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«Habituating pain: Questioning pain and physical strain as inextricable conditions in the construction industry Jeppe Z. N. Ajslev1 ❚❚ Ph.D. ...»

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Nordic journal of working life studies Volume 3 ❚ Number 3 ❚ August 2013

Habituating pain: Questioning pain and physical strain as

inextricable conditions in the construction industry

Jeppe Z. N. Ajslev1


Ph.D. fellow, Centre for Working Life Research, Roskilde University

Henrik L. Lund


Associate professor, Centre for Working Life Research, Roskilde University

Jeppe L. Møller


Ph.D. fellow, Centre for Working Life Research, Roskilde University

Roger Persson ❚❚ Associate professor, Department of Psychology, Division of Work- and Organizational Psychology, Lund University Lars L. Andersen ❚❚ Professor, National Research Centre for the Work Environment


In this article, we investigate the relations between discursive practices within the Danish construc- tion industry and the perceived pain, physical deterioration, and strain affecting the construction workers. Of central importance is the widely accepted hegemonic discourse on physical strain and pain as unavoidable conditions in construction work.

Based on 32 semi-structured interviews performed in eight case studies within four different construction professions, workers’ descriptions of physical strain and its relation to the organiza- tional and social context are analyzed through concepts of subject positioning in discursive practice and a focus on power relations.

The analysis shows that workers and employers reproduce certain types of traditional work- ing class masculinities and search for high-pace productive working rhythms, which in combina- tion with economic incentives common within the industry reproduce physical strain and the habituation of pain as unquestioned conditions in construction work. The understanding of this mutual reinforcement of the necessity of physically straining, painful, high-paced construction work provides fruitful perspectives on the overrepresentation of musculoskeletal deterioration within construction work and also sheds light on some of the difficulties in addressing and changing occupational health and safety practices in the construction industry.


Brutal rhythms / conditional orientation / construction work / deterioration / habituation / health / masculinity / musculoskeletal disorder / pain / physical strain / safety culture E-mail: jza@ruc.dk 1 195 196 Habituating pain: Questioning pain and physical strain Jeppe Z. N. Ajslev et al.

Introduction C onstruction work around the world has historically been a field of work character- ized by high levels of physical strain (Andrésen 1984; Applebaum 1999; Morton 2002). It is characterized by high work pace (NFA 2012), heavy lifting, dragging, and pulling and requires people to work in awkward positions (e.g., hands above shoulders, knees or back bent (Bach et al. 2011)). In biomedical and epidemiological research, this kind of physically straining work involving heavy loads and high work pace has been shown to be associated with physical deterioration and musculoskeletal disorders (MSDs) (Andersen et al. 2007; Andersen et al 2012). MSDs are sometimes characterized by specific medical symptoms but more often by nonspecific pain or soreness in neck/ shoulder, arm/hand, back, or knees (Waddell 2006).

Compared with other job groups in Denmark, construction workers experience a very high degree of postwork body pains and fatigue (NFA 2012). Eriksen et al. show that pain, especially in the lower back, can lead to long-term disability (1998). Physically straining work is one of the main reasons for early retirement in the construction industry (the Danish Construction Association 2006; Frøyland et al. 2004). In addition, workers suffering from MSDs have an increased risk of losing work ability in their profession, being excluded from the labor force, and becoming physically impaired, with loss of well-being as a consequence (Mortensen et al. 2008). Further, MSD increases the risk of future long-term sickness absence (Andersen et al. 2012), and higher levels of musculoskeletal pain in the neck, back, and knees are associated with progressively higher risk for long-term sickness absence (Andersen et al. 2011). Also, a ten-year German cohort study has shown musculoskeletal diseases to make for 45% of the disability pensioning in the construction industry (Arndt et al. 2005).

From a historical perspective, there has been much effort to reach a more sustainable physical workload and to reduce physical deterioration in the construction industry. Since the late 19th century, labor unions in particular have fought for initiatives that focus on reducing wear and tear of the construction worker. This focus has been sustained and developed throughout the 20th century and is described in both Danish and international research (examples are Andrésen 1984; Frøyland et al. 2004; Gherardi & Nicolini 2002; Hasle 1982).

Until now, most MSD research in the construction industry has primarily focused on the approximate ergonomic and biomedical problems. However, recent research on work and deterioration as well as domestic political agenda on occupational health and safety suggest that MSD problems should be resolved through more interdisciplinary approaches (MSD-committee report 2010; Westgaard & Winkel 2011); there is an imminent need to study and approach deterioration and physical strain in the construction industry by the inclusion of social theory and methodology aiming to understand the interrelation of body, identity, and context. This necessity is underlined by research indicating that psychosocial perspectives in the job situation have a considerable impact on the prevalence of MSD (Mortensen et al. 2008; Waddell & Burton 2006).

In this article, we investigate the relations between construction workers’ discursive practices and the perceived strain and physical deterioration in the construction industry. While physical strain and deterioration are commonly accepted as unavoidable consequences of construction work among researchers and actors within the construction industry (Vad & Kines 2011), we challenge this discourse by including perspectives on social relations of power in the analysis of work and culture within the industry.

197 Nordic journal of working life studies Volume 3 Number 3 August 2013 ❚ ❚ As occupational health and safety in the construction industry is widely known for the lack of measurable impact from efforts for improvement (Dyreborg 2006;

Morton 2002), this article also provides possible explanations as to why earlier preventive measures and interventions have seemingly had little or no effect despite many years of endeavors.

Construction workers in work gangs and the framing of the conditional orientation In the Danish construction industry, work is usually organized in small self-organizing groups known as construction gangs. Gang organization is widely perceived as an appropriate solution, both by the workers themselves and by the parties in the Danish construction industry since many tasks require on-the-spot collaboration and coordination. The construction gang has traditionally managed the direct supervision of the work with the foreman as democratically elected leader. This kind of self-management encompasses division of labor, cooperation, and working methods. Workers in this type of organization are believed to have great opportunity to influence their own work (Andrésen 1984; Hasle 1982). And influence is from several theoretical perspectives perceived as resource-building and associated with positive expectations and feelings of mastery and therefore believed to promote both good mental and physical health (Hvid 2009; Karasek & Theorell 1990; Ursin 2004).

As a phenomenon, gang organization is embedded in the complex relationships between legislation, labor market, companies, trade unions, employers’ associations, types of organization and management, culture, traditions, workers’ subjective orientations, etc. All of these factors contribute to the context of the construction workers’ conduct in relation to handling physically straining work and the associated risks of physical deterioration. One could address this issue from a coping perspective studying how people manage their life conditions (Lazarus 1999). But rather than focusing on the individual worker’s way of coping, we study how social practices of dealing with the physical strain are presented and influence workers’ practices. Our focus in this article is aimed at the gang as the everyday framework for social contact and daily collaboration between workers as it must be understood as a main arena for production of professional and social identities and meaning through discursive practice; a term defined by Bronwyn Davies and Rom Harré as “all the ways in which people actively produce social and psychological realities” (1990, p. 22). This further implicates that norms and ethics of handling physical strain as well as considerations for bodily well-being come into practice through discursive practices and thus relations of power in the gang.

The workers’ conceptualizations and practices of body, deterioration, and physical strain in the work become significant perspectives in the investigation of the discursive practice reproducing these norms and ethics. By shedding some light on these norms and ethics, we gain better optics for perceiving and identifying when workers reproduce norms that could either lessen the physical strain they take upon themselves or norms that seem to support a culture of acceptance or accommodation of physical strain.

Recent research on the topic of construction workers’ perceptions of straining work conditions show that workers describe strain and deterioration as a “fatalistic phenomenon, difficult if not impossible to prevent” (Vad & Kines 2011, p. 8). Since such a conceptualization of the relation between work and physical strain and deterioration 198 Habituating pain: Questioning pain and physical strain Jeppe Z. N. Ajslev et al.

is likely to pose a substantial complication for preventive actions against MSDs, it is important to explore the social dynamics behind its maintenance. Our empirical studies support the notion that certain hegemonic discourse upon physical strain and deterioration as unavoidable conditions within work is reproduced at all levels in the construction industry. In order to conceptually define and grasp this phenomenon, we propose the term conditional orientation for this form of practice where subjects take the dominant discourse for granted and (re)position themselves accordingly in everyday life.

As an analytical concept thought to expand our vocabulary on a certain kind of subjectification (Foucault 1983), the conditional orientation is not to be perceived as some stable or objective character trait within the studied subjects. Rather, it is a concept allowing for analytical discussion of a certain discursive reproduction of subjectivity at the level of the individual and the group.

The concept of conditional orientation draws upon an understanding that discourses (collective interpretations) on a topic (object/subject) can take hegemonic forms—very shortly stated—in the sense that they become almost the sole common conception of truth on a given phenomenon (Foucault 1976; Laclau & Mouffe 1985). The conditional orientation as a concept is developed on the notion of hegemonic discourse but is to be understood very specifically in the sense that it points to a certain subjective orientation in relation to the discursive production of “conditions” within work or other activity (construction work for instance)2—namely an orientation that accepts the necessity of a certain type of behavior as foundational for participation.

To specify the conditional orientation in relation to the social context and behavior of construction workers, we draw upon the concept of habitus. Habitus is described by Bourdieu as the behaviors, the benefits, and the practices characterizing an individual or a group. These practices lead to all the forms of “reasonable” or “common sense” behavior that is enabled within the boundaries of the group, because they are ultimately founded on the basis of existence—shared by the group—that puts life and family relations under social and economic coercion (Bourdieu 1996). The habitus of Danish construction workers as such is to be understood as social practices that have a certain meaning in relation to discursive perception of contemporary conditions in the industry.

The discursive perception of these conditions frames the room for agency in relation to what types of behavior can be positively sanctioned in the social context of construction work. Therefore, for a certain practice to become part of the construction workers’ habitus—become habituated—we argue that it has to rely on a certain perception of the conditions of work. While always leaving room for negotiation and variation in practices, this leaves plenty of options for different sorts of agency, but will inevitably also limit the options for agency in certain areas of work.

As we draw upon an understanding of conditions as discursive productions,3 the phenomenon “physically straining work as a condition in the construction industry” can and shall not be interpreted as the final explanation to the behavior of the construction workers. Rather habituation of certain types of behavior is produced by the rationalities tying social or material benefit or usability to certain types of conduct in relation to physically straining work.

Following this argument, the final specification of the conditional orientation lies in its focus on the individual’s relation to the rationalities structuring the agency of the individual and group. The conditional orientation is focused on the area that can be defined and centered upon the individual’s perception of power, control, influence, and/ 199 Nordic journal of working life studies Volume 3 Number 3 August 2013 ❚ ❚ or agency in relation to the given phenomenon. Here, the conditional orientation is to be defined as a specific part of the subject’s relation, namely a relation characterized by powerlessness, as also emphasized by Bronwyn Davies and Rom Harré in their work on positioning theory (1990). The singular focus on this powerless relation is what distinguishes the conditional orientation from the concept of habitus, as habitus consists of all the practices belonging to the individual or group, not only the ones to which people see no apparent alternative.

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