Construction is big business. In the UK it is now the country’s biggest industry and the same is true for many economically developed countries. It is also a dangerous business and construction workers do not enjoy good health: studies in Britain, Europe and the USA have shown that construction workers have high overall mortality rates independent of social class—both those employed in specific trades and “construction workers not otherwise classified”. There are increased mortality risks for all malignant neoplasms including lungs, stomach and thyroid gland, high levels of mesothelioma deaths, chronic obstructive pulmonary disease and high rates of transportation and other injuries. Psychological ill health is also common with high rates of alcohol and drug abuse. Construction used to be a young man’s industry because of the high attrition rate resulting from poor work conditions and premature ill health and disability. Now, as with other industries, the workforce is getting older. Unlike other industries, the work cannot be exported.

The last decade has seen an explosion of interest in the construction industry and its hazards1 but most of the literature is shot through with expressions of …