Construction Safety and Health Science in the U.S.: 20 Years of Progress

Introduction
Before 1990, construction safety and health policies and program in the U.S. were based on anecdotal information. In 1990, the National Institute for Occupational Safety and Health in Collaboration with CPWR: The Center for Construction Research and Training, launched the US construction safety and health research program to provide a scientific basis to drive safety and health performance. Since then CPWR has managed the National Construction Center, a consortium of about 30 organizations dedicated to improving safety and health science in the U.S. construction industry.

Methods
This paper describes the systematic process of development of construction safety and health over the past 20 years, going from industry and risk characterization, to development and testing of targeted interventions, to translation strategies to get best practices more widely adopted.

Results
We show a significant decline in safety and health outcomes that can be linked to the more widespread adoption of good safety and health practices in general and to specific interventions in certain areas. We estimate the likely savings that have been derived from this development. The paper also describes the growing trend of underreporting injuries and illnesses.

Discussion
This paper shows that a highly targeted and dedicated investment in research and translation of research can have a significant impact on safety and health performance that is highly cost effective. There is concern that growing underreporting may undermine the scientific approach to improving safety performance.