Falls from Ladders in Ontario

Posted November 18, 2016

Ladders: A Seasonal Falls Hazard


When we talk about falls and fall prevention, we’re usually focused on two high-risk age groups – young children and older adults. This is for good reason, of course.


In the past couple of years, injury prevention stakeholders in Ontario have shown an interest in addressing falls among the “ignored” age group – young and middle-aged adults. In 2015, the OIPRC was thrilled to partner with the Ontario Neurotrauma Foundation (ONF) and University of Toronto to present a webinar on adult falls, examining the scope of the issue and approaches to prevention. You can access that webinar content here.


Research shows one category of falls that disproportionately affects adults is falls from ladders.  While we may naturally assume this is largely an occupational safety issue, significantly more ladder falls actually occur at home than in the workplace.


‘Tis the Season


Ladder falls at home occur in higher numbers between July and December. The summer months are a popular time to make repairs or apply a fresh coat of paint to the house. As the colder weather approaches, Ontarians bring out their ladders to clear leaves from the eaves troughs and hang seasonal decorations.


Not Our Typical Fallers


Broadly speaking, most fall-related injuries occur among young children (0-6 years) and older adults (aged 65 and over).  And, as age increases, we know that fall risk ultimately becomes higher for females than for males.  Yet, in the case of falls from ladders, those at highest risk are a completely different population. The typical faller in this scenario would most likely be male and in middle adulthood.



  • Males are overrepresented among those seeking medical care after ladder falls. In 2014/15, males accounted for 82% of hospital admissions and 81% of emergency visits in Ontario for injuries related to falls from ladders.



  • The rates of falls from ladders start to rise much earlier in adulthood than other types of falls. Whereas rates for falls typically continue to increase with age, the rates for ladder falls begin to decrease again in the later years. This rise and fall creates a peak in middle age. When we look over the last 5 years of data in Ontario, emergency visits peaked in 50-54 year olds, and hospital admissions in 60-64 year olds.  According to 2009/10 Ontario trauma data, trauma hospitalizations for these injuries peaked in 55-64 year olds (CIHI, 2011).


Interested in more data? Check out the Ontario Injury Compass: Falls from ladders among Ontario Adults


A Campaign for Change


Resources, training, and education about ladder safety in the workplace are widely available (Volpe, 2014). We do not find the same level of awareness and intervention for home ladder use.  The home environment certainly presents unique challenges compared with the workplace, not having systems of supervision, training, policy, and enforcement in place.


Dr. Richard Volpe’s (2014) research on mid-life fall prevention highlights a successful initiative from New Zealand, a campaign titled DIY Falls: Take Time Before You Climb. The campaign was built on multiple components, including media coverage, event and trade show participation, point-of-sale training (at hardware stores, for instance), and a ladder amnesty where community members could trade in shoddy ladders for new ones at a discount.  The impact evaluation of the campaign showed an 86% commitment to behavioural change in respondents. In addition, 58% reported they had spoken to others about the issue.


Read more about the DIY Falls campaign: www.onf.org/system/attachments/294/original/MLF_COMBO_RS_Fin_Dec_14.pdf 



Key Prevention Messages and Resources


As a start, there are some key tips we can promote – and use ourselves at home – for safer ladder use in any season:



  • Have someone hold the bottom of the ladder so it doesn’t move. Do not use a ladder when you are by yourself.

  • Select an appropriate, CSA approved ladder for the task you are performing.

  • Check the ladder for any defects, such as loose screws or cracks, and make sure the rungs are dry.

  • Place the ladder away from areas others need to access, such as doorways. If you need to use the ladder by a doorway, ensure the door is closed and locked. When using a ladder outdoors, choose a location that is well away from all power lines. 


  • Place the ladder on level ground and open it completely, making sure all locks are engaged. 


  • Always face the ladder when you are climbing and wear slip-resistant shoes. 


  • Ensure your hands and feet are free from oil, grease or other substances before climbing a ladder. 


  • Stand at or below the highest safe standing level on a ladder. For a stepladder, this is the second rung from the top. For an extension ladder, it’s the fourth rung from the top. 


  • Take the time to move the ladder as necessary to avoid overreaching. If your belt buckle crosses either side of the ladder you are reaching too far. 


  • The distance from the feet of an extension ladder to the wall should be no more than 1/4 to 1/3 of the height on the wall it is reaching. 
(OIPRC, 2009)


For further information, the following resources are freely available:






  • Posters: Ladder Falls (Preventable)


Version 1: http://preventable.ca/media/preventable_poster_falls_extrafoot.pdf


Version 2: http://preventable.ca/media/preventable_poster_falls_ladder.pdf


 


References


Canadian Institute for Health Information. (2011). Ontario Trauma Registry 2011 Report: Major Injury in Ontario, 2009-2010 Data. Ottawa: CIHI.


OIPRC. (2009). Falls from ladders. Ontario Injury Compass, 6(12). Toronto: SMARTRISK.


Ontario Ministry of Health and Long-Term Care: IntelliHEALTH Ontario.  Last refreshed December 2015.


Volpe, R. (2014).  Best Practices in the Prevention of Mid-life Falls in Everyday Activities. Toronto: Ontario Neurotrauma Foundation.


 

Content Related To: Holidays, Ladders, mid-life falls