The primary aim of this follow-up study was to evaluate the association between the use of ergonomic measures and musculoskeletal complaints among construction workers during an informational campaign on sector level. A questionnaire was sent twice to a cohort of 914 Dutch carpenters and pavers, once in 2000 and once in 2005. Relative risks (RR) were calculated for the regular use of ergonomic measures and regular or sustained lower back and shoulder pain among workers at baseline and 4.5 years follow-up. The response percentages were 78% (n = 469) for carpenters and 64% (n = 202) for pavers. Regular use of specific ergonomic measures varied from 15-66% at baseline to 17-66% at follow-up. Four specific ergonomic measures showed a statistically significant increase in usage. Regular or sustained lower back and shoulder complaints among carpenters decreased from 38 to 34% (p = 0.07) and 24 to 22% (p = 0.18), respectively. Among pavers, lower back (34%) and shoulder (17 to 18%) complaints remained the same or increased. Regular use of a height-adjustable working platform was associated with a lower likelihood of shoulder complaints at baseline (RR = 0.68; 95% CI: 0.46-<1.00) and low back complaints at follow-up (RR = 0.66; 95% CI: 0.50-0.88) among carpenters. Also regular use of aids for handling heavy loads was associated with no shoulder complaints at baseline RR = 0.62 (95% CI: 0.40-0.97) among carpenters. In conclusion, despite a large informational campaign, regular use of ergonomic measures remained low in a 4.5 year period. Regular use of the majority of ergonomic measures was associated, although not statistically significantly, with a lower likelihood of lower back or shoulder complaints. It is recommended to select, apply and monitor powerful implementation strategies to ensure the use of effective ergonomic measures at construction sites.