It's one of America's most dangerous professions - and not just because of the heavy machinery, backbreaking labor and sky-high settings.
It's because construction workers are the most likely to become ensnared in the deadly opioid epidemic, according to a NYU report published Wednesday.
The study, which gathered responses from over 290,000 workers in 13 different professions, found that 3.4% of the construction workers in the survey were misusing painkillers. The average rate of misuse in other careers was about 2%.
For recovering addict Elvin "Elbo" Krigsman, a unionized painter for two decades who works in Manhattan, the results aren't surprising. His colleagues are constantly complaining of pain, especially back pain. Some become addicted to the painkillers they turn to for relief.
Krigsman can recognize the signs of addiction - he got hooked on opioids in his youth by "hanging out with the wrong people." He was inspired to quit only after his 41-year-old brother died of an overdose in 2013, and he decided to use his time in lock-up - for dealing ecstasy as well as second-degree robbery - to get clean.
He says he's been sober for six years - and prescription drug addiction has become the elephant in the room of his profession. "People want to keep it undercover because they're scared they'll lose their job," he said, instead of being offered a chance to get help.
Research by the National Institutes of Health confirms that lower-back pain is the most common workplace injury and reason for missing shifts. Opioids are one of the most common treatments for symptoms, according to New England Journal of Medicine's Catalyst blog.
The new workplace study's lead author, Professor Danielle Ompad of NYU's College of Global Public Health, agrees that pain and painkillers may be part of the reason for the construction industry's high addiction numbers, though she noted that her researchers didn't ask why or when people used drugs.
"My guess is the individuals are still in pain and still trying to treat that pain, or in the process of treating that pain they may have become dependent on opioids," Ompad said.
The injury rate for construction workers is a substantial 77% higher than the national average of all types of workers, according to the Midwest Economics Policy Institute. It also found that 15% of construction site laborers have a history with substance abuse.
But more than the potential for injury, there's also the issue of workplace culture. Krigsman says there are "a lot of people" like him at work: under-educated, with criminal backgrounds and history of drug use - because, unlike many other professions, his employers don't require a degree or clean record.
They do, however, often enforce a "zero-tolerance" policy when it comes to illicit drug use while at work. The rule can be so unforgiving that Krigsman claims he's avoided telling his supervisors about personal injuries on the job - for fear they'd drug test him.
"I didn't say nothing … because I was scared [they would make me] take a urine test," he explained, suggesting that a fall might raise suspicions of being high at work.
This approach also means that there's not much support at work for employees when it comes to personal struggles for substance abuse.
Ompad, too, argues that this unforgiving policy is hurting workers. She believes that zero-tolerance "seems to not have a huge association with lower prevalence of … non-prescription opioids," and suggests employers gain a better understanding of addiction and treatment - and have a bit more sympathy for their workers.
"Drug testing can result in a really good worker being fired," she said. "We can probably come up with better ways to support companies and their workers."
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