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Texas Department of Insurance
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OSHA’s “Fatal Four” - The leading causes of death in the construction industry

The Bureau of Labor Statistics reported 5,190 fatal work injuries in the U.S. in 2021. Of those deaths, nearly 20% occurred in construction, second only to transportation and materials handling. Fortunately, the “Fatal Four” leading causes of construction deaths – falls, stuck-by, electrocutions, and caught-in or -between -- are preventable by using these tips.

OSHA Fatal Four - falls, caught-in-between, struck-by, and electrocution


1 Use fall protection.

Falls caused 37% of construction deaths in 2021. OSHA standards require fall protection any time a construction worker is 6 feet or more above the ground.

2 Ground or double-insulate all electrical equipment.

Electrocution accounted for about 8% of construction worker deaths in 2021. Among the electrocution risks on construction sites are exposed wiring and wet conditions near outlets; contact with overhead power lines; energized conductors or circuit parts; poorly maintained power tools and cords; and lightning strikes. Strictly following OSHA electrical standards can prevent these accidents.

3 Know the greatest risk of being struck by an object on a job site.

Another 8% of construction deaths in 2021 were due to workers who were struck-by objects that were swinging, falling, or misplaced. These included falling objects due to rigging failure; loose or shifting materials; equipment malfunctions; and vehicle or equipment strikes. Be aware of all possible struck-by hazards including dropped tools and flying objects, and review these tips and resources.

4 Use strict safety precautions when surrounded by moving vehicles, unguarded heavy equipment, or cave-in hazards.

About 5% of construction worker deaths in 2021 were from employees getting caught in or between machines, devices, tools, or trenches including workers caught between moving or rotating equipment or collapsing structures or materials. Ensure control measures are in place and workers are trained to prevent the most common caught-in and caught-between hazards including getting pulled into unguarded machinery; caught between equipment and a fixed object; or trapped in a masonry wall, trench, or excavation collapse.


For more information on construction worker safety training and ways to prevent the “Fatal Four,” contact a workplace safety training specialist at the Texas Department of Insurance, Division of Workers’ Compensation at or 1-800-252-7031, option 2.


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Last updated: 5/24/2024