Stair-related injuries treated in United States emergency departments

Blazewick, Danielle Herbert; Chounthirath, Thiphalak; Hodges, Nichole L.; Collins, Christy L.; Smith, Gary A.

doi:10.1016/j.ajem.2017.09.034

Cited by 47 publications

(49 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Stair walking is a routine activity and one of the five most difficult tasks for old adults 6 . More than four million old adults are treated for stair-related injuries in emergency departments annually in the United States, and 70.6% of them are women 7 . Compared with stair ascent, stair descent is more challenging 8 and requires greater mobility, 2 lower extremity strength, 9 and better balance control 10 .…”

Section: Introductionmentioning

confidence: 99%

Performance of older adults under dual task during stair descent

Zhang

Sun

Song

et al. 2018

Journal of Exercise Science & Fitness

View full text Add to dashboard Cite

BackgroundStair walking, especially in dual-task conditions, is a challenging daily routine for older adults. The purpose of this study is to investigate gait and postural control and explore the possible reasons for the fall risk encountered by healthy older adults under dual-task conditions during stair descent.MethodsThirty healthy older female adults (aged 67 ± 1 years, standing height of 1.64 ± 0.17 m, body mass of 66.01 ± 4.27 kg, and education of 8.92 ± 0.95 years) were randomly recruited from local communities and instructed to perform stair descent in a step-by-step manner on a standardized staircase under single-task (stair descent) and dual-task (stair descent with subtraction in series of three) conditions. Multivariate analysis of variance with repeated measures was performed to test the significance of multiple comparisons of kinematic variables in the single- and dual-task conditions. A paired t-test with Bonferroni adjustment was performed when a significant difference was detected.ResultsGait speed, foot clearance, and hip flexion angle at the cross of the support leg decreased considerably, and step width increased remarkably among the healthy older adults under the dual-task condition relative to the situation in the single-task condition during stair descent.ConclusionThe gait performance and posture control of the healthy older female adults were disturbed by the second cognitive task. These adults implemented a compensation strategy to enhance their body stability under the dual-task condition during stair descent.

show abstract

Section: Introductionmentioning

confidence: 99%

Performance of older adults under dual task during stair descent

Zhang

Sun

Song

et al. 2018

Journal of Exercise Science & Fitness

View full text Add to dashboard Cite

show abstract

“…Given the disproportionately high rate of injurious falls that occur on stairs/steps and in bathrooms [ 10 – 12 ], it was surprising to us that checklists did not always include an assessment of these locations and that outdoor stairs/steps were so infrequently included. Outdoor stairs/steps often comprise part of older adults’ walking paths (Edwards & Dulai, under review); affect the visitability of a home; and may be more prone to hazardous characteristics since they may not be covered by building code legislation.…”

Section: Discussionmentioning

confidence: 99%

“…Although causes of falls are considered multi-factorial, it is well-established that environmental hazards are implicated in as many as one third of all falls among older adults [ 5 – 9 ]. Research on falls indicates that two areas in the home are particularly hazardous for injurious falls; bathrooms, and indoor or outdoor stairs or steps [ 10 – 12 ]. In the most recently available National Electronic Injury Surveillance data for 2017, for example, the product category stairs, ramps, landings and floors is the top-ranked location of injuries in the United States for those 65 years and older, while bathtub and shower structures rank fourth for this age group [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

A need to improve the assessment of environmental hazards for falls on stairs and in bathrooms: results of a scoping review

Blanchet

Edwards

2018

BMC Geriatr

View full text Add to dashboard Cite

BackgroundFalls occurring on stairs or in bathrooms are associated with a high risk of injuries among older adults. Home environmental assessments are frequently used to guide fall-prevention interventions. The aims of this review were to describe how, where, by whom, and for whom environmental hazard checklists are used, and to examine the characteristics of environmental hazard assessment checklists with specific attention to features of bathrooms and stairs/steps assessed in them.MethodsStudies published before January 5, 2018, were identified using several databases. Publications reporting the use and/or evaluation of environmental hazard checklists were eligible if they assessed bathrooms or stairs/steps in homes of older adults (≥65 years). Content analysis was conducted on publications that provided a complete list of specific environmental hazards assessed. Checklist items related to bathrooms and stairs/steps were extracted and categorized as structural or non-structural and as objective or subjective.Results1119 studies were appraised. A pool of 136 published articles and 4 checklists from the grey literature were included in this scoping review. Content analysis was conducted on 42 unique checklists. There was no widely used checklist and no obvious consensus definition of either environmental hazards overall or of single hazards listed in checklists. Checklists varied greatly with respect to what rooms were assessed, whether or not outdoor stair/steps hazards were assessed, and how responses were coded. Few checklists examined person-environment fit. The majority of checklists were not oriented towards structural hazards in bathrooms. Although the majority of checklists assessing stair/steps hazards evaluated structural hazards, most features assessed were not related to the construction geometry of stairs/steps. Objective features of bathrooms and stairs/steps that would deem them safe were rarely specified. Rather, adequacy of their characteristics was mostly subjectively determined by the evaluator with little or no guidance or training.ConclusionThe lack of standard definitions and objective criteria for assessing environmental hazards for falls is limiting meaningful cross-study comparisons and slowing advances in this field. To inform population health interventions aimed at preventing falls, such as building code regulations or municipal housing by-laws, it is essential to include objectively-assessed structural hazards in environmental checklists.Electronic supplementary materialThe online version of this article (10.1186/s12877-018-0958-1) contains supplementary material, which is available to authorized users.

show abstract

“…The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), in its current form, does not provide a code-linked data set. Even comprehensive surveillance systems of large populations, such as the US Consumer Product Safety Commission National Electronic Injury Surveillance System, lack this specificity (Stevens et al, 2011;Blazewick et al, 2018).…”

Section: Textboxmentioning

confidence: 99%

Advocating for improvements to building codes for the population’s health

Edwards

Chauvin²,

Blanchet

2019

Can J Public Health

View full text Add to dashboard Cite

Construction codes are a major component of building codes. They provide normative standards by which buildings are designed, built, altered, inspected, and assessed. Persistently high, fall-related injury rates on stairs and in bathrooms indicate that public health advocacy is needed to enhance the passive protection of these codes. Targets and strategies for code improvement advocacy by public health professionals, organizations, and associations are discussed. Approaches pertinent to describing the problem, proposing solutions, and framing the message are considered. Attention is given to issues that may be particularly challenging for advocates. These include the need to address minimum standards, tackling gaps in injury-related surveillance data that may be used by the building industry to rebut proposed code changes, describing how construction code changes align with other progressive legal tools that shape our built environments, and considering which sector pays and which sector benefits from code improvements. Ergonomic and epidemiologic evidence indicates that construction code improvements can reduce falls and fall-related injuries. Public health advocates have an important role to play in strengthening these codes. Résumé Les codes de construction constituent un élément majeur des codes du bâtiment. On y trouve les critères normatifs de conception, de construction, de modification, d'inspection et d'évaluation des bâtiments. Les taux constamment élevés de blessures liés aux chutes accidentelles dans les escaliers et les salles de bain indiquent que des campagnes de santé publique sont nécessaires pour améliorer la protection passive offerte par ces codes. Notre commentaire traite des cibles et des stratégies d'éventuelles campagnes d'amélioration des codes de construction à mener par les professionnels, les organismes et les associations de la santé publique. Des démarches pertinentes pour décrire le problème, proposer des solutions et formuler le message sont examinées. Une attention particulière est accordée aux questions les plus épineuses pour les défenseurs de la santé publique : les révisions nécessaires aux normes minimales, les lacunes dans les données de surveillance des traumatismes qui peuvent être mises à profit par le secteur du bâtiment pour réfuter les modifications proposées, l'harmonisation entre les modifications aux codes de construction et les autres outils juridiques progressistes qui donnent forme à nos milieux bâtis, et l'étude des secteurs qui paient pour les améliorations aux codes et de ceux qui en bénéficient. Selon les données ergonomiques et épidémiologiques, les améliorations aux codes de construction peuvent réduire les chutes accidentelles et les traumatismes liés aux chutes. Les défenseurs de la santé publique ont un rôle important à jouer dans le renforcement de ces codes.

show abstract

Stair-related injuries treated in United States emergency departments

Cited by 47 publications

References 38 publications

Performance of older adults under dual task during stair descent

Performance of older adults under dual task during stair descent

A need to improve the assessment of environmental hazards for falls on stairs and in bathrooms: results of a scoping review

Advocating for improvements to building codes for the population’s health

Contact Info

Product

Resources

About