workers die every year when a sleeping piece of equipment unexpectedly springs to life, but safety experts consider it a major hazard.

EMERGENCY Treatment of worker hit by bucket proved unsuccessful and he died. (Photo courtesy of NIOSH)

On Dec. 27, 2001, during the renovation of a building belonging to a major educational institution in California, tragedy struck that way. The familiar stop-and-start routine had been going on most of the morning. The operator had been brought in as a subcontractor by the general contractor. He owned the machine and had run equipment for 10 years, but he had no formal training or certification. That day, he was adding or removing soil to the foundation to match elevation markings on the existing building wall and grade stakes.

When one of the contractor's employees saw an error on the marked elevations, he went to inform the owner. A 24-year-old carpenter who worked for the contractor, a co-worker and the owner went to re-check the marking. As he waited, the backhoe operator made a cell phone call. When he had finished talking, he noticed soil in the bucket, so he activated it up and out to empty it, then swung it to his right.

The extended bucket and arm struck all three men as they checked the marking, with the victim, co-worker and owner squatting with their backs to the backhoe.

The operator's co-worker was briefly knocked unconscious, but soon awoke and had minor injuries. The victim was knocked into the wall and was lying on the ground unconscious, having sustained multiple trauma injuries. Attempts to revive him failed and he died.

The FACE investigator learned of the accident a week after it happened and found that the general contractor had a safety program and performed safety training. But the investigator also found that the contractor had never specifically addressed the hazards involved in the accident–the use of heavy equipment in close proximity to workers.

Even though backhoe operators might have to stop and start numerous times, safe practices demand that they make certain the area is clear. Employers can ensure safe practices through training and supervision and disciplinary action, the FACE investigator wrote.

Trenches are especially hazardous for workers because the lines of sight with equipment operators are obscured. About 10% of the deaths in trench accidents involve equipment hitting the victim, says Michael McCann, director of safety and ergonomics for the Center to Protect Worker Rights, a union-funded health and safety organization. Full report: www.cdc.gov/niosh/face/stateface/ca/01

FACE report #2002-03: Crushed Under the Tire of a Grader

He never saw the grader backing toward him him until it was too late and the fat rear tire was on his back and head, crushing the life out of him. That's the way it ended for a 54-year-old North Carolina laborer at a housing development on December 4, 2001.

LINE OF SIGHT Grader had dirt on windows and hit laborer and pickup truck. (Photo courtesy of NIOSH)

The FACE investigator found that the grader's lack of a working back-up alarm combined with the operator's failure to check the area behind him and the victim's choice of where to stop were the critical elements in the fatality.

The site contractor had been doing grading and other work for three weeks and the road was not open to the public. The grader operator was teamed with a roller operator and a laborer and the crew had been working since 7 a.m. Shortly before a scheduled 2:30 p.m. lunch break, the operator asked the laborer and a co-worker to take a tamper in a pickup truck to a place near the roadway.

The grader was about 400 ft down the road from where the laborer and co-worker had deposited the tamper. They were standing behind their pickup and neither one was wearing a brightly colored safety vest. When the grader operator began backing his machine uphill, the victim's co-worker called for the grader operator to stop. But the operator didn't hear. The co-worker got out of the way and the victim was run over.

No one knows how close the machine was going to its maximum 20.9-mph backup speed, but the grader had mechanical problems that in retrospect contributed to the tragedy.

The FACE investigator, Doloris Higgins, learned from North Carolina safety officials that the grader's backup alarm did not work. That made the grader more dangerous because with rubber-tired vehicles, "all you can hear is the engine and the power train and tires don't make a lot of noise," says James T. Patterson, vice president for safety at broker HRH Insurance, Denver.

The grader's side view mirrors also "were loose and would not stay in place when adjusted," according to the FACE report. Finally, the grader operator told police and state safety officials that he could not see because the sun was in his eyes as he backed up. There was so much dust and dirt on the cab windows, seeing anything would have been nearly impossible.

The accident provoked FACE investigator Higgins to suggest that strobe lights be installed on pickup trucks and that equipment manufacturers consider installing collision-avoidance technology on their machines. But her main recommendation was for contractors to implement a safety program and train workers to recognize hazards involved with vehicles. Full report: www.cdc.gov/niosh/face/Inhouse/full200203.html#figure1