By TIFFANIE REYNOLDS

Construction work is physically demanding, often transient and short on the support systems that other industries take for granted.

Workers may be local to a project or relocated entirely, following the work wherever it occurs. Either way, they carry the physical and psychological weight of one of the most hazardous industries in the country. The data reflects it.

The Center for Construction Research and Training (CPWR) reports that one in five construction workers suffer from a mental health condition, a number researchers consider a silent epidemic. The physical toll compounds it: the latest Bureau of Labor Statistics update recorded 1,032 construction worker fatalities in 2024 alone, accounting for roughly one in five worker deaths across all U.S. industries. This is the highest share of any sector. They are the portrait of an industry that has treated the body as a tool and the mind as someone else’s problem.

A shift is gaining ground on jobsites across the country, one that starts not with recruitment strategies or signing bonuses, but with something more basic: how the industry treats the people doing the work. Two companies are making the case that care, in a market where the AGC reports 92 percent of construction firms struggle to find qualified workers, may be the most underused competitive tool available.

Treating the industrial athlete

Matt Smith, a board-certified athletic trainer, founded Athletic Training Solutions (ATS) in Cincinnati, Ohio in 2011 after noticing a pattern: minor injuries flowing through his clinic, attributed to workers’ comp, traced to a construction site a few blocks away. “He walked to the jobsite and asked, ‘Why are these minor injuries coming through the clinic?’ We can be better. We can be more proactive. And that right there was the spark of ATS,” says Ian Foley, director of national contracting and strategic operations at ATS.

What started as a one-man operation has grown into a nationwide company with more than 170 employees across 15 states. ATS embeds industrial athletic trainers directly on construction sites to prevent injuries before they happen, not treat them after the fact. “Athletic trainers are steeped in body mechanics, ergonomics and kinesiology and know how the body works,” Foley explains. “And that proactive approach to occupational medicine is what has taken ATS from a one-man show to a nationwide business.”

On large sites, ATS athletic trainers lead job-specific stretch-and-flex programs, run toolbox talks informed by site injury data and walk the job throughout every shift. Where the old standard placed a nurse in a trailer waiting for workers to come in hurt, ATS deploys athletic trainers, so they are visible and building relationships from day one.

The real cost of “Send him to urgent care”

When Foley asks prospective clients what happens when a worker twists an ankle, the answer is almost always urgent care or the ER. “There are really two kinds of costs to an injury,” he says. “There are the hard costs of the actual treatment and then the soft costs like legal or regulatory risks, insurance or contractual impacts and reputational damage.”

A minor sprain routed to urgent care rarely stays minor on paper. A prescription for over-the-counter medication or physical therapy referral transforms a first aid-level injury into a recordable event with a workers’ comp claim attached. ATS athletic trainers handle the same ankle onsite: the worker keeps earning, the injury stays off the log and the foreman stays on the job. The ROI on this, based on National Safety Council estimates, shows clients save approximately six dollars for every dollar invested.

The financial case is compelling, but the cultural shift may matter more in the long run. ATS athletic trainers are visible on the jobsite from day one, building familiarity before any injury occurs.

“It’s not the first time they’ve ever seen our logo or that person walking around,” Foley says. “And that immediately is already building trust in the service itself.” That trust extends beyond recordables. When a worker comes in Monday with a sore shoulder from playing catch with his or her kid on the weekend, a trainer can address it before it becomes a workers’ comp claim by Tuesday. “That comes through building relationships and trust and camaraderie on these job sites,” Foley adds. For workers accustomed to being treated like a number at other jobsites, that kind of attention is something that keeps workers committed to a company over its competitors.

Housing as a retention tool

The 2025 AGC/NCCER Workforce Survey found 48 percent of firms report new hires failing to show or quitting within weeks. For workers who travel, quality of life between shifts matters as much as conditions on site.

Laura Campbell, sales manager at Blueground, has built the company’s construction-specific housing division around that premise.

“Superintendents will move company to company based on experience,” she says. “If they aren’t traveling the country in an RV, they will go with whoever is taking the best care of them.” The alternative – a company scrambling to arrange housing on the fly — tells workers something about how they’re valued before they ever set foot onsite. “If living in an apartment is something the company is doing on the fly,” Campbell says, “it makes for a different experience, usually a chaotic one.”

Blueground sources, furnishes and manages units across major metro areas, handling everything from background checks to maintenance, taking the administrative burden off project managers who are already stretched. “The management piece for just the housing is its own lane,” Campbell adds. “We found that companies would rather take that piece off their plate entirely.” Workers who come home to a functioning kitchen and a clean unit feel differently about their employer than workers who are dropped at a Motel 6. “Skilled laborers will work with GCs because the day-to-day experience is better or better managed,” she says. “It’s time to treat them better.”

A total worker philosophy

What connects ATS and Blueground is a brilliant philosophy: the industry’s people are its most constrained resource, and treating them as unique, talented professionals provides cascading benefits. “In an ideal world, if we can start a project from day one and implement our proactive care and wellness protocols for mental and physical needs, a lot of the injuries we mitigate never happen,” Foley says.

An injury that never happens does not appear in a recordable log, does not trigger a workers’ comp claim and does not give a skilled worker a reason to leave the trades. The firms that make construction a place workers want to stay are already gaining ground. The numbers suggest the rest of the industry needs to catch up.