Participating core and specialty programs: Center for Occupational Robotics Research, Center for Workers’ Compensation Studies, National Center for Productive Aging and Work, Occupational Health Equity, Safe●Skilled●Ready Workforce, Small Business Assistance, and Surveillance.

Employers, workers, labor unions, insurance companies, and non-governmental organizations adopt interventions to reduce falls among services workers.

NOTE: Goals in bold in the table below are priorities for extramural research.

  Health Outcome Research Focus Worker Population* Research Type
A Non-fatal injuries Falls on the same level Building services, food services, waste management workers, and travel accommodations subsectors; small businesses; contingent workers and other vulnerable workers Intervention Translation
B Fatal and non-fatal injuries Falls to a lower level Buildings services; small businesses, contingent workers and other vulnerable workers Intervention Translation

* See definitions of worker populations

Activity Goal 6.13.1. (Intervention Research): Conduct intervention studies to develop and assess the effectiveness of interventions to prevent falls among services workers.
Activity Goal 6.13.2 (Translation Research): Conduct translation research to understand barriers and aids to implementing effective fall prevention interventions among services workers.


In the services sector, slips, trips, and falls took the lives of 163 workers in the U.S. in 2015 and accounted for about 9% of all occupational fatalities within the service sector [BLS 2017a]. Building and dwellings service (i.e. maintenance and landscape workers), food services and waste management and remediation services, accommodations, and real estate sub-sectors had the highest number of fatalities and/or rates of injuries with days away from work [BLS 2015, 2017b]. Moreover, among these sub-sectors, services to buildings and dwellings recorded a particularly high incidence rate of injuries associated with falls to a lower level (14 per 10,000 full time works).

Work-related injuries and fatalities are known to differ greatly depending on the industry or occupation in which a worker is employed [BLS 2017a, b]. These problems are often exacerbated by the fact that in the services sector, 89% of the 3 million related firms have less than 20 employees and have limited access to safety and health professionals [U.S. Census Bureau, 2011]. In addition, many of these small businesses tend to employ vulnerable workers, such as immigrant or Hispanic workers and contingent workers (i.e. those who do not expect their job to last, such as those employed by temporary staffing companies and contract workers), whose status may be associated with higher occupational injury and illness [Johnson & Ostendorf, 2010; Headd, 2000; Wiatrowski, 1994]. Small businesses have fewer resources to develop safety plans for fall prevention. They are not as likely to have conducted training or purchased appropriate fall protection equipment. Additionally, training for temporary and contract workers on fall protection is often overlooked.


Intervention research is needed to understand, evaluate, and communicate safety, productivity, and latent hazards of emerging work methods (e.g., advanced fall protection technologies, height access devices, drones, and robots) in adopting them in the workplace to reduce slip, trip and fall incidents among building service (maintenance and landscape workers), food services, waste management, accommodations, and real estate workers. For instance, successful interventions that are used in construction for fall control could be evaluated and redesigned, as needed, for adoption by the building service subsectors.

Research to practice efforts are also needed to develop and communicate evidence-based fall prevention and protective measures and graphics-based guidelines for incorporation into industry practice and safety standards for building service (maintenance and landscape workers), food services, waste management, accommodations and real estate workers. Outreach in creative ways to small businesses, immigrant, and working populations with non-standard arrangements is needed to reduce falls.

Translational research focusing on expanding the use of proven interventions across diverse high-risk groups is required. This includes assessing barriers to implementing interventions that could include cultural issues as well as small or limited resource companies. Smaller businesses engage in fewer occupational safety and health activities than larger businesses, thus, there is clearly a need for delivering appropriate occupational safety and health assistance to smaller businesses [Sinclair, Cunningham, & Schulte, 2013]. Research is needed to understand risks associated with immigrant workers and workers with non-standard work arrangements. The risks may be a result of lack of knowledge by the worker or non-traditional employer (e.g., homeowner), or perhaps a worker’s concern of losing a temporary position.

BLS [2015]. Occupational injuries and illnesses and fatal injuries profiles. Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics, icon

BLS [2017a]. TABLE A-1. Fatal occupational injuries by industry and event or exposure, all United States, 2015. Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics, icon

BLS [2017b]. TABLE R8. Incidence rates for nonfatal occupational injuries and illnesses involving days away from work per 10,000 full-time workers by industry and selected events or exposures leading to injury or illness, private industry, 2015. Washington, DC: U.S. Department of Labor, Bureau of Labor Statistics, icon

Headd B [2000]. The characteristics of small-business employees. Monthly Labor Review 123:13-18.

Johnson S, Ostendorf J [2010]. Hispanic employees in the workplace. AAOHN Journal 58(1):11-16.

Sinclair R, Cunningham TR, Schulte P [2013]. A model for occupational safety and health intervention in small businesses. Am J Ind Med 56(12):1442-51.

U.S. Census Bureau [2011]. Statistics for all U.S. firms with paid employees by geographic area, industry, gen­der, and employment size of firm: 2007, Washington DC: U.S. Department of Commerce, U.S. Census Bureau, tml?pid=SBO_2007_00CSA09&prodType=tableexternal icon

Wiatrowski WJ [1994]. Small business and their employees. Monthly Labor Review 117(10):29-35.

Page last reviewed: April 24, 2018