Objective The construction industry experiences a high rate of injuries. A pattern of minor injuries may increase risk of severe injuries within a company. The assistance of outside safety and health professionals (S&HP) may help reduce risk of injury in construction firms. The goal of this study was to determine the association between minor injuries and risk of lost-time injury and to determine the association between company contact with an external S&HP and risk of lost-time injury.

Methods Workers’ compensation data were evaluated covering 1,360 construction companies from 2004–2009. In analysis 1, minor injury experience prior to lost-time injury was categorised as: 0–1 claim, 2–3 claims, 4–6 claims, 7 or more claims. For analysis 2, S&HP contact prior to lost-time injury was categorised as: 0 contacts, 1 contact, 2 contacts, and3 or more contacts. Hazard Ratios (HR) and 95% confidence intervals (CI) were estimated using a proportional hazards regression model and accounting for repeated events and time-varying covariates. A model based variance estimate accounted for correlated observations within companies over time. Models included confounding covariates of company size and union status.

Results Compared to experiencing 0–1 claims, increased risk occurred with experiencing 2–3 claims (HR = 1.25, CI = 1.32- 1.75), 4–6 claims (HR = 1.36, CI = 1.19- 1.56), and 7 or more claims (HR = 1.52, CI = 1.12- 1.39). Compared to experiencing no S&HP contact, reduced risk occurred with experiencing 1 contact (HR = 0.77, CI = 0.67–0.88) and 2 contacts (HR = 0.63, CI = 0.55–0.74). Once companies reached the highest category of contacts, three or more, there was no longer and significant reduction in risk (HR = 1.06, CI = 0.92–1.22). Companies of larger size were associated with greater risk of a lost-time claim, as were union companies.

Conclusion The results indicate increasing non-lost-time claims experience is associated with increasing risk of lost-time injury, whereas contact of a S&HP may reduce the risk of lost-time injury.