An 82-year-old self-employed construction worker in Singapore died after suffering a head injury during a fall at a worksite, a coroner's inquiry found.

The May 7 report also found that his death was due to "an unfortunate accident", with foul play ruled out.

Had been engaged to build low concrete wall

Chia Ngan Chai was at a worksite at 38 Genting Lane in MacPherson when the fatal accident happened on May 2, 2023.

He had been working in construction for 60 years.

Contractor Leong Eng Gin, which had been engaged to construct an eight-storey industrial building there, hired Chia's brother to build a concrete enclosure for the existing hose reel and sprinkler pump area.

Chia's brother in turn engaged Chia and two other self-employed workers for the work team.

A safety briefing was conducted before Chia and another worker began work on a low wall where the sprinkler pump was located.

They started at around 9am and finished the wall at 3pm following a lunch break.

Fainted at worksite, died in hospital

At around 3:50pm, one of the workers found Chia lying on the ground with his head near the wall. He did not see exactly what had occurred, as he was on the other side of the wall and shorter than its height.

Chia's eyes were closed and he was unresponsive.

Later, the other workers managed to support him to a sitting position. Chia's brother asked him if he wanted a drink of water and he nodded.

Chia's brother then informed the director of Leong Eng Gin that Chia had fainted. The director made his way to the worksite before driving Chia to Singapore General Hospital (SGH) in his car.

However, when Chia arrived at SGH at around 4:48pm, he was in cardiac arrest.

Despite efforts to resuscitate him, he was pronounced dead at about 8pm that day.

"Could not be proved" that medication, cardiovascular disease caused fall: Coroner

State Coroner Adam Nakhoda said in his report that Chia's death was due to head injury, and not a natural disease process.

The autopsy doctor noted that Chia's head injuries, which included a skull fracture and bruise on his scalp, "were consistent with those sustained in a fall".

Chia had been prescribed citalopram, an anti-depressant, for his obsessive-compulsive disorder by the Institute of Mental Health (IMH).

“The IMH medical report highlighted that side effects from citalopram, amongst others, included an increased risk of falls,” Nakhoda said.

He also noted that Chia also likely suffered from undiagnosed ischaemic heart disease or coronary heart disease, as an autopsy found narrowing of four of his major coronary arteries.

As cardiovascular diseases can restrict blood flow to the brain, leading to dizziness or fainting, Nakhoda said it was possible that Chia's fall could have been caused by consuming citalopram, his cardiovascular disease or a combination of the two.

However, the coroner pointed out that it "could not be proved at autopsy" that either of these factors had contributed to his fall.

Chia's brother also had no recollection of Chia having fainting spells in the past, Nakhoda added.

Unlikely that overwork caused fall: MOM

The police and the Ministry of Manpower (MOM) also conducted investigations at the worksite.

No foul play is suspected in Chia's death.

MOM investigators opined that it was unlikely that work fatigue had contributed to Chia's fall.

The report stated that Chia had not worked on the two days preceding the incident, and was working out of the sun on the day of the fall.

Another worker observed Chia was not breathing heavily and did not appear pale at the time, and he also had beverages during a rest break.

Likely fell of his own volition: Coroner

Chia had last attended a construction safety course in 2012, at the Building Construction Authority (BCA).

Its certification had expired in February 2017.

Nevertheless, the coroner said that apart from an unsecured safety helmet, there was no evidence of a breach of workplace safety and health measures that contributed to Chia's fall.

"As such, the evidence would suggest that Mr Chia fell of his own volition without the influence of any external factors," the coroner concluded.

Top image from Unsplash.