Objective The effectiveness of a regulatory training standard to prevent falls from heights in construction in the province of Ontario, Canada was evaluated. The standard specifies a full day of working-at-heights safety training, including both theoretical and practical elements, delivered by a government-approved training provider. Once the regulatory requirements were in full effect in fall 2017, over 400,000 workers were trained to the standard.

Methods A comprehensive effectiveness evaluation of the working-at-heights training standard was undertaken, including a longitudinal survey of over 600 workers who underwent the training, collection of their pre-post-training knowledge test scores, and a quasi-experimental analysis of lost-time injury claims for work disability insurance.

Results A large increase in mean knowledge test score (out of 10 points) was observed for workers on their day of training: from 6.8 to 9.5 points (p Follow-up after two years, showed a large decline in knowledge test scores (to mean score 7.5). In contrast, the work practice improvements had been sustained. The incidence rate of lost-time claim injuries due to falls targeted by the training (e.g. falls from roofs) declined by 21.0% from 2012–2014 to 2017–2018 in the Ontario construction sector. In comparison, the rate due to falls not targeted by the training (e.g. falls at the same level) increased by 2.9%; and the rate due to non-fall traumatic injuries decreased by 7.3%. These differences in incidence rate changes were statistically significant. (Analyses are currently being updated to include injuries from 2019.)

Conclusion The evaluation findings provide consistent support for a conclusion that the mandatory training standard was effective in reducing the incidence of injuries targeted by the training.