Causation model for psychological injuries in the

construction industry

Imriyas Kamardeen
Faculty of Built Environment, University of New South Wales, Australia
imriyas@unsw.edu.au
Raufdeen Rameezdeen
School of Natural and Built Environments, University of South Australia, Australia
Rameez.Rameezdeen@unisa.edu.au

Abstract

A plethora of studies is found, which investigates physical injuries and health problems in
construction. Similarly, numerous models have been developed to date to explain their causes.
However, an equally important work health and safety issue, the psychological wellbeing of
construction workers, is an under explored area. This research empirically analysed 376 cases of
psychological injuries occurred to construction workers and developed a causation model. The study
found seven causes that are responsible for psychological injuries amongst construction workers, viz.:
(1) workplace harassment and bullying, (2) work pressure, (3) work-life conflict, (4) discrimination,
(5) poor physical work environment, (6) job uncertainty and (7) poor workplace relationships. Among
these, long sustained workplace harassment and bullying, often accompanied by violence, produces
critical psychological injuries that require time-off-work for longer than a year. Similarly, constant
work pressure leads to severe psychological injuries that require time-off-work for 100 to 365 days.
The study highlights the urgent need to curb workplace harassment and bullying in order to make the
construction industry free from critical psychological injuries.

Keywords: Work health and safety, psychological injury, construction operatives, causation model.

1. Introduction
Construction accidents have been explored extensively to date, resulting in several accident causation
models. These various models focus on physical injuries and health issues because these are visible to
the outer world and loud when occur. Most of the existing safety management strategies and systems
too are heavily focused on curbing physical injuries and health problems. An equally important work
health and safety (WHS) issue is the psychological wellbeing of construction workers. Because
psychological injuries suffered by workers are invisible and silent, unlike physical injuries, they go
unnoticed for extended periods, causing serious damages to workers. Hohnen and Hasle (2011)
asserted that most employers fail to see the psychosocial injuries endured by workers and current
WHS management practices too are heavily focused on technical aspects and neglect psychosocial
hazards.

Some previous studies are noted within the broader topic of psychological health of construction
workers. Golderhar et al. (1998) examined the impact of sexual harassment, gender discrimination,
job uncertainty and over compensation at work on female construction workers’ physiological well-
being. Golderhar et al. (2003) modelled the relationships between job stressors and accident outcomes

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in construction projects. Likewise, Siu et al. (2004) investigated relations among safety climate,
psychological strains and safety performance in construction projects. Larsson et al. (2008) studied
the significance of good psychological climate in construction projects for improved safety outcomes.
Leung et al. (2010) identified workplace factors affecting job stress of construction workers and
further explored the impact of it on injury incidents. Melia̕ and Becerril (2007) explored how factors
such as leadership, role conflict and mobbing behaviours influence workers’ psychological health.
Most of these studies still placed the focus on accident outcomes and treated psychological symptoms
as mediators of physical injuries and health problems. The other studies were narrow in scope,
suggesting further explorations are needed to understand and model the realm of psychological
injuries of construction workers. To this end, this research aimed at identifying the factors that affect
the psychological health of construction workers and mapping them in a causation model.

2. Literature review
Psychological health is defined as a state of mental well-being that influences one’s ability to realise
his/her potentials and work productively to contribute to the advancement of self and society while
successfully managing the stressors of work and life (CSA 2013). Poor psychological health lead to
several undesirable behaviour patterns and symptoms in employees, viz.: difficulty to focus on work
and to make rational decisions; finding it hard to meet reasonable goals and deadlines; being absent
from or late to work frequently; excessive tiredness and fatigue; getting overwhelmed or irritated
easily with people or work tasks; displaying negative thoughts and loss of self-confidence; avoiding
workplace gatherings such as staff meetings, socialisations, etc.; appearing atypically worried,
apprehensive, emotional or tearful; and resorting to alcohol or drugs to cope (Beyondblue 2014).

Unfavourable conditions and/or stressors encountered at workplaces can trigger poor psychological
health in employees. Eight such themes were elicited in a critical review of literatures, as discussed
below. The literature review provided valuable insights and a solid foundation for the empirical study.

2.1 Work pressure

The inherent nature of construction could exert pressure on site management team and workers as
they try to accomplish several tasks concurrently within a limited time and space. Choudhry and Fang
(2008) reported that construction workers were constantly instructed by their supervisors to perform
the task quickly, which often led to compromising safety for productivity and thereby higher injury
rates. This situation causes worker to be under constant job stress. Leung et al. (2010) added that work
overload also increases job stress within workers.

2.2 Workplace relationships

Poor support or relationships at workplaces can put a psychological strain on workers (Walen and
Lachman 2000). Having a sense of team spirit and developing good relationships with workmates are
of significant socio-psychological influencers for workers (Kazaz and Ulubeyli 2007). This creates a
harmonious and positive workplace where workers tend to be morally supportive to each other.
However, social relationships among co-workers can be a challenging issue for migrant workers.
Language barrier is an impediment. Fang and Goldner (2011) argued that local language competency
is a determining factor for migrant workers’ successful transition into work culture. Moreover, it is
directly linked to their economic success, which also influences the psychological well-being.

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 2.3 Poor physical work environment

Arboleda and Abraham (2004) postulated that being constantly exposed to extreme outdoor
temperatures, poor air quality, excessive noise, dirty drinking water, odour, chemicals and hazardous
working conditions can induce stress in workers.

2.4 Work-life conflict

Tennant (2001) observed that most adults attain satisfaction in life from work and family; however,
these could also be sources of stress if not balanced effectively. Van Amelsvoort et al. (2004)
postulated that work-family conflicts often result in inadequate time and energy to fulfil both family
and work duties; one of them is likely to be compromised. Bust and Gibb (2006), for example, found
that shift work among construction workers created family problems and stress. Moreover, workers
with family issues had their work performance affected, which in turn showed repercussions on their
economic situations. These factors collectively affect their psychological state (Glasscock et al. 2006).

Overtime work is commonly practised by organisations when a project is behind schedule or faces
labour shortages. Overtime can be in the form of extending the daily work hours or rostering weekend
work. In construction projects, workers generally cannot opt out overtime work. Long work shifts
exceeding 13 hours or continuously working throughout weekends could lead to both physical and
mental exhaustion, particularly in difficult conditions like extreme heat or cold (SoialistWorker 2011).

2.5 Workplace harassment and bullying

Mikkelsen & Einarsen (2002) found that exposure to harassment and bullying at work was associated
with an increased number of psychological and psychometric complaints. Likewise, Law et al. (2011)
found in Australia that 24% of compensation claims in 2007 and 2008 were linked to workplace
harassment and bullying. Moreover, gender-based and sexual harassments were identified by
Goldenhar et al. (2003) as strong stressors that cause poor psychological wellbeing for women in the
construction industry. Severe forms of harassment and bullying are regarded as violence, which are
extreme social stressors (Zapf et al. 1996). Leymann (1996) enlisted behaviours that constitute
violence at work, which include: social isolation, assigning a person too little or too simple tasks,
slander, intimidating or criticising, physical violence and threat of violence, and rumours about one.

2.6 Discrimination
Literature suggests that migrant workers may face discriminatory treatments by employers, local
workers and/or unions. Discrimination by employers include unequal wages for the same jobs,
offering jobs un-matching their qualifications/skills and limited work hours. Wong et al. (2007)
claimed that migrant workers are perceived to be increasing competition in the market, thereby
threaten job opportunities for local workers. As such, migrant workers face hostility from locals and
at times are linked to increased crime rates in the city. Harcourt et al. (2008) argued that
discrimination against migrant workers is not limited to employers or local workforce and pointed out
that unions that lobby for restrictions on immigration to satisfy the majority group are hesitant to help
ethno-cultural groups to acquire decent work conditions. Depending on the country of origin and
economic backgrounds, migrant workers would initially tolerate discrimination. However, over time
they experience frustration, feelings of shame, bitterness, strain and loss of sleep (Simich et al. 2006).

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 2.7 Job uncertainty

Dekker and Schaufeli (1995) found that job uncertainty faced by employees of a transport
organisation in Australia was strongly associated with psychological distress. They further argued that
the negative psychological effect of job uncertainty extends beyond the potentially redundant
employees and affects their families too. Among the organisational practices that pose a sense of job
uncertainty are: casual/contract employment, redundancy, gender/ethnic/nationality preferences, etc.
Job uncertainty for construction workers is placed in a delicate position. The continuity of
construction jobs is heavily dependent on the availability of new projects for the employer. Many
external factors influence this; i.e., changes to government policies on infrastructure development and
other economic issues can impact on construction demand, which may make job insecurity a constant
issue in construction.

3. Research method
Figure 1 illustrates the methods deployed in this empirical research, which utilised a large database of
construction accidents for developing the causation model. Accident data for the research were
obtained from Safe Work South Australia, which is a state government agency responsible for work
health and safety. They maintain a database of workplace accidents across all industries in South
Australia. The database encompassed 29,205 construction accidents, reported during 2002-13.
Filtering the database, a subset of 444 records was extracted, which described incidents related to
psychological injuries to construction workers.

Data collection

Data pre-processing

Critical review of
existing literature

Exploratory data
analysis

Statistical Qualitative data Consolidation Model

association analysis analysis causes development

Figure 1: Research process and method

Pre-processing was undertaken to prepare the filtered data for statistical analysis. A typical case was
characterised by variables such as: mechanism of incident, occupation, age, gender, language,
nationality origin, experience, timing of incident, date of incident, employer size, description of
incident, lost days and worker’s compensation paid. First, records that are not related to construction,
but had been incorrectly recorded were removed (21 cases). Further checking was conducted to
identify cases that are not significant for analysis. Forty-seven cases with both zero lost days and zero
compensation were identified and removed, resulting in 376 usable cases for further analysis. Then,
entries and descriptions across records were made consistent. Finally, nominal scales were introduced
for variables that had numerical entries to facilitate non-parametric statistical analyses.

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After the data pre-processing, an exploratory analysis using descriptive statistics was performed to
gain a broader understanding of the psychological injuries in the South Australian construction
industry. Subsequently, associations between the independent variables and the severity of
psychological injuries were investigated using chi-square tests. While chi-square statistics are helpful
for revealing associations they cannot be interpreted as causations. Thus, incident descriptions were
qualitatively analysed to corroborate how the associations exhibit causation. Finally, findings from the
quantitative and qualitative analyses and the literature review were consolidated, enabling the
development of a new causation model for psychological injuries in the construction industry.

4. Quantitative data analysis and findings

The data set was redefined by 10 independent variables and one dependent variable (severity of
psychological injury) in the pre-processing stage. In the original database, some of these variables
were defined by different measurement scales, such as: occupation of victim had 67 job titles; age was
in years; language background had 7 entries; nationality origin consisted of 9 countries; time of
incident was 30-minute class intervals; and month of incident had 12 entries. Table 1 shows how these
variables were re-categorised using nominal scales. Some of the categories, such as gender,
mechanism of injury and employer size, were directly taken from the original dataset.

Table 1: Variable measurements

Variable Measurement (nominal)
Independent variables:
1. Mechanism of injury Assault; exposure to a traumatic event; exposure to workplace or
occupational violence; work pressure; workplace harassment and/or
bullying; suicide or attempted suicide; other mental stress factor
2. Season of injury Summer (Dec, Jan & Feb.); autumn (Mar, Apr & May); winter (Jun,
Jul & Aug); spring (Sep, Oct & Nov)
3. Work shift of injury Morning shift; afternoon shift; evening shift; night shift
4. Age range of victim Under 20; 20 to 29; 30 to 39; 40 to 49; 50 to 59; over 60
5. Gender of victim Male; female
6. Occupation category of victim Office staff; site staff; trades personnel; machinery operator;
apprentice; general worker
7. Experience of victim Experienced worker; new worker
8. Native language of victim English; non-English
9. Nationality origin of victim Australian; non-Australian
10. Employer size Small (1 to 20 employees); medium (21 to 200 employees); large
(more than 200 employees)
Dependent variable:
11. Severity of psychological injury Minor; moderate; major; severe; critical
The dependent variable, severity of psychological injury, was derived based on the number of lost
days reported for the cases. The utilisation of lost days to categorise injuries in to different severity
levels has commonly been used by previous researchers who investigated physical injuries in
construction; for example, Dumrak et al. (2013) and Arquillos et al. (2012). Nonetheless, varied
severity levels and groupings of lost days were implemented by different researchers. This research
adopted five levels of severity such as: minor, moderate, major, sever and critical, and the definitions
for these categories are given below, which were derived from the risk matrix recommended by the
National Patient Safety Agency (NPSA) (2008):

• Minor – psychological injuries requiring time off work (lost days) for shorter than 3 days.

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 • Moderate – psychological injuries requiring time off work (lost days) for 4 to 14 days.
• Major – psychological injuries requiring time off work (lost days) for 15 to 99 days.
• Severe – psychological injuries requiring time off work (lost days) for 100 to 365 days.
• Critical – psychological injuries requiring time off work (lost days) for longer than 365 days.

In interpreting the results, findings of both exploratory and chi-square analyses were looked at in a
combined manner. The below sections expound the findings. In general, an upward trend in
psychological injuries to construction workers in the South Australia is discernible. Whilst the
severity level of psychological injuries are more on the minor category, the combination of major,
severe and critical injuries constitutes one-third of all incidents. Given the psychological injuries are
on constant increase, the ratio is likely to result in negative social outcomes and sufferings. It is
therefore crucial that lessons are learnt from past incidents and measures are put in place to curtail
them in the future. Table 2 elucidates chi-square analysis results. Interpretations of these results are
provided below under appropriate subheadings.

Table 2: psychological injury severity pattern

% of accident within severity level
Factor Category (% of total accident)
Minor Moderate Major Severe Critical
Mechanism of psychological Being assaulted by a person or
80 2.2 0 13.3 4.4
injury persons (12%)
(x2 = 50.909, df =24, p =0.001) Exposure to a traumatic event (12.5%) 83 4.3 6.4 0 6.4
Exposure to workplace or occupational
70 3.3 6.7 10 10
violence (8%)
Work pressure (33.2%) 54.4 2.4 23.2 17.6 2.4
Work related harassment and/or
51.4 2.9 16.2 16.2 13.3
workplace bullying (27.9%)
Suicide or attempted suicide (0.8%) 100 0 0 0 0
Other mental stress factors (5.6%) 76.2 4.8 4.8 9.5 4.8
Occupation Apprentice (6.6%) 72 4 4 8 12
work-related factors

(x2 = 28.047, df =20, p =0.108) General worker (7.7%) 62.1 0 20.7 6.9 10.3
Machinery operator (17.3%) 60 6.2 16.9 6.2 10.8
Office staff (19.4%) 54.8 1.4 15.1 24.7 4.1
Site staff (11.7%) 54.5 4.5 15.9 15.9 9.1
Trade personnel (37.2%) 70 2.1 11.4 12.1 4.3
Work shift Morning shift (32.4%) 66.4 3.3 16.4 8.2 5.7
(x2 = 13.257, df =12, p =0.351) Afternoon shift (21.5%) 63 3.7 7.4 17.3 8.6
Evening shift (2.7%) 40 10 30 10 10
Night shift (43.4%) 62 1.8 14.1 15.3 6.7
Employer size Large (34%) 56.3 5.5 24.2 9.4 4.7
(x2 = 29.209, df =12, p =0.004) Medium (36.7%) 62.3 0.7 10.1 18.1 8.7
Small (29%) 71.6 2.8 6.4 11.9 7.3
Unknown (0.3%) 100 0 0 0 0
Season Autumn (24.5%) 66.3 0.0 15.2 9.8 8.7
(x2 = 27.245, df =12, p =0.007) Spring (25.3%) 60.0 5.3 10.5 22.1 2.1
Summer (22.9%) 73.3 2.3 8.1 10.5 5.8
Winter (27.4%) 54.3 3.9 20.4 10.7 10.7
Gender Female (19.1%) 50.0 2.8 18.1 22.2 6.9
(x2 = 8.890, df =4, p =0.064) Male (80.9%) 66.1 3.0 12.8 11.2 6.9
Age Under 20 (1.9%) 71.4 0 28.6 0 0
(x2 = 15.266, df =20, p =0.761) 20 to 29 (14.9%) 69.6 1.8 10.7 12.5 5.4
Worker-related factors

30 to 39 (26.1%) 61.2 3.1 15.3 12.2 8.2

40 to 49 (27.4%) 64.1 3.9 10.7 11.7 9.6
50 to 59 (25.8%) 58.8 2.1 17.5 18.5 3.1
Over 60 (4%) 66.7 6.7 6.7 6.7 13.2
Experience Experienced (84.3%) 61.2 3.2 15.8 13.9 6
(x2 = 9.949, df =4, p =0.041) New Worker (15.7%) 72.9 1.7 3.4 10.2 11.9
Nationality origin Australian (75.8%) 67.4 2.8 11.2 12.3 6.3
(x2 = 18.553, df =8, p =0.017) Non-Australian (13.6%) 58.8 3.9 13.7 15.7 7.8
Unknown (10.6%) 37.5 2.5 32.5 17.5 10.0
Native language English (96.3%) 63.3 3.0 13.3 13.5 6.9
(x2 = 7.955, df =8, p =0.438) Non-English (2.1%) 62.5 0.0 12.5 12.5 12.5
Unknown (1.6%) 50.0 0.0 50.0 0.0 0.0

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 4.1 Mechanism of incident

Data analysis revealed that work pressure and workplace harassment and bullying are the major
causes of psychological injuries among construction workers with almost one-third of incidents are
attributable to each. Moreover, these mechanisms are represented heavily in the major, sever and
critical categories of injury severity. That is, work pressure recorded a total of 43.20% incidents in
these categories whilst workplace harassment and bullying represented a total of 45.7%. Chi-square
test results (x2 = 50.909, df =24, p =0.001) reveal that there is a statistically significant association
between injury severity levels and incident mechanisms.

4.2 Occupation

In terms of occupation, trades personnel were heavily represented in psychological incidents,

followed by office-based employees of construction organisations and then machinery operators.
Even though no statistically significant association between the occupations and the psychological
injury severity levels was observed (x2 = 28.047, df =20, p = 0.108), a quarter of office-based
employees in construction suffered severe injuries, which resulted in time-off-work between 100 days
and a year.

4.3 Work shift

No statistically significant association was observed between work shifts and psychological injury
severities (x2 = 13.257, df =12, p = 0.351). This finding contradicts with literature on severities in
physical injuries, which confirms that a large proportion of fatalities occur in afternoon shifts (known
as ‘after lunch effect’), and more injuries occur in morning shifts. However, night shift workers
represent psychological injury statistics heavily, across severity categories of major, sever or critical.

4.4 Worker’s gender

Females accounts for only 13% of the South Australian construction workforce (Australian Bureau of
Statistics 2013); but, they are represented doubled the rate for male workers in severe psychological
injuries, as revealed in this study. In other categories of severities, females and males seem to
represent almost similarly, leading to weak chi-square statistics (x2 = 8.890, df = 4, p = 0.064) to
conclude that there is no significant association between gender and psychological injury severity.

4.5 Worker’s age

Past studies on physical injuries have concluded that the severity of physical injury increases with the
age of workers (Arquillos et al. 2012). However, this study has found that there is no significant
association between the age and the severity of psychological injury (x2 =15.266, df =20, p =0.761).
Age groups such as 30 - 39, 40 - 49 and 50 - 59 are nearly equally represented in the overall records.

4.6 Worker’s experience

This study indicated a weak association between experience and psychological injury severity (x2
=9.949, df =4, p =0.041). In contrary to psychical injuries reported in literature, new workers
represented double the rate of experienced workers in the severity category of ‘critical’ psychological
injuries that lead to time-off-work for longer than a year.

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 4.7 Worker’s nationality origin and native language

Australian-born workers represented more in psychological injury statistics than overseas-born

workers and an association is noted between the nationality origin and the injury severity (x2 =18.553,
df =8, p =0.017). However, language background of the worker did not show any association.
Australian workforce comprises 26% persons born overseas (Australian Bureau of Statistics 2010),
but their representation in psychological injury statistics (13.6%) is lesser. Nevertheless, they are
disproportionately represented (37.2%) in injury categories of major, severe and critical.

4.8 Employer size

Only minor differences in the number of psychological incidents was observed across employer sizes
though a significant association between the employer size and injury severity levels was apparent (x2
=29.209, df =12, p=0.004). Small organisations represent more in minor incidents whilst nearly 25%
of incidents occurred in medium-sized organisations resulted in severe or critical injury outcomes. A
similar proportion of incidents in large organisations caused major psychological injuries. No
significant differences in the percentage of critical incidents arose in small and medium organisations.

4.9 Season

The climatic season of winter recorded slightly a higher number of incidents (27.4%) of psychological
injuries than spring (25.3%) and autumn (24.5%). Similarly, winter accounted for the largest
proportion of major, sever and critical incidents than the other seasons, with a total of 41.8% of all the
incidents occurred in that season. Chi-square test results also prove that there is a strong association
between the season and injury severity (x2 =27.245, df =12, p =.0007).

5. Qualitative data analysis and findings

The quantitative analysis displayed the aforementioned patterns within the incident cases. However,
they did not explain the underlying issues that yield them. Hence, the qualitative analysis probed into
the incident descriptions reported by victims and the following trends were discovered.

• One of the major causes of work pressure was excessive workload along with working long
hours, sometimes continuously working without breaks, and trying to achieve unrealistic
goals set by the management. Most of the workers were unable to cope with such excessive
workloads, found the job to be very stressful and ended up having anxiety and depression. As
reported by one of the victims “I was standing in the yard, shaking in tears, unable to
achieve..... build up of pressure due to worrying about getting the job done on time........
unbearable work load”.
• Under workplace harassment, bullying was reported to be the major issue followed by verbal
abuse and sexual harassment. Interestingly these were mainly committed by co-workers rather
than the management or employer. In most cases victims reported an ongoing harassment for
a long time; for example, a worker indicated “I was going about my normal duties and could
no longer handle the harassment and bullying that I was suffering. I find harassment about on
that I had nothing to do with”. Few cases of threatening behaviours either by a co-worker or
employer were also reported. For example, a worker reported “I was victimised by the
directors of the company and made to feel threatened and bullied. I feared for my life and felt

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 very unsafe at work. I had to call the police” and another worker alleged “I received
threatening phone calls at night. Caller said he would kill or damage me and my family”.
• Few workers reported stress and anxiety due to repetitive tasks over a long period of time.
Others reported work environment to be the major cause of work pressure. They have
experienced intolerable conditions and unsafe work practices that led to work stress.
• Confrontations with the employer or management were reported as causes of work stress.
Arguments, aggressive and violent actions at meetings, false accusations, allegations of
misconduct were the major reasons behind these confrontations.
• Job uncertainty, non-payment, underpayment or delayed payments of wages were also found
to have caused depression. In few cases, unfair dismissals have caused stress.
• Work situation (isolation) and workload were cited as main reasons for anxiety and
depression that led to very long absenteeism.

The qualitative analysis was extended to scrutinise the level of injury severity against incident
descriptions and discovered the below patterns in the incident cases.
• Critical incidents were predominantly caused by multiple sources of harassment over a
period; for example, “work and work environment causing anxiety, panic attacks and
depression due to harassment, bullying and victimization”; and “workplace bullying, verbal
and behavioural threats, sexual harassment, undermining authority, defamation”.
• Unlike the above, severe incidents were equally caused by harassment and work pressure.
Seventy-five percent of major incidents were caused by work pressure while only 25% were
due to harassment; for example, a worker reported “work related stress and anxiety due to
staff shortages and performing work of two”, and another worker’s account “work pressure,
working long hours, work overload, and overseeing too many projects”.

6. Discussion
The empirical analysis investigated the influence of personal factors (age, gender, experience,
nationality and language background), work factors (occupation, work shift, work conditions, and
employer) and environmental factors (season) on the psychological injury outcomes in the
construction industry. It has been found that work factors have predominant influence in
psychological injuries than other factors. Hence, the seven themes discovered in the literature
research are confirmed to be relevant to the construction industry. However, the degree of influence
varies in the construction industry setting in the descending order of: (1) workplace harassment and
bullying, (2) work pressure, (3) work-life conflict, (4) discrimination, (5) poor physical work
environment, (6) job uncertainty, and (7) poor workplace relationships. Similarly, the above order is
also a reflection of the severity of these incidents, where harassment and bullying resulting mainly in
critical to severe outcomes while work pressure and work-life conflict lead to severe to major
outcomes. Other causes are not generally associated with higher order severities. It is interesting to
observe that all critical incidents, except four cases, were caused by harassment and bullying. Thus,
the study clearly highlights the need for curbing harassments and bullying to make construction
workplaces free from critical psychological incidents.

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7. Formulation of a causation model for psychological injuries
The findings of the two distinct research methods were consolidated and corroborated towards
formulating a causation model for psychological injuries in the construction industry. Figure 2
demonstrates the model by mapping out the factors and their influence paths. The far left end of the
diagram encompasses seven umbrella stressors with their originating sources. Being a victim of one or
a combination of these stressors causes emotional distress with feelings such as tension, anxiety,
insecurity, frustration and/or trauma in workers. Enduring these distress symptoms for an extended
period can lead to excessive mental stress. When the excessive stress is not controlled, it can result in
psychological depression, which often impacts on the physical health, behavioural and social
patterns/habits, work performance and family relationships. These negative consequences in turn
reinforce the emotional distress and mental stress.

Workplace Harassment & Bullying

• Sexual harassment
• Social isolation
• Slanders and rumours
• Intimidation or unreasonable
Work Pressure
criticism
• Physical violence
• Excessive work overload
• Threat to violence
• Productivity/schedule
pressure
Work-life Conflict
• Overtime work
• Shift work

Discrimination Emotional Distress

• Gender discrimination • Psychological health
• Unequitable wage & work • Tension • Physical health
cause lead to Psychological impacts
hours • Anxiety • Work performance
Stress
• Under-valuing skills • Insecurity • Social relationships
• Differential treatment due to • Frustration • Behaviours
ethno-cultural background • Trauma

Poor Physical Work Environment

reinforce
Constant exposure to:
• Hazardous work conditions
• Extreme weather
• Excessive noise
• Poor air & water quality
• Odour & chemicals

Job Uncertainty
• Casual/contract employment
Poor Workplace Relationships
• Redundancy policies
• Economic/market conditions • Poor social support
• Bias employment terms • Ethno-cultural barriers
• Language barriers

Figure 2: Causation model for psychological injuries

8. Conclusion
While numerous models have been developed by researcher to explain the causation of workplace
accidents and health damages that occur to construction workers, silently suffered psychological
injuries have not gained attention. This study proposes a causation model, which maps out seven
factors along a stress influence path. The factors include: workplace harassment and bullying, work

10
pressure, work-life conflict, discrimination, poor physical work environment, job uncertainty, and
poor workplace relationships. The degree of distress exerted by workplace harassment and bullying,
and work pressure is found to be more significant in the construction industry context than that of
caused by other stressors. Workplace harassment and bullying have the potential to cause
psychological damages that can lead to lost days in excess of a year and excessive work pressure
could result in lost days due to psychological injuries longer than 100 days. Hence, these factors
warrant special attention and scrutiny from organisational management as well as WHS authorities in
order to maintain a construction industry that is free from serious or critical psychological incidents.

References
Arboleda C A and Abraham D M (2004) “Fatalities in Trenching Operations—Analysis Using
Models of Accident Causation.” Journal of Construction Engineering and Management, 130, 273.
Arquillos A L, Romero J C R and Gibb A (2012) “Analysis of construction accidents in Spain, 2003-
2008.” Journal of Safety Research, 43, 381-8.
Australian Bureau of Statistics (2013) Census 2011, Canberra, ACT.
Australian Bureau of Statistics (2010) Forms of employment: a comparison of Australian and
overseas born persons, (available online http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup
/3416.0Main%20Features42010?opendocument&tabname=Summary&prodno=3416.0&issue=20
10&num=&view =#EMPLOYEES [accessed on 25 Mar 2015]).
Beyondblue (2014) For people with depression and anxiety, (available online
http://www.beyondblue.org.au/resources/in-the-workplace/for-people-with-depression-or-anxiety
[Accessed on 27 June 2014])
Bust P and Gibb A (2006) Construction health and safety in developing countries. European
Construction Institute.
Choudhry R and Fang D (2008) “Why operatives engage in unsafe work behavior: Investigating
factors on construction sites.” Safety Science, 46, 566-584.
CSA (2013) Psychological health andsafety in the workplace —Prevention, promotion, and guidance
to staged implementation, Canada, Canadian Standards Association.
Dekker S W and Schaufeli W B (1995 “The effects of job insecurity on psychological health and
withdrawal: A longitudinal study.” Australian Psychologist, 30, 57-63.
Dumrak J, Mostafa S, Kamardeen I and Rameezdeen R (2013) “Factors associated with the severity
of construction accidents: the case of South Australia.” Australasian Journal of Construction
Economics and Building, 13(4), 32-49.
Fang M L and Goldner E (2011) “Transitioning into the Canadian workplace: Challenges of
immigrants and its effect on mental health.” Canadian Journal of Humanities and Social Sciences,
2, 93-102.
Glasscock D J, Rasmussen K, Carstensen O and Hansen O N (2006) “Psychosocial factors and safety
behaviour as predictors of accidental work injuries in farming.” Work & Stress, 20, 173-189.
Goldenhar L M, Swanson N G, Hurrell Jr J J, Ruder A and Deddens J (1998) “Stressors and adverse
outcomes for female construction workers.” Journal of Occupational Health Psychology, 3, 19.
Goldenhar L, Williams L J G and Swanson N (2003) “Modelling relationships between job stressors
and injury and near-miss outcomes for construction labourers.” Work & Stress, 17, 218-240.
Harcourt M, Lam H, Harcourt S and Flynn M (2008) “Discrimination in hiring against immigrants
and ethnic minorities: the effect of unionization.” The International Journal of Human Resource
Management, 19, 98-115.

11
Hohnen P and Hasle P (2011) “Making work environment auditable–A ‘critical case’study of certified
occupational health and safety management systems in Denmark.” Safety Science, 49, 1022-1029.
Jannadi O (1995) “Impact of human relations on the safety of construction workers.” International
Journal of Project Management, 13, 383-386.
Kazaz A and Ulubeyli S (2007) “Drivers of productivity among construction workers: A study in a
developing country.” Building and Environment, 42, 2132-2140.
Larsson S, Pousette A and Törner M (2008) “Psychological climate and safety in the construction
industry-mediated influence on safety behaviour.” Safety Science, 46, 405-412.
Law R, Dollard M F, Tuckey M R and Dormann C (2011) “Psychosocial safety climate as a lead
indicator of workplace bullying and harassment, job resources, psychological health and employee
engagement.” Accident Analysis & Prevention, 43, 1782-1793.
Leung M Y, Chan Y S and Yuen K W (2010) “Impacts of stressors and stress on the injury incidents
of construction workers in Hong Kong.” Journal of Construction Engineering and Management,
136, 1093-1103.
Leymann H (1996) “The content and development of mobbing at work.” European journal of work
and organizational psychology, 5, 165-184.
Melia̕ J L and Becerril M (2007) “Psychosocial sources of stress and burnout in the construction
sector: a structural equation model.” Psicothema, 9(4), 679-686.
Mikkelsen E and Einarsen S (2002) “Relationships between exposure to bullying at work and
psychological and psychosomatic health complaints: the role of state negative affectivity and
generalized self–efficacy.” Scandinavian Journal of Psychology, 43, 397-405.
National Patient Safety Agency (2008), A risk matrix for risk managers, (available online
http://www.nrls.npsa.nhs.uk/EasySiteWeb/getresource.axd?AssetID=60149&... [accessed on 10
April 2014]).
Simich L, Hamilton H and Baya B K (2006) “Mental distress, economic hardship and expectations of
life in Canada among Sudanese newcomers.” Transcultural Psychiatry, 43, 418-444.
Siu O, Phillips D and Leung T (2004) “Safety climate and safety performance among construction
workers in Hong Kong: The role of psychological strains as mediators.” Accident Analysis &
Prevention, 36, 359-366.
Socialist Worker (2011) Thousands of workers strike in Saudi Arabia [available online
http://www.socialistworker.co.uk/art.php?id=24025 [Accessed on 14-2-2015]).
Tennant C (2001) “Work-related stress and depressive disorders.” Journal of psychosomatic research,
51, 697-704.
Van Amelsvoort L G, Jansen N W, Swaen G M, Van Den Brandt P A and Kant I (2004) “Direction of
shift rotation among three-shift workers in relation to psychological health and work-family
conflict.” Scandinavian Journal of Work, Environment & Health, 149-156.
Walen H R and Lachman M E (2000) “Social support and strain from partner, family, and friends:
Costs and benefits for men and women in adulthood.” Journal of Social and Personal
Relationships, 17, 5-30.
Wong K, Fu D, Li C Y and Song H X (2007) “Rural migrant workers in urban China: living a
marginalised life.” International Journal of Social Welfare, 16, 32-40.
Zapf D, Knorz C and Kulla M (1996) “On the relationship between mobbing factors, and job content,
social work environment, and health outcomes.” European Journal of Work and Organizational
Psychology, 5, 215-237.

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