Reducing Inequities in Workplace Safety through City Ordinances: The Impact of Rest Break Ordinances on Access to Rest for Workers in the Construction Industry

Background. Disparities in workplace injury, illness and death, as well as in the enforcement of workplace safety by race, gender and industry have been well established. This is particularly notable with regard to heat-related illnesses (HRIs). A total of 17 construction workers in the U.S. died from heat-related causes in 2015, making the 6.7 million workers in the U.S. construction industry second only to agriculture workers in their risk of death from HRIs. Fatal HRIs may occur when workers are not adequately acclimatized or do not receive sufficient water and rest. While fatal HRIs are relatively rare, non-fatal HRIs, ranging from mild heat cramps to heat stroke, occur more frequently. Their prevalence, however, is largely unknown as workers rarely receive medical care. Work-related HRIs are particularly concerning as they are easily prevented with little employer cost. According to OSHA, adequate time to acclimate to the heat, rest, shade and water are generally all that is needed. Despite this, national policies have not been adopted to reduce their risk. As such, some state agencies and municipalities have enacted their own HRI prevention measures. One such measure is a city rest break ordinance (RBO). A RBO requires construction employers to ensure that workers receive rest breaks, in addition to the regular meal break, in accordance with the number of hours they work.

Methods. While RBOs have been implemented in some cities, no attempts have been made to evaluate their efficacy. We aim to address this by analyzing the likelihood of receiving a rest break for construction workers in cities with and without a RBO. We utilize a unique local level dataset that combines three years of data from construction workers surveyed at randomly selected construction sites in two major cities. We compare worker access to rest breaks in a single city pre- and post-RBO and compare a RBO city to a non-RBO city. We use logistic regression to calculate the odds of receiving rest breaks controlling for demographic and job characteristics associated with precarious work, and adjust for the inflation of odds due to high prevalence using the method of Zhang and Yu (1998)

Results. Rest Break Ordinances appear effective in improving access to rest at work. Construction workers were more likely to report receiving rest breaks in a city with an RBO. In the single city comparison, we found construction workers 35% more likely to receive a rest break in the survey years post-RBO than in the year prior. Using the same controls, we found construction workers 17% less likely to report access to a rest break in the city without a RBO than in the city with a RBO across the same time period.

Implications. These findings suggest that RBO policies may be an effective way cities can incentivize employers to ensure their employees take rest breaks while on the job, a key factor in preventing HRIs. Future research could compile work-related HRI data to better understand the direct impact of RBOs on HRIs and heat related deaths.