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Ergonomic solutions that have gained acceptance in other industries are often considered not applicable to a construction work environment, even though the industry is characterized by high physical work demands.We conducted 50 key informant interviews with 23 contractor representatives and 27 union staff, plus 4 focus groups with a total of 48 workers.Many workers hold the belief that WMSDs are inevitable as part of the job, and did not consistently believe that changing the nature of the work could prevent that injury or pain. The interviewees reported limited availability and accessibility of tested and effective tools that both reduce physical demand and also get the job done efficiently and effectively. Yet for each major obstacle to implementation of ergonomics in the industry identified, the construction professionals we interviewed offered a variety of solutions.Contractors, unions, and workers need to work together to find actions that work within the parameters of the current economic environment. Am. J. Ind. Med. 58:858–869, 2015. © 2015 Wiley Periodicals, Inc.