Occupational safety and health interventions for construction workers: A scoping review

In August 2023, GreyBay Institute researchers and colleagues from the Harvard T.H. Chan School of Public Health published A Scoping Review of Interventions to Improve Occupational Safety and Health of Construction Workers in the American Journal of Health Promotion. The paper is one of the first reviews to combine occupational-safety and health-promotion perspectives for construction workers and provides an evidence base for integrated policy in high-risk urban occupations.

The team screened 1,297 studies from PubMed and Web of Science published between 1990 and 2019 and included 24 intervention studies. Using a multilevel intervention framework, the review examined intervention design, heterogeneous effects, and reasons for implementation failure across six countries: the United States, the Netherlands, Denmark, China, Australia, and the United Kingdom. Topics included dust and noise control, fall-prevention training, physical-activity promotion, smoking cessation, diet improvement, musculoskeletal pain, and mental-health support.

Seventeen studies reported significant intervention effects, but only two truly integrated occupational safety with health promotion. This imbalance reflects a long-standing split between injury prevention and lifestyle-focused health work. The review showed that individual-level behaviour change alone is often limited and difficult to sustain, whereas multilevel designs combining worker education with environmental improvement and organisational policy change can substantially strengthen outcomes, including doubling smoking-cessation effects relative to purely individual approaches.

For policy in Shenzhen and the Greater Bay Area, the paper highlights three priorities. First, construction-worker health governance must move beyond accident prevention toward whole-life-cycle health protection, including chronic disease risk, smoking, drinking, and sedentary behaviour. Second, environment-behaviour co-interventions should become a core policy tool, with structural measures such as healthier canteens, physical separation of smoking areas, and better noise zoning embedded in "healthy worksite" standards and public procurement criteria. Third, implementation-science collaboration across government, industry, and occupational-health institutions is essential, since many failed interventions reflect delivery barriers rather than weak ideas.

This review is a milestone in GreyBay's work on health equity in priority occupational groups. The team is now developing a decision-support toolbox for integrated safety-and-health interventions in construction enterprises and is supporting an 18-month cluster randomised trial with a major construction company to test effects on metabolic health and injury outcomes. For enquiries about the evidence map, policy translation, or enterprise collaboration, please contact contact@greybay.org.

Publication:
A Scoping Review of Interventions to Improve Occupational Safety and Health of Construction Workers. Hana Hayashi, Yue Li et al. American Journal of Health Promotion, 2023 Aug 11;37(8):1162-1170.
DOI: 10.1177/08901171231193783 | PMCID: PMC10631273
Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC10631273/