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Fall Injuries Prevention in the Workplace

Collage of Construction workers performing different jobs

Spotlight

Human Factors Special Issue

document coverSpecial Issue on Occupational Fall Prevention and Protection

Falls are a persistent hazard found in all occupational settings. A fall can occur during the simple acts of walking or climbing a ladder to change a light fixture or as a result of a complex series of events affecting an ironworker 80 feet above the ground. According to the 2009 data from the Bureau of Labor Statistics, 605 workers were killed and an estimated 212,760 workers were seriously injured by falls to the same or lower level.

The highest frequency of fall-related fatalities was experienced by the construction industry, while the highest counts of nonfatal fall injuries continue to be associated with the health services and the wholesale and retail industries. Healthcare support, building cleaning and maintenance, transportation and material moving, and construction and extraction occupations are particularly at risk of fall injuries.

Circumstances associated with fall incidents in the work environment frequently involve slippery, cluttered, or unstable walking/working surfaces; unprotected edges; floor holes and wall openings; unsafely positioned ladders; and misused fall protection. Federal regulations and industry consensus standards provide specific measures and performance-based recommendations for fall prevention and protection. However, persistent unsafe practices and low safety culture across many industries define steady fall injury rates year after year.

Fall injuries constitute a considerable financial burden: workers’ compensation and medical costs associated with occupational fall incidents have been estimated at approximately $70 billion annually in the United Sates [NSC 2002]. Many countries are facing the same challenges as the United States on fall injury in the workplace. The international public health community has a strong interest in developing strategies to reduce the toll of fall injuries.

Successful reduction of fall injury and fatality rates requires continued concerted efforts of regulators and industry leaders, professional associations and labor unions, employers and employees, safety professionals and researchers in enhancing the work environment, implementing new effective fall prevention and protection technologies, and improving the work safety culture through continuous education of the workforce. NIOSH, as the leader in occupational safety research, plays a key role in these complex fall-injury prevention efforts.

Reference:
NSC [2002]. Report on injuries in America 2002. Itasca, IL: National Safety Council.

Fall-Related Research and Development Activities at NIOSH

Planning and Guidance of Fall-Related Research at NIOSH

The NIOSH fall-injury prevention research strategic planning and goal setting is structured throughout industry sector and cross-sector programs, and takes into consideration the magnitude or emergence of the problem as evidenced by data, immediacy of need expressed by critical stakeholders, current resources and expertise in the goal area, current research, strength of partnerships in current research, and status and momentum on the course of research-to-practice. The strategic planning process has been recently enhanced with input from the National Academy of Sciences program review. 

Project contact: Hongwei Hsiao, Ph.D.
Protective Technology Branch
(304) 285-5910; HHsaio@cdc.gov
Project period: 2007-2011

Research Laboratories

Virtual Reality Laboratory

collage of images from virtual reality lab at NIOSHThe Virtual Reality Laboratory contains a virtual-reality simulation space, which is a computer-generated projection that gives a user the illusion of being fully immersed in a three-dimensional world. At present, this 28x35x14-foot laboratory is being utilized to understand human behavior, physical response, and decision-making skills under simulated conditions of elevated work. Findings are validated and compared with measurements taken under non-simulated work conditions. In addition, investigations of fall-risk factors, injury processes, and fall prevention are being conducted. The Virtual Reality Laboratory is equipped with four projectors and four screens (three walls and one floor), an image generator, a position tracking system, and stereo eyewear. The projectors and image generator function as an integrated system, controlling the projected images as well as the software application. The motion-tracking system continuously adjusts the stereo projection to the current position of the user, tracking the subject's position and updating the stereo projection in real time to that position. The stereo eyewear is integral to the 3D experience, creating the illusion of depth so that the user can walk through the surrounding virtual environment, experiencing for example the sights and sensation of elevation. In addition to the virtual-reality simulation space system, the Virtual Reality Laboratory is equipped with the following scientific equipment and software for measuring human movement and forces: (1) Vicon MX3, an advanced 6-camera 3D motion analysis system; (2) Visual3D, an advanced 3D motion analysis software that provides maximum flexibility for managing, analyzing, and reporting motion data, and (3) MaxMate and MaxTRAQ software packages, which have the unique capability of performing motion tracking with multiple video sources with or without the use of markers, and (4) AMTI and Bertec force platforms that can capture the forces and moments induced at the workers’ feet during task performance.

Human Factors Laboratory

collage of images from human factors lab at NIOSHThe Human Factors Laboratory is a unique facility for research in the areas of biomechanics, ergonomics, applied physiology, and industrial psychology. The 30x40- foot laboratory has a 17-foot-high ceiling to permit the study of a variety of work practices. The laboratory supports studies of postural stability, human motor responses, machine safety, musculoskeletal injuries, and heat stress evaluations. This laboratory is equipped with the following core systems: a unique gantry system, an environmental control unit (ECU), a Vicon motion measurement system, and two Kistler force platforms. Various physical signal measurement devices are also available. The gantry system provides adjustable and unobtrusive fall protection anchoring throughout the whole lab space. The ECU can control temperature and lighting with a high degree of precision; temperature can be controlled in a range of 35° F to 95° F, 30% to 90% relative humidity, and 4.1- to 100-foot candles lighting. The Vicon motion measurement system uses six state-of-the-art high-speed and high-resolution T10 cameras, which are connected with an MX Giganet core unit to a PC for motion data collection. The system is controlled by the Vicon NEXUS software which can objectively collect, quantify, and document motion in 2D and 3D space. The NEXUS software automatically calculates body-position velocities and accelerations and when integrated with data from force platforms can be used to calculate body joint forces. The two Kistler force platforms are used to capture data such as the amount of forces and moments at the worker’s feet during walking, as well as the amount of sway in a worker's standing posture as a predictor of stability and fall potential. These platforms rest on a concrete pad, positioned flush with the floor surface so that the plate surface is level with the floor surface. The supporting pad is isolated from the rest of the floor to reduce the effects of building vibration.

High Bay Laboratory

collage of images from high bay lab at NIOSHThis laboratory is a specially constructed facility with elevated (37 feet) ceilings and an overhead catwalk, and is dedicated to research efforts in reducing fall-related injuries, as well as in improving the safety of large equipment used in industrial, construction, and agricultural applications. The lab is equipped with a 5 ton overhead bridge crane and a 24,000 lb test bed with a dual-axes (2 x 20,000 lb) MTS system. The overall dimensions of the laboratory are 30 by 36 by 37 feet, sufficient for accommodating such research efforts as studies of scaffolding systems, ladder stability, tension/compression testing of fabricated protective structures, and access/egress safety for construction equipment.

Anthropometry Research Laboratory

collage of images from anthropometry lab at NIOSHA fleet of whole body scanners, head scanners, hand scanners, FaroArm and traditional anthropometry measurement equipment have been used by the NIOSH Anthropometry Researchers for various equipment safety evaluation and design applications. Additional information is available on the Anthropometry website.

 

 

NIOSH Fall-related Research Projects

Assessment Technology and Interventions for Package Drivers

This project will build upon prior NIOSH research on sensor development and digital human modeling and will respond to industry-wide demands for effective assessment methods and interventions to control exposures to musculoskeletal disorders (MSDs) and slips, trips, and falls (STFs) for package-delivery truck drivers who are exposed to unique, multiple biomechanical and vibration hazards. The primary outcomes of this project will be new technologies to conduct evaluations and integrated assessment methods leading to effective interventions and real-time monitoring of MSDs and STFs. Newly developed exposure assessment and control devices and intellectual property will be transferred to stakeholders via commercialization agreements with selected package delivery companies, and a comprehensive injury reduction/control program will be recommended and disseminated to stakeholders.

Project contact: Chris Pan, Ph.D.
Protective Technology Branch
(304) 285-5978 CPan@cdc.gov
Project period: 2011-2014

Evaluation of Slip, Trip, and Fall Prevention Practices in Food Services

The purpose of this research project is to evaluate the efficacy of slip, trip, and fall (STF) prevention practices in the food services industry. A randomized controlled trial is being conducted to evaluate the effectiveness of slip-resistant shoes in reducing slips and falls injuries. The study involves the participation of approximately 4,000 employees wearing slip-resistant shoes and will continue through 2014. One of the largest food service companies in the US is collaborating in this NIOSH-led research by providing access to its workforce. It is anticipated that this research would impact worker safety by providing scientific evidence and business case support for a comprehensive STF prevention program to effectively reduce STF injuries among food service workers. By demonstrating the effectiveness of STF prevention measures, it is anticipated that food service companies initially hesitant to expend time and money on prevention programs with unknown effectiveness could use these research findings to help justify implementing prevention strategies.

Project contact: Jennifer L. Bell, Ph.D.
Division of Safety Research, Analysis and Field Evaluations Branch
(304) 285-5802; JBell@cdc.gov
Project period: 2010-2014

Injury Assessment for Emerging Mast Elevated Work Platform Technology

This study applies advanced engineering technologies to identify the mechanisms of fall injuries and fatalities for selected mast elevated work platforms (MEWP). The project also studies fall protection systems; the physical reactive forces and motions upon the platforms and fall-control systems; the interactions among workers, platforms, environments, and fall protection systems; and the sequence of events following the imposition of a sudden load on a worker or a platform. The outputs of this project will provide information associated with fall protection systems to MEWP and fall-protection-system standards committees and manufacturers.  

Project contact: Chris Pan, Ph.D.
Protective Technology Branch
(304) 285-5978 CPan@cdc.gov
Project period: 2010-2013

Effectiveness Evaluation of the NIOSH Roof Bracket Assembly

A direct result of the carpenter study was the development of a new, NIOSH-developed, patented design (U.S. Patent No. 7,509,702) of an adjustable roof bracket and safety rail system. This follow-on research study was initially focused on evaluating the new design with a series of laboratory tests. The study has been expanded to include an assessment of the system performance in a field evaluation study. The initial design was focused on preventing falls from roof edges, or through roof holes and skylights. The adjustable design permits guardrail system on flat commercial and industrial roofs, and on residential roofs with seven different slopes (designated as rise over run), ranging from 6:12 (27°) to 24:12 (63°, or A-frame) Along with the initial roof design, a total of 5 other system designs have been developed – two additional for roofs and three for interior work. The field evaluation studies, scheduled for summer and fall 2011, will be conducted with the West Virginia University Safety & Health Extension Office and two construction contractors from the north-central West Virginia area to assess the system performance.

Project contact: Thomas Bobick, Ph.D., P.E., CSP
Protective Technology Branch
(304) 285-5986; TBobick@cdc.gov
Project period: 2009-2011

Effectiveness of Extension-Ladder Safety Innovations

The purpose of this research is to develop and comparatively evaluate, in controlled laboratory settings, extension-ladder safety innovations, e.g., a multimodal inclination indicator, multifunctional convertible top ladder stabilizer, an electro adhesion safety device, and a walkthrough device. A surround-screen virtual reality system is used to simulate ladder transitioning tasks at elevation. Ladder users’ performances is being quantified by motion systems and force platforms, and their perceptions is being collected using computerized questionnaires. A graphic-oriented practical guide on ladder use, maintenance, and inspection will be developed and evaluated by focus groups and trainers at partner sites. The project results will be transferred to manufacturing partners for product adaptation and advancement, to improve the safety of extension ladders and reduce the risk of fall injury for millions of ladder users across many industries.

Project contact: Peter Simeonov, Ph.D. and Hongwei Hsiao, Ph.D.
Protective Technology Branch
(304) 285-5910; PSimeonov@cdc.gov   HHsaio@cdc.gov
Project period: 2007-2011

Fall Injury Controls and Interventions for Aerial Lifts

The objective of this study is to identify fall protection strategies and recommend effective intervention programs to workers who are at risk of injury from work at elevation on aerial lifts. This project has three study components: (1) biomechanical and mechanical assessment of harness/lanyard uses on aerial lift operators; (2) establishment of lift stability margins and their impact on operators; and (3) evaluation of fall hazards and relevant intervention effectiveness. This project addresses strategic priorities for prevention of traumatic injuries for two out of the four leading causes (i.e., falls and machines) of fatal injury, and one of the priority industries (i.e., construction). The outcomes of this project will provide information associated with fall protection systems to aerial-lift standards committees, industries, and interested parties.

Project contact: Chris Pan, Ph.D.
Protective Technology Branch
(304) 285-5978 CPan@cdc.gov
Project period: 2007-2011

Laboratory Evaluation of Guardrail Systems

This laboratory study used local carpenters to construct job-built guardrail systems around a roof hole, and then compared with two commercial products for strength and installation times.  A total of 45 different guardrail configurations were constructed with typical construction supplies or the two commercial products.  All of the guardrail configurations met the OSHA requirement of having to support a 200-lb dynamic load on the top rail of the guardrail system.  Guardrail systems built with all-purpose screw fasteners (3″ length) were significantly stronger than guardrails constructed with standard 16-penny framing nails (3½″ length).  Constructing guardrails with screw fasteners occurred slightly, but not significantly, quicker than building them with framing nails.

Project contact: Thomas Bobick, Ph.D., P.E., CSP
Protective Technology Branch
(304) 285-5986; TBobick@cdc.gov
Project period: 2004-2008

Harness Design and Sizing Effectiveness

Fall-arrest harnesses provide the last line of defense to 6.3 million construction workers in areas where fall-from-height hazards cannot be completely eliminated. This project provides updated harness sizing and cut-length information for harness design to reduce the risk of worker injury that results from poor fit or improper size selection. The research results are currently used by leading harness manufacturers to develop the next-generation harnesses and to update current sizing systems which relied on body measurements of military personnel taken during 1970s and 1980s. The major impacts of the project to occupational safety and health include (1) the development of a computer-graphics procedure to quantify national human torso-shape variations, (2) the formulation of improved harness sizing systems that accommodate diverse populations in the current workforce, and (3) the determination of harness strap lengths for manufacturing production runs.

Project contact: Hongwei Hsiao, Ph.D.
Protective Technology Branch
(304) 285-5910; HHsiao@cdc.gov
Project period: 2002-2008

Sensory-Enhanced Balance Control at Elevated Workplaces

The risk of falls from height on a construction site increases under conditions which degrade workers’ postural control. At elevation, workers depend heavily on sensory information from their feet to maintain balance. This study tested two hypotheses: “sensory enhancement” – sub-sensory (undetectable) random mechanical vibrations at the plantar surface of the feet can improve worker’s balance at elevation; and “sensory suppression” – supra-sensory (detectable) random mechanical vibrations can have a degrading effect on balance in the same experimental settings. The study findings suggest that sensory suppression associated with elevated vibration levels on a construction site may increase the danger of losing balance. Construction workers at elevation, e.g., on a beam or narrow plank might be at increased risk of fall if they can detect vibrations under their feet. To reduce the possibility of losing balance, mechanical vibration to supporting structures used as walking/working surfaces should be minimized when performing construction tasks at elevation.

Project contact: Peter Simeonov, Ph.D.
Protective Technology Branch
(304) 285-6268; PSimeonov@cdc.gov
Project period: 2003-2008

Drywall Installation Safety

This study was undertaken to quantify stresses and changes in gait biomechanics associated with stilts. Falls and overexertion are the leading causes of traumatic injuries in the construction industry and are largely attributable to the nature of construction work, which continually requires workers to maintain awkward postures and perform tasks at elevations. Stilts are elevated tools that are frequently used by construction workers to raise workers 18 to 40 inches above the ground. Three methods were carried out for this project. Results were analyzed and validated along with findings from the two previously mentioned laboratory methods with human subject tests. To reduce the potential for loss of balance and overexertion, workers should avoid or limit prolonged use of stilts, especially when stilts are elevated at high levels. Also, placing the feet parallel and directly beneath the body, with the feet positioned either 1 to 1½ shoulder width apart, caused less postural instability and joint loadings than at half shoulder width.

Project contact: Chris Pan. Ph.D.
Protective Technology Branch
(304)285-5968; CPan@cdc.gov
Project period: 2003-2007

Influence of Visual Cues and Restricted Space on Workers at Elevation

Falls from elevation continue to be the most serious hazard for the workers in construction. Simple and cost effective technical approaches to improve workers’ balance on sloped roofs and deformable/unstable platforms have the potential to reduce the risk of falls. This project evaluated the effectiveness of simple vertical structures as visual references for balance improvement. Results indicate that the roof-environment characteristics, height, and sloped-support surface synergistically increased workers’ standing postural instability, while simple proximal structures (e.g., narrow vertical bars) can serve as visual cues and assist workers’ balance. The results further demonstrate that workers’ balance improves linearly with cue proximity within the tested distance range both on sloped and deformable surfaces. At a moment of instability, workers can redirect their attention to a proximal structure, available in the line of sight, to assist their balance control. These findings may be useful in modifying elevated work environments and construction procedures to improve workers’ postural balance during various construction phases.

Project contact: Peter Simeonov, Ph.D.
Protective Technology Branch
(304) 285-6268 PSimeonov@cdc.gov
Project period: 2003-2007

Evaluation of Scaffolding Tasks

This study determined the most favorable strategy for carrying scaffold end frames while minimizing the risk of injuries from being struck by an object, falling, and overexertion. Scaffold erectors are at risk of high exposure to the aforementioned hazards associated with the dynamic human-scaffolding interface and work environments. Identifying an optimal work strategy can help reduce risk of injuries to the worker. Three carrying methods, four types of work surfaces, two weights of scaffold frames, and three directions of stepping movement were tested in a laboratory with 18 construction workers. The effects of carrying method on postural instability and task difficulty rating were significant for handling the 22-kg end frame. Response time, postural instability, and perceived task difficulty rating were significantly reduced when the 9-kg end frame was used as compared with the 22-kg flame. The symmetric side-carrying method was the best option for handling 22-kg scaffold end frames. A 9-kg end frame (e.g., made of reinforced light weight materials) has the potential to reduce injury risk among scaffold handlers during their scaffold erection and dismantling jobs. Scaffold erectors may want to adopt the symmetric side-carrying method as the primary technique for handling the 22-kg scaffold end frame, which is currently the one most used in the industry.

Project contact: Hongwei Hsiao, Ph.D.
Protective Technology Branch
(304)285-6354; HHsiao@cdc.gov
Project period: 2003-2007

NIOSH Publications

Preface to the special section on occupational fall prevention and protection
Human Factors: June 2012 / 54(3):301-302

Factors affecting extension ladder angular positioning
Human Factors: June 2012 / 54(3):334-345

Impact of harness fit on suspension tolerance
Human Factors: June 2012 / 54(3):346-357

Assessment of fall-arrest systems for scissor lift operators: computer modeling and manikin drop testing
Human Factors: June 2012 / 54(3):358-372

Effect of boot weight and sole flexibility on gait and physiological responses of firefighters in stepping over obstacles
Human Factors: June 2012 / 54(3):373-386

The epidemiology of slips, trips, and falls in a helicopter manufacturing plant
Human Factors: June 2012 / 54(3):387-395

Slip, Trip, and Fall Prevention for Healthcare Workers
NIOSH Publication No. 2011-123 (2010)
According to the U.S. Bureau of Labor Statistics [2009], the incidence rate of lost-workday injuries from slips, trips, and falls (STFs) on the same level in hospitals was 38.2 per 10,000 employees, which was 90% greater than the average rate for all other private industries combined (20.1 per 10,000 employees). STFs as a whole are the second most common cause of lost-workday injuries in hospitals.

Occupational Injuries & Fatalities Due To Falls
NIOSH Publication No. 2010-143 (May 2010)
An estimated 15.9 million people worked in the Manufacturing Sector in 2008, which accounted for approximately 10.9% of the employed U.S. workforce. In 2008, 411 manufacturing sector workers died from occupational injuries. The leading causes of death were contact with objects and equipment (116), transportation incidents (104), and falls (58).

Take Pride in Your Job: Fall Protection 
NIOSH Publication No. 2009-108D (DVD) (November 2008) 
This video encourages oil and gas extraction workers to use fall protection and never be “un-clipped” and thus vulnerable when at height. The video features oil and gas extraction workers talking about their use of fall protection and sharing their personal stories about why fall protection should always be worn when working at height. The purpose of the video is to raise awareness of fall injuries in this industry and to provide information about the use, proper fit, and inspection of fall protection. This video is designed to be used in pre-shift or weekly safety meetings.

Effect of scaffold end frame carrying strategies on worker stepping response, postural stability, and perceived task difficulty
Human Factors: February 2008 / 50(1):27–36

Worker Health Chartbook, 2004
NIOSH Publication No. 2004-146 (September 2004)
This publication is a descriptive epidemiologic reference on occupational morbidity and mortality in the United States. A resource for agencies, organizations, employers, researchers, workers, and others who need to know about occupational injuries and illnesses, the Chartbook includes more than 400 figures and tables describing the magnitude, distribution, and trends of the Nation's occupational injuries, illnesses, and fatalities.

Alert: Preventing Falls of Workers through Skylights and Roof and Floor Openings
NIOSH Publication No. 2004-156 (August 2004)
This Alert describes five deaths resulting from falls through skylights and roof and floor openings. Recommendations are provided to help prevent similar deaths in the future. 

Alert: Preventing Injuries and Deaths of Workers Who Operate or Work Near Forklifts
NIOSH Publication No. 2001-109 (June 2001)
The National Institute for Occupational Safety and Health (NIOSH) requests assistance in preventing injuries and deaths of workers who operate or work near forklifts. Most fatalities occur when a worker is crushed by a forklift that has overturned or fallen from a loading dock.

NIOSH Update: Strategic Precautions Against Fatal Falls on the Job are Recommended by NIOSH (January 2, 2001)
Once the third leading cause of work-related death across all industries, falls have surpassed workplace homicide to become the second leading cause after motor vehicle crashes. Last year alone, some 717 workers died of injuries caused by falls from ladders, scaffolds, buildings, or other elevations. That equaled almost two deaths per day on average.

In the construction industry, falls lead all other causes of occupational death, but the risk is present in virtually every kind of workplace. It may occur in many forms, from standing on a ladder to change a light bulb, to connecting bolts on steel girders hundreds of feet above the ground.

Worker Deaths by Falls: A Summary of Surveillance Findings and Investigative Case Reports
NIOSH Publication No. 2000-116 (November 2000)
This monograph summarizes surveillance data and investigative reports of fatal work-related falls from elevations. It reviews what is known about occupational fatalities due to falls from elevations, identifies common risk factors and exposures, and recommends general approaches to preventing these fatal events.

NIOSH Update: Fatal Falls of Contractor, Teen Workers Highlight Safety Concerns in Telecommunication Tower Work (April 27, 2000)
The deaths of a contractor, his 16-year-old stepson, and a 19-year-old employee highlight the serious risk of fatal falls for workers who construct and maintain telecommunication towers in the rapidly growing cellular and wireless communications industry, a report from the National Institute for Occupational Safety and Health (NIOSH) finds.

Available data suggest that workers in those tasks sustain fatal occupational injuries, mostly from falls, at a substantially greater rate than employees in all U.S. industry. Because the industry has grown rapidly to meet increasing demand for additional towers, many new employers, supervisors, and workers may be unaware of the injury risk and unfamiliar with safety requirements.

Alert: Preventing Worker Injuries and Deaths From Moving Refuse Collection Vehicles
NIOSH Publication No. 97-110 (May 1997)
The National Institute for Occupational Safety and Health (NIOSH) requests assistance in preventing worker injuries and deaths associated with moving refuse collection vehicles. Data from the NIOSH National Traumatic Occupational Fatalities (NTOF) Surveillance System indicate that many fatalities occur when workers fall from or are struck by refuse collection vehicles. Recent NIOSH investigations conducted under the Fatality Assessment and Control Evaluation (FACE) Program suggest that employers and workers may not be fully aware of or may be complacent about the hazards of riding on and working near moving refuse collection vehicles. This Alert describes six fatal incidents involving these vehicles and offers recommendations for preventing such incidents.
En español

Update: NIOSH Issues Nationwide Alert on Dangers of Working from Scaffolds

•

 On September 5, 1992, a 45-year-old masonry worker fell 50 feet to his death from a scaffold in New York.
• On September 8, 1992, a 34-year-old painter plunged 364 feet from a bridge in Pennsylvania when a scaffolding cable broke. He was killed instantly.
• On October 2, 1992, two bricklayers, age 35 years and 50 years, fell 47 feet to their deaths when the plywood on their scaffold gave way at a construction site in Missouri.
• On October 27, 1992, a construction worker fell 13 feet when a scaffold collapsed in North Dakota. Fortunately, he was wearing a safety harness which prevented serious injury.

Tragically, these incidents are neither unusual nor unique. The National Institute for Occupational Safety and Health (NIOSH) reports that falls are a leading cause of traumatic occupational death. For the period 1980-1985, the NIOSH National Traumatic Occupational Fatalities (NTOF) database indicates that 3,491 workers fell to their deaths while trying to earn a living. Of those workers identified, 461 (17%) fell while working from a scaffold.

Alert: Preventing Worker Injuries and Deaths Caused by Falls From Suspension Scaffolds
NIOSH Publication No. 92-108 (August 1992)
The National Institute for Occupational Safety and Health (NIOSH) requests assistance in preventing worker injuries and deaths caused by falls from suspension scaffolds. "Suspension scaffold" means one or more working platforms suspended by ropes or other means from an overhead structure. Recent investigations by NIOSH suggest that fatal falls occur as a result of defective scaffold equipment, improper installation or operation, improper training of workers, or a failure to use appropriate personal fall protection equipment. This Alert describes five incidents resulting in six deaths caused by falls from suspension scaffolds.

Preventing Falls and Electrocutions During Tree Trimming
NIOSH Publication No. 92-106 (August 1992)
The National Institute for Occupational Safety and Health [NIOSH] requests assistance in preventing falls and electrocutions during tree trimming or cutting. Recent NIOSH investigations conducted under the Fatal Accident Circumstances and Epidemiology (FACE) program suggest that many tree trimmers and their employers lack training and knowledge of Occupational Safety and Health Administration (OSHA) standards and may be unaware of the risk posed by inadequate or improper safety procedures and equipment. This Alert describes eight incidents involving five electrocutions and three fatal falls of tree trimmers.
En español

Preventing Worker Deaths and Injuries from Falls Through Skylights and Roof Openings
NIOSH Publication No. 90-100 (December 1989)
The National Institute for Occupational Safety and Health (NIOSH) requests assistance in preventing deaths from work near skylights, skylight openings, and other types of roof openings. Recent investigations by NIOSH suggest that many fatal falls involve such openings. This Alert describes eight deaths resulting from falls that occurred during work around these openings.
En español

Falls to lower level

Postural stability effects of random vibration at the feet of construction workers in simulated elevation
Applied Ergonomics: July 2011 / 42(5):672-681

Non-fatal construction industry fall-related injuries treated in US emergency departments, 1998-2005
American Journal of Industrial Medicine: February 2011 / 54(2):128-135

Changes in fall prevention training for apprentice carpenters based on a comprehensive needs assessment
Journal of Safety Research: June 2010 / 41(3):221-227

Evaluation of guardrail systems for preventing falls through roof and floor holes
Journal of Safety Research: June 2010 / 41(3):203-211

Fall prevention among apprentice carpenters
Scandinavian Journal of Work, Environment & Health: May 2010 / 36(3):258-265

Fatal falls among Hispanic construction workers
Acciddent Analysis & Prevention: September 2009 / 41(5):1047-1052 

Development of sizing structure for fall arrest harness design
Ergonomics: September 2009 / 52(9):1128-1143

Harness sizing and strap length configurations 
Human Factors: August 2009 / 51(4):497-518 

Don't become another statistic: work safely at heights
Occupational Health & Safety: July 2009 / 78(7):36,38,40,42-43 

Fall hazard control observed on residential construction sites
American Journal of Industrial Medicine: June 2009 / 52(6):491-499 

Effectiveness of vertical visual reference for reducing postural instability on inclined and compliant surfaces at elevation
Applied Ergonomics: May 2009 / 40(3):353-361

Scissor lift safety - an initiative to model static stability
Professional Safety: April 2009 / 54(4):43-48

Footwear effects on walking balance at elevation
Ergonomics: Dec 2008 / 51(12):1885-1905

Extension-ladder safety: solutions and knowledge gaps
International Journal of Industrial Ergonomics: November-December 2008 / 38(11-12):959-965

Development of the St. Louis audit of fall risks at residential construction sites
International Journal of Occupational and Environmental Health: October-December 2008 / 14(4):243-249

Development of a unique fall-prevention guardrail system for the construction industry
2008 National Occupational Injury Research Symposium, October 21-23, 2008, Pittsburgh, Pennsylvania. Morgantown, WV: National Institute for Occupational Safety and Health: October 2008 / :69  

Development of improved harness sizing system
2008 National Occupational Injury Research Symposium, October 21-23, 2008, Pittsburgh, Pennsylvania. Morgantown, WV: National Institute for Occupational Safety and Health: October 2008 / :78-79

Falls on the same level

Causes, sources and costs of falls in a helicopter manufacturing plant
Proceedings of the 2010 International Conference on Fall Prevention and Protection May 19-20, 2010, Morgantown, WV. Morgantown, WV: National Institute for Occupational Safety and Health, May 2010 May / :35

Effect of boot weight on gait characteristics of men and women firefighters negotiating obstacles
Proceedings of the 2010 International Conference on Fall Prevention and Protection May 19-20, 2010, Morgantown, WV. Morgantown, WV: National Institute for Occupational Safety and Health, May 2010 / :34

Focus on: risk management. Don’t let costly slip and fall injuries trip you up
Chain Store Aget: March 2010 / 86(3):40,42-43 

Age-related joint moment characteristics during normal gait and successful reactive-recovery from unexpected slip perturbations
Gait Posture: October 2009 / 30(3):276-28

The effects of obesity and standing time on postural sway during prolonged quiet standing
Ergonomics: August 2009 / 52(8):977-986

Effects of foot placement on postural stability of construction workers on stilts
Applied Ergonomics: July 2009 / 40(4):781-789

Biomechanics of trailing leg response to slipping - evidence of interlimb and intralimb coordination
Gait & Posture: June 2009 / 29(4):565-570

Analysis of musculoskeletal loadings in lower limbs during stilts walking in occupational activity
Annals of Biomedical Engineering: June 2009 / 37(6):1177-1189 

Effects of external loads on balance control during upright stance: experimental results and model-based predictions
Gait Posture: January 2009 / 29(1):23-30

Evaluation of a comprehensive slip, trip and fall prevention programme for hospital employees
Ergonomics: 2008 / 51(12):1906-1925

Impact of joint torques on heel acceleration at heel contact, a contributor to slips and falls
Ergonomics: December 2008 / 51(12):1799-1813 

Slip, trip and fall injuries in potato, sugar beet and open field vegetable production in Finland
Ergonomics: December 2008 / 51(12):1944-1959 

Multidisciplinary research to prevent slip, trip, and fall (STF) incidents among hospital workers
Contemporary Ergonomics 2008: Proceedings of the International Conference on Contemporary Ergonomics (CE2008), 1-3 April 2008, Nottingham, UK. Bust BD, ed., London: Taylor & Francis: April 2008 / :693-698

Fatality Assessment and Control Evaluation (FACE) Program Investigations

One of the initial emphasis areas for the FACE fatality investigation program was fall from elevation fatality. Since the inception of the FACE program in 1982, hundreds of fatal incidents involving fall from elevation have been investigated by NIOSH and State investigators. These links provide a list of those cases which in turn links to the full-text reports.

NIOSHTIC-2 Search

NIOSHTIC-2 search results on Fall-Related Injuries
NIOSHTIC-2 is a searchable bibliographic database of occupational safety and health publications, documents, grant reports, and journal articles supported in whole or in part by NIOSH.

Other Pages of Interest

Bureau of Labor Statistics - Injuries, Illnesses, and Fatalities (IIF) program

The Electronic Library of Construction Occupational Safety and Health (eLCOSH) - Provides accurate, user-friendly information about safety and health for construction workers from a wide range of sources worldwide.

OSHA Safety and Health Topics: Fall Protection

WorkSafeBC: Safety at Work centre for the Construction industry

 
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