Analyzing Cognitive Dimensions of Construction Fatalities Based on OSHA Investigations

Access paper here

Copy Link to This Page

Construction has high fatality rates, but investigation reports from the Occupational Safety and Health Administration (OSHA) mostly record physical hazards and rule violations. They say little about what workers were thinking or perceiving when things went wrong.

This study analyzed 111 Federal OSHA construction fatality cases investigated between June and August 2024. Each case was coded using three frameworks from cognitive science: the Generic Error Modeling System, which sorts errors into skill-based, rule-based, and knowledge-based types; the Situational Awareness model, which shows where a worker’s understanding of the situation broke down; and Cognitive Load Theory, which describes how much mental effort a task demands. Hazards were coded using OSHA’s own categories.

The type of error and the stage of awareness breakdown were strongly linked. Skill-based errors went with failures to perceive the hazard, rule-based mistakes with failures to anticipate what would happen next, and knowledge-based mistakes with failures to understand the situation. Each of the “Fatal Four” hazards (falls, electrocution, struck-by, and caught-in/between) had its own pattern. Falls were mostly skill-based perception failures, electrocutions were rule-based comprehension failures, and struck-by incidents were knowledge-based failures to anticipate. Caught-in/between incidents had no single dominant pattern. Overall mental workload did not separate hazards or error types, though the effort built into the task itself was linked to failures to anticipate outcomes. Clustering also found three recurring hazard-and-cognition profiles.

The study shows that OSHA fatality reports, although written for compliance, contain cognitive patterns that differ by hazard type. This points to prevention aimed at each hazard: attention-focused training for falls, checking workers’ mental models for electrocution, and anticipation-focused approaches for struck-by and other fast-changing incidents.

Recommended citation: Pal, U. K., Zhang, C., & Timalsina, S. (2026). Analyzing Cognitive Dimensions of Construction Fatalities Based on OSHA Investigations. Journal of Safety Research. https://doi.org/10.1016/j.jsr.2026.10.013