In commercial and institutional building construction, one misstep can mean tragedy. In 2023, construction accounted for 20.7% of all private-industry worker fatalities—with falls alone responsible for 35% of deaths (Source: OSHA). Day after day, preventable injuries like falls, struck-by incidents, electrocutions, and caught-in accidents threaten workers’ lives and cost companies millions (Source: U.S. Bureau of Labor Statistics). But the real gut punch? Many of these incidents could have been avoided.
The top five injury types in commercial and institutional building construction aren’t just statistics—they’re ongoing risks that every project manager, safety leader, and jobsite crew faces. Behind each number is a real person and a preventable event. The good news is, a comprehensive safety approach, backed by technology like AI-powered video, is turning the tide for leading construction teams.
In this guide, we’ll break down the top 5 injuries that happen on commercial and institutional construction projects. For each, we’ll show exactly how you can prevent them—combining proven safety protocols with the power of video intelligence.
The Cost of Safety Negligence in Commercial and Institutional Building Construction
Ignoring safety isn’t just risky—it’s expensive, too. OSHA penalties for serious incidents in commercial and institutional building construction can soar into the tens of thousands, with the average penalty at $15,162, a maximum of $78,000, and a median of $5,839 in recent years.
Prevention is always cheaper than paying these penalties. With the right systems, including modern video intelligence, many of these tragedies can be avoided.
The Top 5 Preventable Injuries in Commercial and Institutional Building Construction
Let’s get specific. These are the five preventable injuries where video analytics make a measurable difference—directly supporting OSHA protocols and proven best practices.
1. Falls from Heights
Scenario:
A crew is installing HVAC ductwork on a rooftop. One worker, not clipped into a harness, steps back to avoid a swinging load and falls through an unguarded skylight.
Root Causes & Impact:
Falls account for 505 incidents (36.7% of all injuries) in commercial and institutional building construction (Source: OSHA Injury Summary). Common causes include unprotected edges, missing guardrails, unstable ladders, and complacency about harness use. Falls are the leading cause of construction fatalities, responsible for 35% of deaths in 2023 (Source: OSHA). The injuries range from fractures to traumatic brain injuries—and too often, fatalities.
How video intelligence helps:
AI-powered cameras monitor work at height, detecting when harnesses aren’t used or guardrails are missing. Instant alerts empower supervisors to intervene before a mistake becomes a tragedy.
2. Struck-by Object or Equipment
Scenario:
A worker crosses a busy walkway as a crane lowers a steel beam. The load swings unexpectedly, and the worker is struck by the beam.
Root Causes & Impact:
Struck-by incidents are the second most common injury—238 incidents (17.3%)—often caused by falling tools, swinging loads, or moving vehicles (Source: OSHA Injury Summary). Poor exclusion zones, unsecured materials, and lack of spotters are frequent contributors. These incidents can result in fractures, blunt force trauma, and even death.
How video intelligence helps:
Video systems can monitor exclusion zones, detect when workers enter danger areas, and trigger real-time alerts. Reviewing footage helps identify process gaps—like missing signage or traffic control.
3. Caught-in/Between (Including Trench/Excavation Hazards)
Scenario:
A trench worker is installing drainage pipe when the trench wall collapses, trapping and suffocating him under several tons of soil.
Root Causes & Impact:
Caught-in/between accidents account for 8.7% of injuries, with trench collapses responsible for a high share of fatalities (Source: OSHA Injury Summary). Missing trench boxes, improper soil analysis, and working in unprotected excavations are leading causes. These incidents are devastating—often fatal within minutes.
How video intelligence helps:
AI cameras can monitor excavation zones, detect missing trench boxes, and alert supervisors if workers enter unprotected trenches. Real-time monitoring speeds up emergency response and ensures safety compliance.
4. Amputations and Machine-Related Injuries
Scenario:
A worker feeds material into a table saw with a missing guard. The blade catches a glove, pulling his hand in and amputating two fingers.
Root Causes & Impact:
Amputations make up 15.6% of all incidents—the majority to fingers and hands—usually during use of saws or when handling heavy, shifting materials (Source: OSHA Injury Summary). Missing machine guards, improper lockout/tagout, and complacency about PPE are repeat offenders.
How video intelligence helps:
AI can detect when machine guards are absent or bypassed and flag unsafe tool use. Reviewing video footage after near-misses or incidents supports targeted retraining and root cause analysis.
5. Pedestrian-Vehicle Collisions
Scenario:
During a busy material delivery, a forklift operator backs up, unaware of a laborer behind him. The forklift strikes the worker, causing serious injury.
Root Causes & Impact:
Pedestrian-vehicle collisions account for 2.8% of incidents but often result in severe injury or death (Source: OSHA Injury Summary). Contributing factors include poor traffic management, lack of barriers, and distracted operators.
How video intelligence helps:
AI cameras can track vehicle and pedestrian movement, flag unsafe proximity, and alert operators or spotters in real time. Over time, analytics reveal high-risk patterns—fueling smarter traffic planning.
Challenges and Impact of Injuries
Injury Type | Challenges | Impact | Role of data & technology |
|---|---|---|---|
Falls from Heights | Inconsistent harness use, missing guardrails | Fatalities, fractures, head trauma | Real-time alerts for fall risks, protocol audits |
Struck-by Object/Equipment | Unclear exclusion zones, unsecured materials | Severe trauma, fatalities | Monitors danger zones, flags protocol breaches |
Caught-in/Between | Unprotected trenches, lack of monitoring | Fatalities, traumatic injuries | Ensures trench box use, detects unsafe entry |
Amputations/Machine-Related | Bypassed machine guards, unsafe tool use | Permanent disability, hand injuries | Detects guard absence, documents unsafe actions |
Pedestrian-Vehicle Collisions | Poor traffic control, blind spots | Severe injury, loss of life | Tracks movement, warns of unsafe proximity |
How Technology Strengthens Injury Prevention
Modern video intelligence isn’t just about “watching”—it’s about empowering people to act before things go wrong. Here’s how it directly supports the top five injury types in commercial and institutional building construction.
Falls from Heights
Safety challenge:
Workers skip harnesses, guardrails get removed, or weather changes create new risks—and supervisors can’t be everywhere at once.
Tech Solution:
AI-enabled cameras scan for missing harnesses, open edges, and improper ladder use. Real-time alerts let site managers intervene immediately. Spot AI’s search tools make it easy to review past incidents, identify recurring problems, and train crews with real footage.
Struck-by Object/Equipment
Safety challenge:
Busy sites mean overlapping tasks and moving loads. It’s hard to maintain perfect exclusion zones.
Tech Solution:
AI detects when workers step into danger areas or loads move outside safe paths. Video analytics can even track how often near-misses occur, helping teams redesign workflows and reinforce signage or spotter use.
Caught-in/Between (Trench/Excavation)
Safety challenge:
Trench boxes don’t always get installed, and supervisors can’t babysit every excavation.
Tech Solution:
AI-powered video monitors whether trench protection is in place and alerts teams if anyone enters an unprotected trench. Turner Construction cut caught-in/between incidents by 42% using real-time video alerts (Source: Research Data, 2024). Video records support investigations and OSHA compliance.
Amputations and Machine-Related Injuries
Safety challenge:
Workers bypass machine guards or use unsafe techniques—often to “speed things up.”
Tech Solution:
AI video recognizes missing guards and unsafe tool use. Real-time alerts catch violations instantly. After an incident, teams can review footage to pinpoint causes and coach safer behavior.
Pedestrian-Vehicle Collisions
Safety challenge:
Forklifts and trucks share space with people. Blind spots and distractions make collisions likely.
Tech Solution:
Cameras track vehicle and pedestrian traffic, flagging unsafe proximity. If a worker steps into a forklift’s path, the system can alert both operator and supervisor. Over time, heatmaps identify high-risk areas, informing better layout or signage.
Practical Implementation of Safety Technology
Getting the most out of AI video isn’t just about buying new cameras. It’s about smart integration with your existing safety culture.
Start with what you have: Most modern AI video systems, like Spot AI, can work with your existing camera network.
Align with your safety goals: Set clear objectives—reducing falls, tracking PPE use, or improving incident response.
Team up with your people: Tech is a tool, not a replacement. Involve crews in rollout and use video for positive coaching—not “gotchas.”
Regularly review and act: Schedule reviews of flagged incidents, near-misses, and compliance trends. Use this data to tweak protocols, target training, and celebrate wins.
When evaluating solutions, look for:
Easy-to-use search and alert features
Compatibility with your current infrastructure
Responsive support and training resources
The best tech is the one your team actually uses—and trusts.
Ready to Build a Safer Jobsite? Let’s Partner Up
Every injury prevented is a worker going home safe—and a team that gets to keep building, together. At Spot AI, we believe safety leaders are the real heroes. Our job is to make you even better. If you’re ready to see how video intelligence can drive real results on your construction sites, book a consultation with our experts.
Frequently asked questions
What are the most common preventable injuries in commercial and institutional building construction?
The most common preventable injuries are falls from heights, struck-by object or equipment incidents, caught-in/between accidents, amputations and machine-related injuries, and pedestrian-vehicle collisions (Source: OSHA Injury Summary).
How does video intelligence help prevent falls in construction?
AI cameras monitor for missing harnesses, open edges, and unsafe ladder use. They provide real-time alerts so supervisors can intervene before an incident occurs, and help teams identify root causes by reviewing footage after near-misses.
Can AI video systems replace traditional safety protocols?
No, technology is a support tool—not a replacement for strong safety culture, training, and established procedures. The best results come from integrating video intelligence with your existing safety programs.
What’s the best way to implement safety technology on a jobsite?
Start by identifying your biggest risks, then select a solution that fits your workflows and camera infrastructure. Involve your safety team and tradespeople in rollout, and use video data to drive positive coaching and process improvements.
Are there compliance issues with using AI video in construction?
You must comply with OSHA standards and privacy laws. Choose a provider with strong data security, clear protocols for footage access, and transparent data retention policies. Always inform workers about video monitoring and use footage for safety, not discipline.
How can technology help with incident investigations?
Video intelligence makes it easy to find and review relevant footage, pinpoint root causes, and verify compliance with safety protocols. This speeds up investigations and supports regulatory reporting.
Can video analytics help with near-miss reporting and prevention?
Yes. AI can flag and log near-misses that might otherwise go unreported, providing valuable data for proactive safety improvements.
How does Spot AI work with existing camera systems?
Spot AI is designed to integrate with most modern camera setups, making it easy to add AI-powered analytics and search features without a full hardware overhaul.
About the Author
Amrish Kapoor
VP Technology, Spot AI
Amrish Kapoor leads Spot AI’s technology and engineering teams, driving innovation in AI-powered video analytics for workplace safety. With deep expertise in system architecture, machine learning, and scalable cloud infrastructure, Amrish has helped hundreds of organizations in high-risk industries implement smarter, simpler safety solutions. His mission: make safety technology as practical, accessible, and effective as possible for every frontline team.
