TRIP, SLIP AND FALL

According to the Centers for Disease Control and Prevention (CDC), over o ne million Americans suffer a slip, trip, and fall injury and over 17, 000 people die in the U.S. annually because of these injuries. Slip, trip and fall injuries make up 15 percent of all job related injuries, which account for between 12 and 15 percent of all Workers' Compensation expenses. The CDC categorizes falls into two basic types: elevated falls and same-level falls. Same-level falls are more common and therefore cause more injuries to more people, but elevated falls are the most serious and cause more severe injuries to a less number ofpeople. Over 60 percent of all elevated falls are from a height of less than 10 feet. Same-level falls are usually slips and trip accidents and injury generally takes place when the individual hits a walking or working surface or hits another object in the course of the fall

Reports claimed that almost 1,800 older Americans die every year from falls and fall related injuries in nursing homes across the nation. Estimates that the nursing home residents account for 20% of all deaths from falls in persons 65 years of age and older. Over one third of all adults in that age group will suffer some sort of a slip and fall accident every year. Slip and fall accidents account for more injury deaths of older Americans than any other form of injury. In total, over 15,000 people 65 or older die annually from slip and fall injuries close to 2 million are treated in emergency rooms for injuries suffered as result of a slip and fall.

Slip and falls accidents can cause other complications including:

• Death
• Incapacitation
• Broken bones and fractures
• Long-term medical complications
• Head trauma
• Spinal cord injuries

3 Big Causes of Slips, Trips and Falls

This is an excerpt from our free guide on preventing slips, trips and falls.

A 2014 survey of 1,294 safety professionals revealed the most frequent factors in slip, trip and fall incidents at their workplaces—and a whopping 95% of respondents cited one of three causes.

The main characteristic the three biggest causes have in common is they’re the result of the errors or errors in judgement that people make every day, like how tidy to keep their work area, whether to report a wet surface, how fast to walk and whether to move blindly around corners. People tend to perceive these causes (and especially hu­man factors) as being a lot less risky than they actually are, which makes it challenging to find effective and permanent solutions.

Understanding the Factors of Slip, Trip and Fall Injuries

What risk factors contribute to slip, trip and fall injuries?

As problem solvers, we tend to get way ahead of ourselves. We tend to go for solutions before we totally understand the causes, problems and the systems in which they exist.

This is the problem when we seek to solve slip, trip and fall injuries. Some of our roadblocks come from the paradigm that solving these injuries is easy. Posting signs, quickly cleaning up messes, telling employees to be more careful or specifying safety shoe soles to wear, commonly is our easy way to deal with these problems, but all are totally ineffective solutions.

Perhaps our desire to make slip, trip and fall injuries go away is rooted in our propensity to grab for quick solutions when we don’t understand what the many causes and factors are and what we are trying to improve. slip, trip and fall injuries go away is rooted in our propensity to grab for quick solutions when we don’t understand what the many causes and factors are and what we are trying to improve.

So, let’s take a deeper look at the causes and factors of slip, trip and fall injuries. Taking this “mile-deep-and-inch-wide” look will help us see why adopting new rules for effectively preventing these injuries makes sense.

Slip Hazards

The static coefficient of friction (SCOF), or the measure of slip-resistance commonly is espoused as gospel but grossly misunderstood because we equate SCOF with a measure like handrail height or a PEL.

Let’s talk about slip-resistance testing first. Factually, there is no clear testing method for slip-resistance. The English tribometer is thought by a lot of floor safety experts to be the preferred method of testing for slip-resistance, but the drag or pull meter, as an example, widely is used and gives good results.

The important thing for us to understand is that the variation in testing results of any slip-resistance testing methods is high, perhaps less with the drag meter, for example, because of the size of the floor area actually tested. The English tribometer, in its testing method, strikes the walking surface and each test or strike hits an area of about one square centimeter or less where a drag instrument tests an area around three square inches, depending on the meter used. So, variation in testing results can change by just moving the point tested a centimeter or inch.

All other slip and trip system factors and interrelated issues must be taken into account, especially testing variation. So, this is why many slip experts have been moving away from espousing the importance of or from focusing on measures of slip-resistance as input into solving slip hazard problems.

As those who commonly are called on to say of something is hazardous or not, a murky line doesn’t help us. So, how can we resolve this conundrum?

If we get our heads out of the exactness, the dependence on measures and data, finding a bright line can be easy if we use a legal line, those regarding known hazardous conditions.

Let’s quickly identify some known hazardous slip conditions that really require no slip-resistance testing, as exactness isn’t helpful and only can add to the argument. Conditions that are known to be hazardous and thereby require correction and even more importantly, prevention include:

Ice on any walking surface, especially black ice that cannot be easily seen

• Any lubricant or surfactant on a walking surface, regardless of the texture of that surface, that significantly reduces the slip-resistance
• Water, or any liquid or fleshy material on a surface that is non-porous or sealed or polished, such as linoleum, marble, hardwood, ceramic tile or even highly smoothed and polished concrete
• Wet materials that are transient in form like wet paint or remnants from cleaning up, mopping, etc. and
• Any industry- or process-specific material that is spilled and is known within the industry or business sector to be slick.
• Head trauma

Walking Mechanics

We as safety practitioners depend way too much on people seeing things as a means to preventing injury. So, understanding the mechanics of walking is extremely important for us and not just the muscle, momentum and balance mechanics, but more importantly first, the control mechanics of walking.

We commonly forget how we walk when we quickly try to problem-solve slip and fall injuries. It seems so obvious that people slip and trip when walking, yet we move to solving the problems before we understand the mechanics that contributed to the fall.

The important thing for us to understand is that the variation in testing results of any slip-resistance testing methods is high, perhaps less with the drag meter, for example, because of the size of the floor area actually tested. The English tribometer, in its testing method, strikes the walking surface and each test or strike hits an area of about one square centimeter or less where a drag instrument tests an area around three square inches, depending on the meter used. So, variation in testing results can change by just moving the point tested a centimeter or inch.

If you rose to your feet and walked to get a cup of coffee or to look out a window or to have a conversation, do you remember the foot travel you just took? If you are “normal,” that is, walk like 99.995 percent of people, you don’t. We are wired to place as much “regular” or “routine” things we do under autonomic control, because our brains understand that it would be exhausting to do everything under totally conscious control. Walking is that way as well as driving a car, or eating a meal, reaching for a child or turning on a TV or computer. We do about 90 to 95 percent of our routine things autonomically; we don’t even think about the details of how we do them or when we do them. We direct our minds to well-known tasks, and we do them without much conscious thought

Why is this important for us to know and consider when we seek to prevent slip and trip injuries? Because if we miss things or hazards, in this quick subconsciously-controlled scan, or if a hazard has become “normal” so that it raises no flags nor connects us to our consciousness, the hazard or potential consequence of that hazard becomes invisible and we are at an elevated state to be impacted by it or them.

The second reason is that just because a hazard is “open and obvious”, we can’t rely on a person’s safety awareness to be a factor in injury prevention. The fact is, if we don’t see it, or recognize that it is a hazard, or if the hazard becomes normal “noise” in our environment or from our experiences, our awareness becomes disassociated from risk. So, how do we move into and out of conscious control of our walking, because once you unconsciously hand-off control of your walking mechanics to autonomic-reflex, post the starting scan for hazards, your brain and senses don’t merely check-out for the duration of the walk? Our brains are marvelous organs and the interaction that our brains have with subtle things we sense, goes on constantly. So, if we hear something that is unexpected or our eyes detect something that is again, not normal, our brains immediately kick back into conscious mode, and normally, by reflex, we stop or alter our walking path.

Why is knowing this important? First, it tells us the power of visual cues for helping us see hazards and avoiding them. The second reason is so that we can know that, whereas visual cues are great in the short term, even highly-visible cues can become invisible as they become “normal landscape.” In our normal pre-walk scan for hazards, they too can become invisible over time.

Trip Hazards

A trip simply is when a foot that is moving forward suddenly confronts an unexpected obstacle or resistance. We understand, I hope, the elevated trip hazards that a single rise in walking surface, a single step, creates, because tripping against a single step has a exponentially greater risk than a set of stairs. However, small changes in walking surface elevations create even greater risks.

All foot swing-arcs are not created equal, and the height of that foot off the walking surface can be affected by many things including the velocity we travel. Also of importance is whether the front of the shoe sole being worn has a slanted or curved leading surface or a hard leading sole (toe) angle that more easily can catch on edges. The height of a normal foot swing-arc at mid-point only is about a half inch above the walking surface, give or take a quarter or three-eighths of an inch. Because of the normal mechanics of foot swing, very small rises in walking surface heights can be extremely hazardous.

The Accessibility Standards of the Americans with Disabilities Act recommends that a surface with no greater rise than one-quarter of an inch exist. Also, unexpected changes in walking surface slip-resistance can cause trips, such as going from a slicker surface to a carpet or rug. Why is this important? Knowing this should cause us more closely to look at seemingly small and insignificant rises in walking surfaces, and significant changes in slip-resistance are important considerations for trip-prevention improvements.

Other Risk Factors

If you want to see the entire system that produces slip, trip and fall injuries, you must consider the other factors that not only contribute to a person’s susceptibility for slip and trip hazards and the resulting fall, but also are significant factors that tend to make the extent of injuries from a fall, costs and the recovery times more or less. Those factors are:

• Age
• Physical conditioning
• Inner ear or other balance issues
• Physical conditioning
• Weight
• Area/process familiarity where they are subjected to slip and fall hazards
• Disabilities
• The velocity that the worker is traveling when he/she encounters the hazard
• Process or job complexity
• Exertion or applied forces
• Whether or not there are second fall hazards like from one level to another
• Carrying objects that can block views or intended foot placement
• Objects or other hazards that the worker can fall against.

Comprehensive slip, trip and fall assessments for creating effective fall prevention improvements must consider all of these factors. It is a convenient strategy to construct a simple “fall factors” checklist to create a process that will always be followed in an assessment.

Effectively preventing slip and fall injuries requires building a more in-depth knowledge of the many parts of the system that produces the injuries. It also requires that we reject simple solutions like placing the emphasis on awareness, putting up signs or requiring special shoes.

The point for us is prevention, which means removing the causes of the slips, trips and falls in the first place and not accepting the easy road or attempting to minimize the extent of injury or pass the blame back to the person.

One Step at a Time

Most safety programs focus on the physical hazards of slips, trips and falls. This should always be your first priority, but you can’t eliminate slips, trips and falls by only dealing with physical factors.

Nobody chooses to slip and fall. But no matter how effective the rest of your safety program is, your employees have a higher risk of being injured due to a slip, trip or fall when they’re in one of these four states.

Preventing slips, trips and falls

Slips, trips and falls are an ongoing and severe problem that can only be solved by addressing both physical and human factors. A recent survey by BLR revealed human factors play the biggest part in over half of all workplace incidents.

So what can you do about it?

A slip, trip or fall at work can lead to injuries – and even death. In 2013, injuries from slips, trips and falls resulted in 229,190 cases involving days away from work, and 724 workers died, according to the 2016 edition of the National Safety Council chartbook “Injury Facts.”

These sobering statistics are a stark reminder that workers need to know how to prevent slips, trips and falls. Here, the Canadian Center for Occupational Health and Safety explains the differences between slips and trips, and offers advice on how to prevent falls and stay safe.

Housekeeping procedures are important—but it doesn’t matter how many wet floor signs you use if workers don’t notice them or heed their warning.

Slips and trips

Slips happen when there isn’t enough friction or traction between your feet and the surface you’re walking on. Common causes of slips include wet or oily floors, spills, loose or unanchored mats, and flooring that lacks the same degree of traction in all areas, CCOHS states. Trips happen when your foot strikes an object, causing you to lose your balance. Workers trip due to a variety of reasons, including clutter in walkways, poor lighting, uncovered cables, drawers being left open and wrinkled carpeting or rugs.

To help prevent slips and trips, CCOHS recommends the following:

• Clean up spills immediately. If a spill can’t be cleaned up right away, place “wet floor” warning signs for workers.
• Keeps walkways and hallways free of debris, clutter and obstacles.
• Keep filing cabinets and desk drawers shut when not in use.
• Cover cables or cords in walkways.
• Replace burnt-out light bulbs promptly.
• Consider installing abrasive floor mats or replacing worn flooring.
• Encourage workers to wear comfortable, properly fitted shoes.

Falls

The Centers for Disease Control and Prevention states that falls can happen in all occupational settings, and “circumstances associated with fall incidents in the work environment frequently involve slippery, cluttered or unstable walking/working surfaces; unprotected edges; floor holes and wall openings; unsafely positioned ladders; and misused fall protection.” To reduce the risk of falling at work, CCOHS recommends paying attention to your surroundings and walking at a pace that’s suitable for the surface you’re on and the task you’re performing. Additionally, walk with your feet pointed slightly outward, make wide turns when walking around corners and use the handrails on stairs.

6 TIPS TO HELP PREVENT SLIPS, TRIPS AND FALLS

Protect your employees and business by following these safety tips about fall prevention.

It’s probably happened to most of us. That momentary lapse of attention, thinking about a personal problem or distraction by an activity that ends in a slip, trip or fall. A stumble down a stairway. A trip over an uneven surface. Slipping on the ice. It can lead to a variety of regrettable events ranging from a simple bruised shin to an extremely serious injury. It’s just one of a number of conditions and situations that set the stage for slips, trips and falls in the workplace.

In general, slips and trips occur due to a loss of traction between the shoe and the walking surface or an inadvertent contact with a fixed or moveable object which may lead to a fall. There are a variety of situations that may cause slips, trips and falls:

• Wet or greasy floors
• Dry floors with wood dust or powder
• Uneven walking surfaces
• Polished or freshly waxed floors
• Loose flooring, carpeting or mats
• Transition from one floor type to another
• Missing or uneven floor tiles and bricks
• Damaged or irregular steps; no handrails
• Sloped walking surfaces
• Shoes with wet, muddy, greasy or oily soles
• Clutter
• Electrical cords or cables
• Open desk or file cabinet drawers
• Damaged ladder steps
• Ramps and gang planks without skid-resistant surfaces
• Metal surfaces — dock plates, construction plates
• Weather hazards — rain, sleet, ice, snow, hail, frost
• Wet leaves or pine needles

1. Create Good Housekeeping Practices

Good housekeeping is critical. Safety and housekeeping go hand in hand. If your facility’s housekeeping habits are poor, the result may be a higher incidence of employee injuries, ever-increasing insurance costs and regulatory citations. If an organization’s facilities are noticeably clean and well organized, it is a good indication that its overall safety program is effective as well.

Proper housekeeping is a routine. It is an ongoing procedure that is simply done as a part of each worker’s daily performance. To create an effective housekeeping program, there are three simple steps to get you started:

• Plan ahead — Know what needs to be done, who’s going to do it and what the particular work area should look like when you are done.
• Assign responsibilities — It may be necessary to assign a specific person or group of workers to clean up, although personal responsibility for cleaning up after oneself is preferred.
• Implement a program — Establish housekeeping procedures as a part of the daily routine.

2. Reduce Wet or Slippery Surfaces

Walking surfaces account for a significant portion of injuries reported by state agencies. The most frequently reported types of surfaces where these injuries occur include:

Proper housekeeping is a routine. It is an ongoing procedure that is simply done as a part of each worker’s daily performance. To create an effective housekeeping program, there are three simple steps to get you started:

• Parking lots
• Food preparation areas
• Shower stalls in residential dorms
• Floors in general

PTraction on outdoor surfaces can change considerably when weather conditions change. Those conditions can then affect indoor surfaces as moisture is tracked in by pedestrian traffic. Traction control procedures should be constantly monitored for their effectiveness:

• Keep parking lots and sidewalks clean and in good repair condition.
• When snow and ice are present, remove or treat these elements. In some extreme cases, it may be necessary to suspend use of the area.
• Use adhesive striping material or anti-skid paint whenever possible.

Indoor control measures can help reduce the incidence of slips and falls:

• Use moisture-absorbent mats with beveled edges in entrance areas. Make sure they have backing material that will not slide on the floor.
• Display “Wet Floor” signs as needed.
• Use anti-skid adhesive tape in troublesome areas.
• Clean up spills immediately. Create a procedure for taking the appropriate action when someone causes or comes across a food or drink spill.
• Use proper area rugs or mats for food preparation areas.

3. Avoid Creating Obstacles in Aisles and Walkways

Injuries can also result from trips caused by obstacles, clutter, materials and equipment in aisles, corridors, entranceways and stairwells. Proper housekeeping in work and traffic areas is still the most effective control measure in avoiding the proliferation of these types of hazards. This means having policies or procedures in place and allowing time for cleaning the area, especially where scrap material or waste is a byproduct of the work operation:

• Keep all work areas, passageways, storerooms and service areas clean and orderly.
• Avoid stringing cords, cables or air hoses across hallways or in any designated aisle.
• In office areas, avoid leaving boxes, files or briefcases in the aisles.
• Encourage safe work practices, such as closing file cabinet drawers after use and picking up loose items from the floor.
• Conduct periodic inspections for slip and trip hazards.

4. Create and Maintain Proper Lighting

Poor lighting in the workplace is associated with an increase in accidents.

• Use proper illumination in walkways, staircases, ramps, hallways, basements, construction areas and dock areas.
• Keep work areas well lit and clean.
• Upon entering a darkened room, always turn on the light first.
• Keep poorly lit walkways clear of clutter and obstructions.
• Keep areas around light switches clear and accessible.
• Repair fixtures, switches and cords immediately if they malfunction.

5. Wear Proper Shoes

The shoes we wear can play a big part in preventing falls and are a critical component of PPE. The slickness of the soles and the type of heels worn need to be evaluated to avoid slips, trips and falls. Shoelaces need to be tied correctly. Whenever a fall-related injury is investigated, the footwear needs to be evaluated to see if it contributed to the incident. Employees are expected to wear footwear appropriate for the duties of their work task.

6. Control Individual Behavior

This condition is the toughest to control. It’s human nature to let our guard down temporarily and be distracted by random thoughts or doing multiple activities. Being in a hurry will result in walking too fast or running, which increases the chances of a slip, trip or fall. Taking shortcuts, not watching where one is going, using a cell phone, carrying materials which obstruct the vision, wearing sunglasses in low-light areas, not using designated walkways and speed are common factors in many on-the-job injuries.

It’s ultimately up to each individual to plan, stay alert and pay attention.