- High-risk occupations. Many tasks associated with certain occupations such as painting, postal delivery, construction, firefighting and some types of farming put workers at increased risk of injury from falls.
- Use of ladder. Ladder accidents are a major cause of occupational injuries despite standards and regulations (Chang, 2005). Injuries from falling from ladders account for 1-2% of all occupational accidents in industrialized countries (Chang, 2005, Shepherd, 2006). Falling from ladders most often occurs due to sliding of the ladder feet and top support, during transition onto and off ladders, overbalancing or slipping or falling from the top of stepladders (Shepherd, 2006).
- Activities on roofs. Exposure to elevation affects balance (Hsiao, 2001). Factors that affect the risk for falling from elevation may include a worker’s task and posture, personal characteristics of the worker, such as visual acuity, distance to the edge of the elevated support surface, availability of fall protective devices and barriers and stability of the structure (Hsiao, 2001). Experienced roofers have been found to underestimate the risk associated with their job (Hsiao, 2001). Moving visual scenes, misperception in depth, visual ambiguity (stairs, steps, layers of shingles), lack of experience, restricted support surfaces, inclination of surfaces, properties of surfaces, task-related factors, holding and carrying loads, fatigue, complexity of tasks and attention, use of personal protective equipment and personal factors are all factors involved in the control of balance during roofing work (Hsiao, 2001).
- Increased fatigue. Firefighters’ long hours and heavy gear may contribute to the high occurrence of slips and falls (Sobeih, 2006). Research shows a higher risk for falling in firefighters is associated with longer hours on duty. Fatigue is known to contribute to accidents for postal carriers as well (Bentley, 1998).
- Hazardous working conditions. Firefighters often work on slippery or uneven surfaces, have little or no visual cues, must navigate surfaces damaged by fire, are exposed to extreme temperatures and are under high stress, all of which may contribute to an increased risk of falls (Sobeih, 2006). Lack of clear vision during early winter mornings may increase the risk of falling accidents (Bentley, 1998). The important risk factors for falls from heights in the construction industry include use of ladders or scaffolding, presence of floor and wall openings and working for a small firm employing ten or fewer workers (Sobeih, 2006).
- Hazardous weather. Slips for mail carriers most often occur on snow, ice or grass (Bentley, 1998).
- Uneven surfaces. Trips tend to involve uneven pavements, obstacles and curbs (Bentley, 1998).
- Unsafe work practices. Rushing, reading addresses while walking, carrying overweight mailbags and taking shortcuts on unsafe surfaces are associated with a higher incidence of falls for mail carriers (Bentley, 1998). Carrying heavy mail bags rather than using trolleys contributes to falls (Bentley, 1998). Improper footwear or shoes with the tread too worn to be of use may contribute to slips and falls (Bentley, 1998).
Strategies to address these considerations
- Improve ladder use. Ergonomic designs for ladders can reduce injury (Shepherd, 2006). The inclination angle appears to be crucial in the reduction of falls from ladders (Sobeih, 2006, Chang, 2005, Shepherd, 2006). A reduction in falls can be achieved by assuring that ladders are sturdy and properly positioned with labels that direct 70-75 degree placement, providing methods to secure the ladder, incorporating slip resistive surfaces on ladder rungs and maximizing traction at the ladder feet (Chang, 2005, DHSS, 2006, Shepherd, 2006). To help avoid accidents involving ladders, place ladders on dry surfaces that are free of contaminants such as ice, snow, water and oil (Chang, 2005).
- Practice roof safety. Current safety regulations employ covers, guardrail systems, safety net systems and personal fall-arrest systems to prevent or lessen the severity of injuries from falls (Hsiao, 2001). Immediately marking or eliminating changes in working/walking surfaces such as edges, holes, openings, unevenness or contamination with signal/reflective tape may decrease accidents (Hsiao, 2001). Keeping surfaces even, firm and stable and covering cables or using cordless power tools can prevent accidents (Hsiao, 2001).
- Use high quality materials. Redesigning materials and potential obstacles on the roof to include bright-colored edges for easy detection may reduce falls (Hsiao, 2001). Implementing specific color cues in the design of roofing materials to aid in depth perception and to decrease visual ambiguity may prevent accidents (Hsiao, 2001). Providing structures to serve as visual anchors at heights could decrease the occurrence of loss of balance (Hsiao, 2001). Identifying optimal roof construction materials and protective body equipment can contribute to safer working conditions (Hsiao, 2001).
- Involve the priority populations. It is important to work with employers and unions to develop strategies, including educational initiatives and changes to the work environment, to minimize risks. Evidence suggests that Occupational Safety and Health Administration (OSHA) regulations that address excavation practices have reduced injuries and deaths (Sobeih, 2006). Inspections also appear to have made an impact in other industries (Sobeih, 2006).
- Reduce hours. The greatest reduction in falling for firefighters may come from reducing long work shifts. Developing measures to detect fatigue and instilling work-rest cycles may be appropriate (Hsiao, 2001).
- Increase knowledge. Increasing knowledge of relationships between materials handling methods/techniques and human balance control during roof work may decrease falls (Hsiao, 2001). Raising awareness of the demands of roofing-task complexity on attention and determining proactive mechanisms of balance control, along with determining individual balance threshold levels for performance could decrease injuries from falls (Hsiao, 2001). Using virtual reality technology for fall prevention studies could lead to the development of more safety mechanisms and techniques (Hsiao, 2001).
- Improve environment. Maintaining safety measures and improving the visual and physical characteristics of the work environment can reduce injuries from falls. Falls from roofs can potentially be prevented by safety belts/lines and guardrails (Sobeih, 2006). Preventive measures to reduce the number of delivery falls should include an initiative to encourage householders and local councils to ensure safe walkways for postal employees and other pedestrians (Bentley, 1998).
- Increase training. Improved safety training for all mail carriers focusing on safe work practices can decrease slips and falls and change attitudes regarding the health risk. Reducing on the job training that passes along bad habits such as reading while walking can improve the methods used by new mail carriers (Bentley, 1998). Evidence is suggestive that training programs in the construction industry make a difference (Sobeih, 2006).
- Improve footwear. Improved use of appropriate footwear can decrease falls in hazardous weather conditions (Bentley, 1998). Identifying optimal shoe-sole materials can decrease slips (Hsiao, 2001).
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