Ladder fall injuries: patterns and cost of morbidity

O'Sullivan, Joanne; Wakai, Abel; O’Sullivan, Ronan; Luke, Chris; Cusack, Stephen

doi:10.1016/s0020-1383(03)00265-1

Cited by 35 publications

(29 citation statements)

References 6 publications

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“…Clinical studies have found that approximately 40% of modern agricultural injuries are associated with non-mechanical causes related to animals, falls, and hand tool use (Das 2014;Kumar et al 2008;Pratt et al 1992). Among modern, non-mechanized agricultural injuries, lower limb bones have the highest incidence of extremity trauma (Criddle 2001;Pratt et al 1992); the upper extremity is more likely to be fractured in instances when falls are involved (Barber 1973;O'Sullivan et al 2004). …”

Section: Discussionmentioning

confidence: 99%

Gendered Differences in Accidental Trauma to Upper and Lower Limb Bones at Aquincum, Roman Hungary

Gilmour

Gowland

Roberts

et al. 2015

International Journal of Paleopathology

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Additional information:Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-pro t purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. AbstractIt is hypothesized that men and women living in the border provinces of the Roman Empire may have encountered different physical dangers associated with variation in their occupations and activities. Limb bone trauma data were used to assess sex-based differences in physical hazards and evidence for fracture healing and treatment. Two hundred and ten skeletons were examined from a late 1 st to early 4 th century AD cemetery at Aquincum (Budapest, Hungary). Upper and lower limb bone fracture types, frequencies, distributions, and associated complications were recorded, and gendered patterns in injury risks were explored. Of the 23 fractures identified, both sexes had injuries indicative of falls; males exhibited the only injuries suggestive of higherenergy and more direct forces. Most fractures were well-healed with few complications. The extremity trauma at Aquincum suggests that people buried here experienced less hazardous physical activities than at other Roman provincial sites. The patterns of trauma indicate that "traditional" gender roles were in place, whereby male civilians participated in more physically dangerous activities than females. Additionally, treatment may have been equally accessible to men and women, but certain fracture types proved more challenging to reduce using the techniques available.

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Section: Discussionmentioning

confidence: 99%

Gendered Differences in Accidental Trauma to Upper and Lower Limb Bones at Aquincum, Roman Hungary

Gilmour

Gowland

Roberts

et al. 2015

International Journal of Paleopathology

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“…Available studies that address falls from ladders indicate a fatality rate of 0%–2% [1,2]. The low fatality rate contributes to the common notion that falls from ladders are not dangerous.…”

Section: Introductionmentioning

confidence: 99%

“…The low fatality rate contributes to the common notion that falls from ladders are not dangerous. However, the health care costs and opportunity costs from such falls are significant, with one study finding an average hospital stay of 1 wk followed by 6 wk of disability [1]. …”

Section: Introductionmentioning

confidence: 99%

Falls from ladders: age matters more than height

Con

Friese

Long

et al. 2014

Journal of Surgical Research

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Background Falls from ladders account for a significant number of hospital visits. However, the epidemiology, injury pattern, and how age affects such falls are poorly described in the literature. Materials and methods Patients ≥18 y who suffered falls from ladders over a 5½-y period were identified in our trauma registry. Dividing patients into three age groups (18–45, 46–65, and >66 y), we compared demographic characteristics, clinical data, and outcomes including injury pattern and mortality. The odds ratios (ORs) were calculated with the group 18–45 y as reference; group means were compared with one-way analysis of variance. Results Of 27,155 trauma patients, 340 (1.3%) had suffered falls from ladders. The average age was 55 y, with a male predominance of 89.3%. Average fall height was 9.8 ft, and mean Injury Severity Score was 10.6. Increasing age was associated with a decrease in the mean fall height (P < 0.001), an increase in the mean Injury Severity Score (P < 0.05), and higher likelihood of admission (>66 y: OR, 5.3; confidence interval [CI], 2.5–11.5). In univariate analysis, patients in the >66-y age group were more likely to sustain traumatic brain injuries (OR, 3.4; CI, 1.5–7.8) and truncal injuries (OR, 3.6; CI, 1.9–7.0) and less likely to sustain hand and/or forearm fractures (OR, 0.3; CI, 0.1–0.9). Conclusions Older people are particularly vulnerable after falling from ladders. Although they fell from lower heights, the elderly sustained different and more severe injury patterns. Ladder safety education should be particularly tailored at the elderly.

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“…This latter finding seems to corroborate the findings of Hinze and Coates (2011), who stated that the use of extension ladders is more likely to cause a fatal accident due to the height of the equipment. A separate study observed a relationship between the injury pattern and the elevation of the fall, and that upper extremity fractures are the most likely type of injury (O'Sullivan et al, 2004;Mitra et al, 2007). Fractures are also cited as the most frequent type of injury by other researchers (Partridge et al, 1998;Smith et al 2006), while others found that sprains and contusions occur more frequently (Faegermann and Larsen, 2000;Faegermann and Larsen, 2001).…”

Section: Literature Reviewmentioning

confidence: 99%

Underlying causal factors associated with construction worker fatalities involving stepladders

Grant

Hinze

2013

CEB

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Stepladders are frequently utilized on construction projects as a means of access to elevation. Stepladder heights commonly range from 4 feet (1.2 m) to 14 feet (4.3 m). Since these heights are not extreme, there is a common misperception that stepladder use presents a low risk. On the contrary, extreme care must be exercised to ensure that work on stepladders is performed safely, as described in the conspicuously located recommendations and brightly-colored warnings that adorn virtually all newly-purchased equipment. Despite this, accidents involving stepladders occur on a regular basis. This study was conducted to better understand the underlying causes of these accidents. The narrative descriptions of 180 stepladder-related fatalities were obtained from the U.S. Occupational Safety and Health Administration and were analyzed to identify the at-risk behaviors that preceded the fatality incidents. The results showed that most of the incidents should have been anticipated and could have been avoided. Unsafe practices such as improper lockout-tagout of electrical equipment, loss of balance, working on a folded stepladder, over-reaching, straddling the ladder, "walking" the ladder, poor footing, and unstable/shifting ladders, among others were identified. Virtually all of these fatalities could have been avoided by adhering to the guidelines posted on the stepladders and by complying with basic safe construction practices.

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Ladder fall injuries: patterns and cost of morbidity

Cited by 35 publications

References 6 publications

Gendered Differences in Accidental Trauma to Upper and Lower Limb Bones at Aquincum, Roman Hungary

Gendered Differences in Accidental Trauma to Upper and Lower Limb Bones at Aquincum, Roman Hungary

Falls from ladders: age matters more than height

Underlying causal factors associated with construction worker fatalities involving stepladders

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