What injuries make up the construction industry’s Fatal Four?

Construction workers typically earn substantial wages, but it can come with a price – it can be a dangerous, even deadly, occupation. You must perform so much of your work on roofs, scaffolding and ladders, as well as around heavy equipment and machinery. In addition, you must remain vigilant for electrical wires and, if you are working at a multi-story job site, elevator shafts. With all of these and other hazards, it is not surprising that construction workers suffer more than their share of injuries, some of them fatal. 

According to the North Carolina Department of Labor, 53 people died in workplace accidents in North Carolina in 2019, which is an all-time high for the decade. 17 deaths were fall-related accidents, while 15 deaths were caused due to “struck-by” incidents. The majority of workplace deaths occurred in the construction industry, which saw 20 deaths in 2019 – an increase from 16 deaths in 2018.

As recounted by Construction Connect, the Occupational Safety & Health Administration has determined that four types of accidents account for over two-thirds of construction fatalities. In order of the respective percentage of fatalities they cause, the following compose the construction industry’s “Fatal Four:” 

  1. Falls (39.7% of all construction fatalities) 
  2. Struck by object accidents (9.4%) 
  3. Electrocutions (8.3%) 
  4. Caught-between or caught-in accidents (7.3%) 


When you fall, especially from a high place, you risk serious injury, even if you are wearing protective equipment. Chief among them include the following: 

  • A traumatic brain injury that could result in vision, hearing or cognitive loss, as well as debilitating personality changes 
  • A spinal cord injury that could result in partial or complete paralysis 
  • A crush injury that could result in amputation of one or more of your limbs 
  • Broken bones 

The other three 

Even though struck-by, caught-between, caught-in and electrocution accidents together account for slightly less than 25% of all construction deaths, they can, nevertheless, result in serious injuries. The first three generally result in serious crush injuries which can take you months to recover from. If electrocuted, you could sustain neurological damage that may well hinder your mobility. In addition, you could receive extensive burns that will leave disfiguring scars. 

The North Carolina Workers’ Compensation laws address these financial losses when a person is killed or seriously injured on the job in North Carolina. An employer or its insurance company must pay death benefits to the surviving spouse of the deceased worker and to the minor children of a deceased worker. We can help both with workers’ comp claims as well as death benefits. That is what we do.

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