Falling (accident)

Falling is a normal experience for young children, but falling from a significant height or onto a hard surface can be dangerous.

Falling is the second leading cause of accidental death worldwide and is a major cause of personal injury, especially for the elderly.^[1] Builders, electricians, miners, and painters are occupations with high rates of fall injuries. In 2013 unintentional falls resulted in 556,000 deaths up from 341,000 deaths in 1990.^[2]

Causes

Elderly

In elderly, even falls from standing position to flat ground may cause serious injuries. Stephen Lord at the University of New South Wales studied 80,000 elderly persons in Australia and found that the risk of falling increases for any who are taking multiple prescription medications and for all who are taking psychoactive drugs. This increased risk was demonstrated through the use of a variety of balance and reaction time tests. Older men when matched with women of identical height, weight, and age, on average, performed measurably better in all of the balance and reaction time tests.

Workplace

At-risk workers without appropriate safety equipment

Workplace safety campaigns attempt to reduce injuries from falling.

In the occupational setting, falling incidents are commonly referred to as slips, trips, and falls (STFs).^[3] Falls from elevation hazards are present at almost every jobsite, and many workers are exposed to these hazards daily. As such, falls are an important topic for occupational safety and health services. Any walking/working surface could be a potential fall hazard. An unprotected side or edge which is 6 feet (1.8 m) or more above a lower level should be protected from falling by the use of a guard rail system, safety net system, or personal fall arrest system.^[4] These hazardous exposures exist in many forms, and can be as seemingly innocuous as changing a light bulb from a step ladder to something as high-risk as installing bolts on high steel at 200 feet (61 m) in the air. In 2000, 717 workers died of injuries caused by falls from ladders, scaffolds, buildings, or other elevations.^[5] More recent data in 2011, found that STFs contributed to 14% of all workplace fatalities in the United States that year.^[6]

Companies must make sure that they follow the applicable safety legislation (e.g. the Occupational Safety and Health Act in the United States) to keep the work environment safe.

Risk factors

The National Institute for Occupational Safety and Health has compiled certain known risk factors that have been found responsible for STFs in the workplace setting.^[3] While falling can occur at any time and by any means in the workplace, these factors have been known to cause same-level falls, which are less likely to occur than falls to a lower level.^[3]

Workplace factors: Spills on walking surfaces, Ice, snow or rain, Loose mats or rugs, Boxes/containers, Poor lighting, Uneven walking surfaces

Work organization factors: Fast work pace, Work tasks involving liquids or greases

Individual factors: Age, Employee fatigue, Failing eyesight / use of bifocals, Inappropriate, loose, or poor-fitting footwear

Self harm

Falls from buildings are often accidental but can also be caused intentionally, such as by defenestration. Injuries caused by falls from buildings vary depending on the building's height and the age of the person. Falls from the second floor (American; first floor European) usually cause injuries, but are not fatal.

Height and severity

The severity of injury increases with the height of the fall, but also depends on body and surface features and the manner of body impacts on to the surface.^[7] The chance of surviving increases if landing on a surface of high deformity (a surface that bends, moves, or compresses), such as snow or water.^[7]

Overall, the height at which 50% of children die from a fall is between four and five storey heights (around 40 to 50 feet or 12 to 15 metres) above the ground.^[8]

Prevention

Rates of falls in hospital can be reduced with a number of interventions together by 0.72 from baseline in the elderly.^[9] In nursing homes fall prevention problems that involve a number of interventions prevent recurrent falls.^[10]

Epidemiology

Disability-adjusted life year for falls per 100,000 inhabitants in 2004.^[11]

  no data

  less than 40

  40–110

  110–180

  180–250

  250–320

  320–390

  390–460

  460–530

  530–600

  600–670

  670–1000

  more than 1000

In 2013 unintentional falls resulted in 556,000 deaths up from 341,000 deaths in 1990.^[2] They are the second most common cause of death from unintentional injuries after motor vehicle collisions.^[12] They were the most common cause of injury seen in emergency departments in the United States. One study found that there were nearly 7.9 million emergency department visits involving falls, nearly 35.7% of all encounters.^[13]

See also

• Safety net
• Free fall

References

External links

• Falls Among Older Adults: Brochures and Posters (in English, Spanish, and Chinese) US Centers for Disease Control and Prevention
• Falls Among Older Adults: An Overview US Centers for Disease Control and Prevention
• Costs of Falls Among Older Adults US Centers for Disease Control and Prevention
• Hip Fractures Among Older Adults US Centers for Disease Control and Prevention
• Falls in Nursing Homes US Centers for Disease Control and Prevention
• CDC Fall Prevention Activities US Centers for Disease Control and Prevention
• Preventing Falls: What Works―A CDC Compendium of Effective Community-based Interventions from Around the World US Centers for Disease Control and Prevention (PDF)
• Preventing Falls: How to Develop Community-based Fall Prevention Programs for Older Adults US Centers for Disease Control and Prevention
• Public Health Grand Rounds: Help Older Adults Live Better, Longer: Prevent Falls and Traumatic Brain Injuries US Centers for Disease Control and Prevention
• CDC's Division of Unintentional Injury – Podcasts US Centers for Disease Control and Prevention