Falls are the leading cause of death in construction. In 2024, 370 construction and extraction workers died from falls, slips, and trips in the United States, making up the single largest share of the 1,032 total fatalities recorded in the industry that year. While that number was down 7.5 percent from 400 deaths in 2023, falls have consistently topped the list for decades.
The “Fatal Four” Hazards
OSHA groups the most deadly construction hazards into four categories known as the Fatal Four: falls, struck-by incidents, caught-in/between accidents, and electrocutions. Together, these four causes account for the majority of on-the-job deaths in the industry each year. Eliminating just these four hazard types would save hundreds of lives annually.
Falls from roofs, scaffolding, ladders, and structural steel are the most common scenario. But the other three deserve attention because they kill in ways that are often preventable with basic safety measures.
How Struck-By Deaths Happen
Struck-by incidents are the second most common cause of construction death. These involve a worker being hit by a moving vehicle, a piece of equipment, or a falling object. In 2019, vehicles accounted for 47 percent of all struck-by fatalities on construction sites, while falling objects caused 27 percent. The rest involved swinging loads, rolling equipment, or flying debris.
Heavy machinery moving in tight quarters, crane loads passing overhead, and dump trucks backing up in active work zones create the conditions for these deaths. Many happen when spotters aren’t used or when workers enter the swing radius of operating equipment.
Electrocution Risks
Electrical deaths on construction sites follow a clear pattern that depends on the type of worker. For electricians and other electrical tradespeople, the primary killer is contact with live wiring, equipment, and light fixtures. For non-electrical workers like laborers, roofers, and painters, overhead power lines are the major cause of death.
Other sources include energized metal objects, machinery, power tools, and portable lights. Arc flash, the explosive burst of energy from an electrical short circuit, causes about 31 percent of electrical injuries among construction workers but less than 2 percent of electrical deaths. In other words, arc flash is more likely to burn and injure than to kill outright, while direct contact with current remains the lethal threat.
Caught-In and Trench Collapse Deaths
Caught-in/between hazards involve a worker being crushed, squeezed, or trapped between objects. The most deadly version is a trench cave-in. Thirty-nine workers died in trench or excavation collapses in 2022 alone, more than double the number in 2021. From 2011 to 2018, 166 workers died in trench cave-ins, averaging 21 per year, so the recent spike represents a troubling acceleration.
A cubic yard of soil weighs roughly 3,000 pounds. When a trench wall gives way, workers are buried under thousands of pounds of earth in seconds. Survival depends almost entirely on prevention: proper shoring, sloping, or trench boxes that keep walls from collapsing in the first place.
Small Companies Face Higher Risk
Construction is an industry dominated by small firms. More than 80 percent of construction businesses have fewer than 10 employees. These small operations bear a disproportionate share of fatalities. Between 1992 and 2015, 42 percent of all construction deaths occurred in establishments with 1 to 10 employees. In 2015, about 57 percent of construction deaths were in firms with fewer than 20 employees, even though those firms employed less than 38 percent of the construction workforce.
The gap is especially stark for falls and electrocutions. From 2011 to 2015, over 61 percent of fatal falls to a lower level and 47 percent of electrocution deaths occurred at companies with 10 or fewer workers. Small firms often lack dedicated safety managers, formal training programs, and the budget for proper fall protection systems. A roofer working for a five-person crew is statistically far more vulnerable than one employed by a large general contractor with a full-time safety team.
Who Is Most at Risk
Construction is one of the deadliest industries in the country. In 2024, the sector recorded 1,032 fatalities out of 5,070 total workplace deaths across all U.S. industries, meaning construction workers accounted for roughly one in five on-the-job deaths despite making up a much smaller share of the total workforce.
Hispanic workers make up a large and growing portion of the construction labor force and face particular vulnerability. Nonfatal injury data for this group is likely underreported, making the true scope of risk difficult to measure. Language barriers, immigration status concerns, and less access to formal safety training all contribute to higher exposure. Workers over 55 and those new to the industry also face elevated fatality rates, the former because falls are less survivable with age and the latter because inexperience leads to misjudging hazards.
Why Falls Remain the Top Killer
Falls have led construction fatality statistics for as long as reliable records have been kept, and the reason is straightforward: construction work constantly puts people at height. Roofing, steel erection, scaffold work, and even residential framing regularly place workers 10, 20, or 50 feet above the ground. A fall from as little as 6 feet onto a hard surface can be fatal.
The tools to prevent these deaths exist. Guardrails, personal fall arrest systems (harnesses and lanyards), and safety nets are all proven measures. The persistent death toll reflects gaps in compliance, especially among small residential contractors where workers may resist harnesses as cumbersome or where employers cut corners on temporary guardrails. The 7.5 percent drop in fall deaths from 2023 to 2024 is encouraging but still leaves falls far ahead of every other cause on the list.