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Ladder Fall Case Study

Describe about the main causes of ladder falls.
 

Ladders are ubiquitous and frequently used tools, both at home, as well as,in the work-place. According to the statistics conducted by U.S. Bureau of Labor, around 20% of all the incidents occurring in an occupation involve falls. It has been studied that the falls from ladders are increasing and is considered to be the second most common source of injury consisting of falls from the elevation, subsequent to falls on stairways. Moreover, it has been estimated that around 1-2% of the occupational injuries are due to the involvement of the ladders,  commonly seen in the industrialized countries. Though the majority of physical injuries occurring from the ladder falls are minor, but domestic, as well as, occupational ladder associated trauma can lead to significant morbidity or mortality (Barnard, 2006). The Occupational Safety and Health Administration also called OSHA has ascertained that the ladders are one of the major sources of fatalities and injuries occuring among the construction workers where about half of these physical injuries are serious and traumatic enough that requires great time off from the work. It has also been observed that the older workers are at increased and particular risk for facing fatality. Further, it has been noticed that the falls that occurs from the ladders results around 20% of fatalities occurring due to the falls in the workers whose age is greater than 55 years of age.  

The rapid increase in the occurance of ladder associated injuries is one of the disturbing trends, most  prominently observed in the light and area of age-related and dependent co-morbidities, which in turn affects the clinical course. The increase in the ladder falls are leaving men with horrific injuries to the spinal, brain damage, and even dead. Thus, sparking an urgent and necessary safety warning (Con et al., 2014). A study conducted by the Dr Helen Ackland who is the senior clinical research fellow showed the incidence of about 150 major traumatic cases that had occurred in a single period of five-years, and around alomost third of those patients were admitted in the intensive care unit. Further as per Dr Helen Ackland about Fifty-five percent of the ladder fall cases had severe traumatic brain injury, indicating that the patients would not be able to return to their daily and normal activities. Even he said that some of the cases included horrific spinal injuries that occurred due to the way they fell or where they fell and what they hit. These incidents included total 15 deaths, out of which one case was the death of the father of three children with the age of  50 years who suffered an injury causing a massive bleeding from his brain, which occurred after a ladder fall (Wang & Wollin, 2004). The study conducted by Ackland evidenced that the victims of the ladder falls were predominantly men of more than the  50 years of age who were using ladders at their home. Moreover, a lot of those victims were engineers or tradesmen by their profession in their working life, however, they were not following and using the occupational health and safety rules while using ladders at their home. As per Dr Ackland studies, there was an increase of about 67 % of the incidents resulting from the ladder falls in between the period from 2007 to 2011 ("Death rate from falls on the rise", 2007). 

Disturbing Trends in Ladder Falls

Injuries occurring from the ladder fall is considered to be the persistent hazard occurring both at home, as well as, in the workplace. Extension-ladder fall cases can occur due to various reasons, amongst which the common causes resulting in these kind of incidences are incorrect setup angle of the ladder, inappropriate selection of the ladder, insufficient and improper inspection of the ladder, improper use of the ladder use, as well as, lack of access and knowledge of safety tools related to the ladder use and its information. The main cause behind the domestic ladder falls are due to the placement of the ladder on the surface that is uneven, loss of the balance, as well as, slipping on the rungs of the ladder or overreaching.

The leading and main cause for the occurrence of injuries related to the ladder falls is the sliding out of the ladder at its base due to incorrect setup angle of the ladder, which is observed in around 40% of the cases (Diggs et al., 2005). It has been observed that the individuals working or using ladders tend to set their extension ladders at the angles that are shallower than the required optimal angle, which is at 75.5 degrees.

Moreover, selection of the appropriate ladder having the proper and accurate duty-rating is oen of the critical step for avoidance of the occurrence of the structural failure. However, it has been seen that there is lack of proper knowledge and information related to the selection of the proper ladder among many individuals using and working on the ladders, which in turn results in the ignorance of the foremost and important step with respect to the safe use of the ladders. There must be regular inspection, as well as, maintenance of the ladders structure, which are considered to be the good practices that helps in reduction of the likelihood structural failure of the ladders (Dinh, Stark, & Bein, 2012). However, easy, as well as, quick access to these ladder safety checklists are often not available on the regular basis. It has been observed that unsafe and inappropriate behavior of the user or worker using ladder is associated with the incidents resulting from the ladder falls. Other  frequent causes related to the ladder fall injuries involves the activities like overreaching, application of excessive force, carrying objects, slips, as well as, missteps. Moreover, it is seen that the small companies, which accounts for around 80% of all the companies related to the construction, and individual users of ladders, like homeowners, do have access and do not  receive the necessary training that is required for the safe use and working of the extension ladders. These kind of ladder users are hence difficult to reach, do not often have access to information relted to the safety, and generally are deficient of the resources that are required for the development, as well as, for following a program that is focused on an effective and safer use of ladders ("Injuries From Ladder Falls Draw Greater Scrutiny", 2014). 

Main Causes of Ladder Falls

Ladders are one of the frequently used products by the consumers in the domestic environments for carrying out day to day tasks and “DoIt-Yourself.” The studies have shown that the use of ladders attributes to the one of the highest and major risks invoving fall associated injuries and fatalities occurring within the domestic areas and environment. Moreover, the use of ladders by the consumers are most often causative agent for the DIY or “DoIt-Yourself” related deaths, as well as, hospitalizations. There has been a rapid increase in the injuries caused  by ladder falls in the recent years, particularly occurring in the domestic environment (MacLaurin & McConnell, 2011). Further, it has been observed that the injuries caused by these ladder falls have not been the attention or subject of any of the initiatives related to the prevention of the injury, despite the clear and concise gains in the reduction of the ladder associated falls and injuries occurring in the workplace with the help of strict and important rules and regulations, as well as, the preventative action (Cheng, 2014).

No doubt, that there is strict rules and regulations alongwith proper information related to the use of the ladder at the workplaces, but still as per the studies conducted by the researchers of the Centers for Disease Control and Prevention, work associated falls resulting from the ladders resulted in 113 deaths. The study further showed that near about 20%  of the injuries occurring from the occupational falls were caused due to the involvement of the ladders. It has been seen that most of the ladder falls occured in the construction, maintenance and repair activities or mining areas with most of the victims involving male, older, and Hispanics (Mervis, 2014). Further, as per the researchers studies among construction workers, around 81% of the injuries were estimated that was treated in the emergency departments of the U.S. caused by the fall from the ladders. Falls are one of the leading causes behind the occurrence of the unintentional injuries, as well as, the  deaths nationwide, with about 43% of the cases involving fatal falls that had occurred in the last decade were those involving the ladder, as per the studies so far conducted. Near about 34,000 cases involving the nonfatal injuries caused by the ladder related falls were treated in the emergency departments of the hospital during the year of 2011. Hence, there is a need of the development of the new methods and techniques for the prevention of the ladder falls to reduce the occurrence, as well as, the risks associated with the ladder fall injuries and fatalities (Michael & Treml, 2014).   

The Role of Correct Angle and Proper Ladder Selection

It is clear and evident from various studies that the problem of ladder falls is getting worse day by day, with the incidence of staggering 500 falls from the ladder in between the years from 2012 to 2014. Hence, there is a requirement and need for adopting certain measures that will prevent the ladder falls and hence reducing the injuries and fatalities caused by the ladder falls (O’Sullivan, Wakai, O’Sullivan, Luke, & Cusack, 2004). Various key points can be adopted for reducing the incidence of the ladder falls, which includes the improvement of the the design, as well as, the mechanism of ladders for better and safe use by the consumer through proper reviewing of the stability and strength of the design of the ladder design. Deep understanding and knowledge related to how people actually work and use the ladders and, most necessarily, how the people get injured while using the ladders is the main key for designing the safer and new climbing products (Becker, 2001). It has been observed that near about 50% of the reported injuries caused by the ladder falls were due to the awkward size, as well as, weight of the ladder used. The manufacturing of the lighter ladder is an easy solution to solve this problem. We must support the standards and regulations related to the use of the ladder improvements and enhancements for better compliance and manufacturing of the ladder.  The use of features like gutter guards or anchor points can supporting the safe use of ladder. Improvement of the surfaces that are being used around ladders, like using anti-slip floor coverings, as well as, surface treatments will help in reducing the risk of falls and hence injuries caused by the ladder falls. Promotion regarding the  use of protective and safe equipment while using ladders is necessary with respect to the domestic context. Public education about the safe use of the ladder, as well as, related to the public awareness with respect to the dangers and risks associated with the use of the ladders in the domestic setting should be carried out for the prevention of the ladder falls occurring in the domestic environement (Campbell, 2012). Promoting alternatives like services and resources to the ladder use that are available to various domestic users of the ladders within the community can also help in reduction of the domestic ladder falls. It is the high time to get these messages and measures out because individuals are getting up to the ladder, cleaning out their windows and gutters, putting up the Christmas lights, and there is an expectation of an onslaught related to the ladder falls. Hence, the two most important things that are required prominently in the reduction of the falls and injuries occurring due to the ladders are training and innovation, which will help in saving the lives of the people (Brauer, 2011). 

References

Barnard, K. (2006). An unusual cause of falls. Independent Nurse, 2006(12). 

Becker, P. (2001). Prevention of construction falls by organizational intervention. Injury Prevention,7(90001), 64i-67.

Brauer, S. (2011). Falls prevention. Journal Of Physiotherapy, 57(2), 130. 

Campbell, A. (2012). FALLS AND INJURY PREVENTION IN OLDER PEOPLE. Injury Prevention,18(Supplement 1), A50-A51.

Cheng, H. (2014). Falls and Fall Prevention. Mededportal Publications.

Con, J., Friese, R., Long, D., Zangbar, B., O’Keeffe, T., & Joseph, B. et al. (2014). Falls from ladders: age matters more than height. Journal Of Surgical Research, 191(2), 262-267.

Dinh, M., Stark, H., & Bein, K. (2012). A survey of injuries sustained in falls from ladders among patients at an inner-city trauma centre. Med J Aust, 196(5), 314-315. 

Injuries From Ladder Falls Draw Greater Scrutiny. (2014). JAMA, 312(1), 20.

MacLaurin, A. & McConnell, H. (2011). Utilizing quality improvement methods to prevent falls and injury from falls: Enhancing resident safety in long-term care. Journal Of Safety Research, 42(6), 525-535. 

Mervis, J. (2014). Tracking who climbs up--and who falls down--the ladder. Science, 344(6186), 836-837.

Michael, A. & Treml, J. (2014). P250: Causes of falls in older people. European Geriatric Medicine, 5, S163. 

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