Using Death Certificates to Estimate Work-related Fatalities from Falls from Height in the Construction Industry in Ecuador, 2013–2023

Falls from heights (FFH) are a major cause of occupational fatalities in the construction industry. In developing countries, underreporting in social security records limits accurate knowledge of work-related mortality. This observational and descriptive study examined FFH deaths in Ecuador’s construction sector from 2013 to 2023 using data from the Statistical Registry of General Deaths. Cases were identified through ICD-10 codes (W11, W12, W13, W17, W19) with the place of occurrence classified as construction (.6). Descriptive and inferential analyses were conducted (Kruskal–Wallis test, p < 0.05), and working years of potential life lost (WYPLLs) were estimated. Fatal FFH incidents increased until 2017 (14.0%), decreased during 2020–2021, and rose again in 2022–2023. Most deaths occurred in Pichincha (48.2%), primarily from falls from scaffolding (W12, 65.5%). The mean age was 39.6 years (95% CI: 38.3–40.9). Significant differences in age by cause were observed (χ² = 9.74; p = 0.045), especially between W11 and W13 (p = 0.040). A total of 8,221 WYPLLs were estimated, mostly from scaffolding and building falls. These findings highlight a substantial mortality burden and the urgent need to reinforce preventive strategies, strengthen compliance and inspection systems, and promote safety culture within Ecuador’s construction industry.