Safety and Health Implications of COVID-19 on the United States Construction Industry

  • Sang D Choi University of Wisconsin at Whitewater
  • John A. Staley University of North Carolina at Chapel Hill
Keywords: Covid-19; safety; health; construction industry; vulnerable workers


The construction industry is an essential U.S. business sector, yet it suffers from an elevated risk for work-related fatalities and injuries. The COVID-19 pandemic has only exacerbated this risk, as well as shone a light on the severe economic/financial/labor burdens and safety/health concerns the sector has faced. As such, the purpose of this review paper is to synthesize the safety and health issues associated with COVID-19 pandemic in the construction industry, and summarize the challenges and opportunities for construction stakeholders in implementing COVID-19 safety and health measures in the construction industry. This paper has explored the challenges in construction and COVID-19; COVID-19 knowledge, preventative behaviors, and risk perception among construction workers; recommendations/practical implications/preventive measures; and COVID-19 education in compliance/guidance, strategies to combat impacts of COVID-19 pandemic, smart digital technologies, and worker wellbeing and work-related quality of life (e.g., mental health). It is warranted that the construction industry needs to take better steps in preparing for future, man-made or natural disaster events, and subsequent acute and chronic disease risk, in order to yield a healthier/safer construction workplace.

Author Biographies

Sang D Choi, University of Wisconsin at Whitewater
Professor and Graduate Program Coordinator in the Department of Occupational & Environmental Safety & Health at the University of Wisconsin-Whitewater
John A. Staley, University of North Carolina at Chapel Hill
Director of Outreach and Continuing Education North Carolina Occupational Safety and Health Education and Research Center BSPH Core Faculty, Gillings School of Global Public Health Adjunct Assistant Professor, Department of Health Policy and Management University of North Carolina at Chapel Hill


Alberani, V., Pietrangeli, P. D. C., & Mazza, A. M. R. (1990). The use of grey literature in health sciences: a preliminary survey. Bulletin of the Medical Library Association, 78(4), 358-363.

Al Amri, T., & Marey-Perez, M. (2020). Impact of Covid-19 on Oman’s construction industry. Technium Social Sciences Journal, 9, 661-670.

Allan-Blitz L, Turner I, Hertlein F, & Klausner J. (2020, December 9). High Frequency and Prevalence of Community-Based Asymptomatic SARS-CoV-2 Infection. medRxiv. Retrieved from .

Alsharef, A., Banerjee, S., Jamil Uddin, S. M., Albert, A., & Jaselskis, E. (2021). Early impacts of the COVID-19 pandemic on the United States construction industry. International Journal of Environmental Research and Public Health, 18, 1559. ijerph18041559

Allan-Blitz, L. T., Turner, I., Hertlein, F., & Klausner, J. D. (2020). High frequency and prevalence of community-based asymptomatic SARS-CoV-2 infection. medRxiv, 2020.12.09.20246249, doi:10.1101/2020.12.09.20246249.

Al Amri, T., & Marey-Perez, M. (2020). Impact of Covid-19 on Oman’s construction industry. Technium Social Sciences Journal, 9, 661-670.

Al-Bayati, A., Abudayyeh, O., Fredericks, T., & Butt, SE. (2016). Safety Challenges in the U.S. Construction Industry: The Hispanic Workforce Perspective. Conference: Construction Research Congress 2016: Old and New Construction Technologies Converge in Historic. San Juan, Puerto Rico.

Asgary, A., Ozdemir, A. I., & Ozyurek, H. (2020). Small and medium enterprises and global risks: Evidence from Manufacturing SMEs in Turkey. Int J Disaster Risk Sci., 11, 59-73.

Ayodele, O. A., Chang-Richards, A., & González, V. (2020). Factors Affecting Workforce Turnover in the Construction Sector: A Systematic Review. Journal of Construction Engineering and Management, 146(2), 03119010.

Bailey, S. C., Serper, M., & Opsasnick, L. et al. (2020). Changes in COVID-19 Knowledge, Beliefs, Behaviors, and Preparedness Among High-Risk Adults from the Onset to the Acceleration Phase of the US Outbreak. J Gen Intern Med, 35, 3285-3292.

Block, R., Berg, A., Lennon, R. P., Miller, E. L., & Nunez-Smith, M., (2020). African American Adherence to COVID-19 Public Health Recommendations. HLRP: Health Literacy Research and Practice, 4(3):e166-e170.

Brown, K. (2019, January 16). For Generation Z, the value of a construction career is a no-brainer. Construction Dive. Retrieved from .

Bui, D. P., McCaffrey, K., Friedrichs, M., LaCross, N., Lewis, N. M., Sage, K., Barbeau, B., Vilven, D., Rose, C., Braby, S., Willardson, S., Carter, A., Smoot, C., Winquist, A., & Dunn, A. (2020). Racial and Ethnic Disparities Among COVID-19 Cases in Workplace Outbreaks by Industry Sector - Utah, March 6-June 5, 2020. MMWR. Morbidity and mortality weekly report, 69(33), 1133-1138.

Brown, S., Brooks, R., & Dong X. S. (2020). Coronavirus and Health Disparities in Construction. CPWR Data Bulletin. May 2020. Retrieved from .

Brown, S., Brooks, R., Dong, X. S. (2020). Impact of COVID-19 on Construction Businesses and Productions. CPWR Data Bulletin. November 2020. Retrieved from .

Centers for Disease Control and Prevention (CDC) (2021, January 26). COVID-19: Construction COVID-19 Checklists for Employers and Employees.

Centers for Disease Control and Prevention (CDC) (2021, February 18). COVID-19 Hospitalization and Death by Race/Ethnicity.

Centers for Disease Control and Prevention (CDC) (2021, February 24). COVID Data Tracker.

Choi, S. D., Rosenthal, D., & Hauser, S. (2013). Health and safety issues of older workers surveyed in the construction industry. Industrial and Systems Engineering Review, 1(2), 123-131.

Cuschieri, S., & Grech, S. (2020). Obesity population at risk of COVID-19 complications. Global Health, Epidemiology and Genomics, 5, E6. doi:10.1017/gheg.2020.6

De Leo, A., Cianci, E., Mastore, P., & Gozzoli, C. (2021). Protective and Risk Factors of Italian Healthcare Professionals during the COVID-19 Pandemic Outbreak: A Qualitative Study. Int. J. Environ. Res. Public Health , 18, 453

Del Rio C., Collins, L. F., Malani, P. (2020). Long-term Health Consequences of COVID-19. JAMA, 324(17), 1723–1724.
Denny-Smith, G., Sunindijo, R. Y., Loosemore, M., Williams, M., & Piggott, L. (2021). How Construction Employment Can Create Social Value and Assist Recovery from COVID-19. Sustainability 2021, 13, 988.

Dennison Himmelfarb, C. R., & Baptiste, D. (2020). Coronavirus Disease (COVID-19): Implications for Cardiovascular and Socially At-risk Populations. The Journal of cardiovascular nursing, 35(4), 318–321.

Environmental Protection Agency (EPA) (2021, Mar 01). List N: Disinfectants for Coronavirus (COVID-19).

Esa, M. B., Ibrahim, F. S. B., & Kamal, E. B. M. (2020). Covid-19 pandemic lockdown: The consequences towards project success in Malaysian construction industry. Advances in Science, Technology and Engineering Systems Journal, 5(5), 973-983.

Exec. Order No. 13999, 86 Fed. Reg. 7215 (2021, January 21). Protecting Worker Health and Safety. Retrieved from

Food and Drug Administration (FDA) (2021, Mar 01). COVID-19 Vaccines Authorized for Emergency Use. (2020). H.R. 6201 — 116th Congress: Families First Coronavirus Response Act. Retrieved from (2020). H.R. 748 — 116th Congress: Coronavirus Aid, Relief, and Economic Security Act. Retrieved from (2020). H.R. 266 — 116th Congress: Paycheck Protection Program and Health Care Enhancement Act. Retrieved from (2021). H.R. 133 — 116th Congress: Consolidated Appropriations Act. Retrieved from

GreyNet International. (2020). Report on Business. May 2020. Retrieved from e-ISSN 2542-4572

Gunduz, M., Ahsan, B. (2018). Construction safety factors assessment through Frequency Adjusted Importance Index. International Journal of Industrial Ergonomics. ISSN: 0169-8141, Vol: 64, Page: 155-162

Heigl C. 7 Major Trends That Will Impact the Construction Industry. 2018. Construction Industry News. Retrieved from .

Helander, M. G. (1991). Safety hazards and motivation for safe work in the construction industry. International Journal of Industrial Ergonomics, 8(3), 205-223.

Karasneh, R., Al-Azzam, A., Muflih, S., Soudaha, S., Sahar-Hawamdeh, Khader Y. (2021) Media's effect on shaping knowledge, awareness risk perceptions and communication practices of pandemic COVID-19 among pharmacists. Data Research in Social and Administrative Pharmacy, 17(1), 1897-1902

Kaushal, V., & Najafi, M. (2021). Strategies to mitigate COVID-19 pandemic impacts on health and safety of workers in construction projects. Civil Engineering Beyond Limits, 2, 1-8.

Lam, S. C, Arora, T., Grey, I., Suen, L. K. P., Huang, E. Y., Li, D., & Lam, K. B. H. (2020). Perceived Risk and Protection From Infection and Depressive Symptoms Among Healthcare Workers in Mainland China and Hong Kong During COVID-19. Frontiers of Psychiatry, 11:686. doi: 10.3389/fpsyt.2020.00686

Lan, FY., Wei, CF., Hsu, YT, Christiani, D.C., Kales, S.N. (2020) Work-related COVID-19 transmission in six Asian countries/areas: A follow-up study. PLOS One.

Loosemore, M., & Malouf , N. (2019). Safety training and positive safety attitude formation in the Australian construction industry. Safety Science, 113, 233-243

McCaffery, K. J., Dodd, R. H., Cvejic, E., Ayre, J., Batcup, C., Isautier, J. M. J., Copp, T., Bonner, C., Pickles, K., Nickel, B., Dakin, T., Cornell, S., & Wolf, M. S. (2020). Health literacy and disparities in COVID-19–related knowledge, attitudes, beliefs and behaviours in Australia. Public Health Research and Practice, 30(4):e30342012.

Moyce, S. C., & Schenker, M. (2018). Migrant Workers and Their Occupational Health and Safety. Annual Review of Public Health, 39, 351-365

Namian, M., Albert, A., Zuluaga, C. M., & Behm, M. (2016). Role of safety training: Impact on hazard recognition and safety risk perception. Journal of construction engineering and management, 142(12), 04016073.

National Institute for Occupational Safety and Health (NIOSH) (2015). Overlapping vulnerabilities: the occupational safety and health of young workers in small construction firms. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, DHHS (NIOSH) Publication No. 2015-178.

National Institute for Occupational Safety and Health (NIOSH). (n.d.). What is Total Worker Health? Retrieved from

Pandit, B., Albert, A., Patil, Y., & Al-Bayati, A.J., Impact of safety climate on hazard recognition and safety risk perception. Safety Science, 113, 44-53.

Pasco, R. F., Fox, S. J., Johnston, S. C., Pignone, M., & Meyers, L. A. (2020). Estimated association of construction work with risks of COVID- 19 infection and hospitalization in Texas. JAMA Netw. Open, 3, e2026373, doi:10.1001/jamanetworkopen.2020.26373.

Peres, D., Monteiro, J., Almeida, M.A., & Ladiera, R. (2020). Risk perception of COVID-19 among Portuguese healthcare professionals and the general population. Journal of Hospital Infection, 105(3), 434-437.

Raifman, M. A., & Raifman, J. R. (2020). Disparities in the Population at Risk of Severe Illness From COVID-19 by Race/Ethnicity and Income. American Journal of Preventive Medicine, 59(1), 137-139.

Rodriguez, J. (2019). Managing Five Generations at the Construction Site. Communication and Integration Are Essential for Success. Updated March 2019. Retrieved from Updated March 18, 2019

Sorensen, O. H., Hasle, P., & Bach, E. (2007). Working in small enterprises – Is there a special risk? Safety Science, 45(10), 1044-1059.

Stor, V.H., Haeffele, S., Lofthouse, J.K., & Grube, L.E. (2021). Essential or not? Knowledge problems and COVID‐19 stay‐at‐home orders. Symposium Article. Southeast Economic Association. 08 February 2021. DOI: 10.1002/soej.12491.

Tixier, A. J., Hallowell, M. R., Albert, A., van Boven, L., & Kleiner, B. M. (2014). Psychological antecedents of risk-taking behavior in construction. J. Constr. Eng. Manage, 140 (11), 04014052.

Uddin, S. M. J., Albert, A., Alsharef, A., Pandit, B., Patil, Y., & Nnaji, C. (2020). Hazard Recognition Patterns Demonstrated by Construction Workers. International Journal of Environmental Research and Public Health, 17(21), 7788.

U.S. Bureau of Labor Statistics (BLS) (2019). Number and rate of fatal work injuries, by industry sector, 2019. Retrieved from .

U.S. Bureau of Labor Statistics (BLS) (2021, February 24). News Release, National Census of Fatal Occupational Injuries in 2019.

U.S. Bureau of Labor Statistics (BLS) (2021, February 24). Industries at a Glance. Construction: NAICS 23.

U.S. Bureau of Labor Statistics (BLS) (2020, December 16). BLS News Release.

U.S. Environmental Protection Agency (EPA). List N: Disinfectants for Coronavirus (COVID-19). Available at .

U.S. Occupational Safety and Health Administration (OSHA) (2021, March 6). OSH Act 5(a)(1). The General Duty Clause. Retrieved from .

U.S. Small Business Administration (SBA) (2021, March 6). Coronavirus (COVID-19): Small Business Guidance & Loan Resources. Retrieved from

Velasco-Mondragon, E., Jimenez, A., Palladino-Davis, A.G., Davis, D., & Escamilla-Cejudo, J. A. (2016). Hispanic health in the USA: a scoping review of the literature. Public Health Review, 37(31).

Wang, X., Dong, X.S., Choi, S.D., & Dement, J. (2017). Work-related musculoskeletal disorders
among construction workers in the United States from 1992 to 2014. Occupational and Environmental Medicine, 74(5), 374-380

Wolf, M. S., Serper, M., Opsasnick, L., O'Conor, R. M., Curtis, L., Benavente, J. Y., Wismer, G., et al. (2020). Awareness, Attitudes, and Actions Related to COVID-19 Among Adults With Chronic Conditions at the Onset of the U.S. Outbreak: A Cross-sectional Survey. Annals of Internal Medicine, 173(2), 100-109.

World Economic Forum (2019). The global risks report 2019. Geneva: World Economic Forum. Retrieved from
World Health Organization (WHO) (2021, February 24). Coronavirus Disease (COVID-19).

Zheng, L., Chen, K., & Ma, L. (2021). Knowledge, Attitudes, and Practices Toward COVID-19 Among Construction Industry Practitioners in China. Frontiers in public health, 8, 599769.

Zidan, A., Mousa, A., & Mahgoub, M. (2013). A survey-based vision for restructuring concrete business in the new residential communities in Egypt. Industrial and Systems Engineering Review, 1(2), 162-172.