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Logo of nihpaAbout Author manuscriptsSubmit a manuscriptHHS Public Access; Author Manuscript; Accepted for publication in peer reviewed journal;
 
Int J Ind Ergon. Author manuscript; available in PMC 2010 July 1.
Published in final edited form as:
Int J Ind Ergon. 2006 January 1; 36(1): 83–92.
doi:  10.1016/j.ergon.2005.08.005
PMCID: PMC2895328
NIHMSID: NIHMS212315

Nonfatal occupational injuries associated with slips and falls in the United States

Abstract

The purpose of this study was to examine nonfatal occupational injury data associated with slip and fall accidents by extracting the latest information from the database of the Bureau of Labor Statistics (BLS). Systematic information on the cost and causes of industrial slip and fall accidents are not readily available from statistical and survey data sources, as such, detailed information regarding the slip-/fall-related injuries in US industries categorized by various factors are presented in this study. Nonfatal injuries resulting in days lost from work due to fall and slip were categorized by the number and incidence rate by various characteristics such as major US industry, nature of injury, source of injury, types of fall, occupation, part of body injured, age of the injured, gender of the injured and number of lost workdays utilizing the BLS database. Additionally, cost per claim associated with industrial slip and fall accidents are reviewed using the National Safety Council database. This information may be used to focus our attention toward most relevant intervention strategies associated with workplace slip and fall accidents.

Keywords: Fall, Slip, Nonfatal occupational injury and illness

1. Introduction

In spite of advances in automation technologies to reduce the workload, industrial workers are often faced with work-related injuries leading to 1 or more days away from work. Slip and fall accidents have been recognized as a major threat to the safety of individuals not only in industry but also in daily living. However, a review of slip/fall losses reveals that, in addition to contributory negligence of the accident victims, there is often an action the property owner/management could have executed to reduce/prevent the severity of the fall incident (Pilla, 2003).

According to the 2002 annual report of science activity, “same level fall” and “fall to lower level” were cited as the two of the five leading injury causes accounting for 5 or more days away from work. Also, $4.6 billion, that is, 11.5% of the direct cost disabling work place injuries (payments to injured workers and their medical care providers for injuries or illnesses resulting in more than 5 days away from work) reported in 2002 was due to same level fall (Liberty Mutual Research Institute for Safety, 2002). Excluding motor vehicle accidents, fall was second only to poisoning as cause of unintentional injury death accounting for 14,500 deaths in 2002 (National Safety Council, 2002).

The BLS collects national data on nonfatal occupational injuries and illnesses of employers in private industry by Survey of Occupational Injuries and Illness (SOII) and estimates the overall US occupational injury and illness experience. The BLS SOII classifies nonfatal injuries and illness resulting in work absences by nature, source, part of the body, age, gender, occupation, race and length of serve, etc. The data for years 1999 through 2001, presented in this paper, are based on the SOII that is shown with electronic files (Bureau of Labor Statistics (BLS) (1999–2001) maintains at its website). The various BLS tables were examined carefully to extract and compile injury statistics relevant to the fall and slip. In this paper, slip means the slips and trips without a fall, whereas, fall means the uncontrolled slips leading to impact against a part of the body part.

The focus of this study is on fall- and slip-related injuries. Injury data with fall and slip as exposure or events are summarized. This study contains detailed information on fall- and slip-related injuries in US industries categorized by various factors such as major US industry, nature of injury (such as sprains, strains, etc.), source of injury (such as floor, walkways, tools, etc.), types of exposures or events, especially for fall (such as fall on same level, fall to lower level), part of body injured (such as head, trunk, back, etc.), occupation, age of injured, gender of injured, and the number of days away from work due to the fall-and slip-related injuries. All nonfatal injury and illness data in this paper involved at least 1 day away from work following the day the incident occurred.

2. Summary of fall- and slip-related injuries

BLS categorized four main events or exposures in fall-related injuries such as fall to lower level, fall on same level, jump to lower level, and unspecified events. The definitions are as follows:

Falls on same level: When the point of contact with the source of injury is on the same level or above the surface supporting the injured person.

Falls to lower level: When the point of contact with the source of injury is below the level of the surface supporting the injured person.

Jump to lower level: When the injured person leaps from an elevation voluntarily, even if the jump is to avoid an uncontrolled fall or other injury.

Unspecified: Other fall-related injuries explained above.

The percentage of fall-related injuries classified by four main events from 1999 to 2001 is illustrated in Fig. 1. Among these events, “falls on same level” cases were associated with most of fall-related injuries (3 years average of 65%), followed by “falls to the lower level” cases (3 years average of 32%). According to BLS data, for the “falls to lower level”, “fall downstairs” or “steps” and “fall from ladder” cases contributed over 50% of the injuries, on the other hand, in the event of “fall on same level”, “fall to floor”, “walkway”, floor contamination and uneven walking surfaces was the main reason for the injury (over 85%). Based on the information from Fig. 1, the main cause of fall-related injuries were “fall on same level” and “falls to lower level” cases.

Fig. 1
Percentage of injuries in four main events in falls.

2.1. Number of injuries

The number and percentage of injuries due to falls and slips in major US industries between 1999 and 2001 is presented in Table 1. Over 20% of all injuries in the US private industries were related with fall and slip incidents (3 years average of 21.4%). Based on the proportion of the fall-related injuries to the total number of injuries in specific industry, finance, insurance and real estate sector was the highest (3 years average of 26.5%), and showed increasing tendency during 3 years. The construction industry, service industry, and wholesale and retail trade industry also had more than 20% of fall-related injuries to total injuries and this rate is higher than those in all private industry (3 years average of 18.2%).

Table 1
Number and percentage (%) of injuries and illness involving days away from work due to falls and slips in major US industries

The proportions of industries to the total number of each slip events are illustrated in Figs. 24. For the fall incidents, services and wholesale and retail trade were leading sectors contributing to falls on same level injuries (over 60%), on the other hand, construction industry was the leading sector for fall to lower level injuries (3 years average of 25%) followed by wholesale and retail trade and services industries.

Fig. 2
Proportion of industries in fall on same level related injuries.
Fig. 4
Proportion of industries in slip-related injuries.

Over 50% of the slip-related injuries are from wholesale and retail trade industry, and services industry. Manufacturing, and transportation and public utilities are also significant sectors to slip-related injuries.

2.2. Incidence rate

The BLS publishes incidence rates (number of injuries) for worker’s risk for different industry division in the US The incidence rates represent the number of injuries per 10,000 full-time workers. Incidence rates are used to illustrate the relative level using a common base to provide comparable injuries among different industries. The incidence rates are calculated as: (N/EH) × 20,000,000, where

N = number of injuries and illness,

EH = total hours worked by all employees during period covered, 20,000,000 = represents the equivalent of 10,000 employees working 40 h/week, 50 weeks/year, and provides the standard base for the incidence rates.

The number of incidence per 10,000 full-time workers of different US industries for “falls to lower level”, “falls on same level”, and slip cases are illustrated in Figs. 57. Fig. 5 suggested that the highest number of incidence of “falls to lower level” was in the construction industry (3 years average of 39.1), followed by transportation, and public utilities industry that shows increasing tendency for 3 years (3 years average of 22.1). However, for the “falls on same level” cases (Fig. 6), transportation and public utilities industry exhibited highest rates (3 years average of 29.4), followed by wholesale and retail trade industry and construction industry. The slip case also showed highest incidence rate in transportation and public utilities industry (3 years average of 11.2), followed by construction industry, and wholesale and retail trade industry.

Fig. 5
Number of incidence per 10,000 full time workers for nonfatal occupational injuries involving days away from work due to fall to lower level in different US industries.
Fig. 6
Number of incidence per 10,000 full time workers for nonfatal occupational injuries involving days away from work due to fall on same level in different US industries.
Fig. 7
Number of Incidence rates per 10,000 full time workers for nonfatal occupational injuries involving days away from work due to slips in different US industries.

According to the proportion of industries to the total number of fall- and slip-related injuries (Figs. 24), transportation and public utilities industry was not a leading sector to cause the fall and slip injuries; however, incidence rates shows that the workers in transportation and public utilities faced greatest risk, especially for fall on same level and slip cases.

Overall, workers in transportation and public utilities industry, construction industry, and wholesale and retail trade industry had the big risk for a nonfatal workplace fall and slip injury.

2.3. Nature of injury

The number and percentage of nonfatal occupational injuries for fall- and slip-related injuries by selected nature of injury or illness is presented in Table 2. Sprains and strains were the most common cause of fall injuries (3 years average of 35.9%). Additionally, these injuries occurred mostly following a slip event (3 years average of 85%). Besides sprains and strains, fractures and bruises were the second leading cause of injury for both “falls to lower level”, and “falls on same level” cases (Figs. 8 and and9).9). Furthermore, nearly 70% of all multiple injuries of fall accident were due to sprains and fractures.

Fig. 8
Percentage of injuries due to fall to lower level by selected nature of injury or illness.
Fig. 9
Percentage of injuries due to fall on same level by selected nature of injury or illness.
Table 2
Number and percentage of nonfatal occupational injuries for fall and slip related injuries by selected nature of injury or illness

Overall, greater than 70% of fall-related injuries resulted in sprains and strains, fractures, and bruises. Compared to other source of injury or illness, fractures and bruises were more frequently occurring injuries due to fall accident and sprains and strains were dominant injury due to slip accident.

2.4. Source of injury

The number and percentage of nonfatal occupational injuries sources for slip and fall accidents are presented in Table 3. Floors, walkways or ground surfaces were the major source of injuries causing the fall-related injuries (3 years average of 86.9%). The “falls to lower level” and “falls on same level” events lead to a similar trend of source of injuries. On the other hand, over 90% of slip-related injuries were occurring from bodily motion or position of injured workers during the work activities.

Table 3
Number and percentage of nonfatal occupational injuries for fall and slip related injuries by selected sources of injuries

2.5. Part of body injured

The number and percentage of slip and fall injuries by the body parts are presented in Table 4. The trunk, including the shoulder and the back, were the most affected body parts (3 years average of 36.9%). Lower extremities including knee, foot and toe were the second most injured body parts (3 years average of 32.8%) associated with slips and falls. Injury to the back was also a very significant category due to fall and slip incidents (3 years average of 15.9% for fall, 23.2% for slip). BLS uses the classification “multiple body parts” for an injury in which body parts from two or more divisions of the body are injured. Workers injured multiple body parts in approximately 20% of fall accidents. The injuries of “body parts” due to “falls to lower level” and “falls on same level” showed a similar pattern; however, lower extremity injuries were more prevalent during “falls to lower level” case than “falls on same level” cases. Additionally, “falls on same level” cases caused more “back” injuries than the “falls to lower level” cases (Figs. 10 and and1111).

Fig. 10
Percentage of injuries due to fall to lower level by selected part of body.
Fig. 11
Percentage of injuries due to fall on same level by selected part of body.
Table 4
Number and percentage (%) of occupational injuries and illness involving days away from work involving falls and slips by part of body

2.6. Occupation of injured

The percentages of fall- and slip-related injuries among selected occupational specialties are presented in Table 5. Overall, operators, fabricators and laborers had the most fall- and slip-related injuries (3 years average of 33%). Workers in service occupation accounted for the second highest rate with approximately 20% of fall and slip cases. Technical, sales, and administration support also accounted for approximately 18% of the fall and slip cases. Trend difference was evident between “falls on same level” cases and “falls to lower level” cases. For the “falls to lower level” cases, workers in the precision production, craft and repair area exhibited the highest rate of the slip-and fall-related injury (3 years average of 27.8%), on the other hand, for the “fall on same level” and “slip” cases, workers in the service area exhibited the highest rate of the injury (3 years average of 26.6%).

Table 5
Percentage of nonfatal injuries involving days away from work due to falls and slips among selected occupations in 1999–2001

2.7. Age of injured

Workers between ages 35 and 44 had the most fall- and slip-related injuries (3 years average of 26.7% for fall, 28.9% for slip), and this is the same trend with all the events. Table 6 shows some characteristics in age groups concerning fall- and slip-related injury rate. While workers from 35 to 44 years of age accounted for majority of slip-related injuries, due to the highest employee population among this age cohort, conclusion regarding highest incident rate based upon the total population should not infer age-related characteristics of slip-related injuries. For example, compared to all disabling injuries, disabling fall victims were more likely to be over the age of 55 years (Courtney et al., 2001), and occupational fall mortality rates increased substantially with age peaking in workers 65 years of age and older (i.e., the workers over 65 age groups were involved in higher injury/mortality rate due to fall on same level cases than other events).

Table 6
Percentage of injuries by age groups due to falls and slips accident

2.8. Gender of the injured

High percentage (60%) of slip- and fall-related injuries were associated with male which is mostly attributed to “falls to lower level” cases. In terms of the “falls on same level” cases, male and female exhibited similar rate of injury; however, in “falls to lower level” cases, male workers were involved in a greater proportion of the injuries than female workers (3 years average of 75%). Again, caution should be taken in inference of gender-related characteristics of slip-related injuries due to the proportion of the male/female working population (Figs. 1214).

Fig. 12
Percentage of gender of the injured due to falls and slips in 1999.
Fig. 14
Percentage of gender of the injured due to fall and slip in 2001.

2.9. Number of days away from work

The percentage of injuries due to fall and slip by the number of days away from work is presented in Table 7. Median days away from work for those who were injured due to slip and fall events (8 days) were on the average greater than all other injuries and illnesses (6 days). Over one-quarter of overall fall-related injuries resulted in 31 days or more workdays being lost (3 years average of 26.7%).

Table 7
Percentage of injuries due to falls and slips by the number of days away from work

For “falls to lower level” cases, nearly 40% of the injuries resulted in over 21 days or more workdays being lost. Additionally, nearly 30% of the “falls on same level” cases resulted in over 21 days or more workdays being lost.

2.10. Costs associated with industrial slips and falls

The National Safety Council reported that the slips and falls are the leading cause of death in the workplace and source of more than 20% of all disabling injuries (National Safety Council, 2002). The findings of the latest Liberty Mutual Workplace Safety Index indicated that workplace injuries cost businesses nearly $1 billion/week, and costs associated with “falls on same level” was $5.7 billion, “falls to lower level” was $4.1 billion/year. Additionally, the National Safety Council (2002) estimated that compensation and medical costs associated with employee slip and fall accidents are approximately $70 billion/year. Averaged cost per claim of slip and fall injury between 1999 and 2001 was nearly $12,000, of which total cost per claim for slips and falls were over $400,000. Thirty-one percent of all WC claims in FY 2002–2003 were related to slips and falls injuries (NSC, 2002).

3. Conclusion

Occupational injuries associated with slip and fall accidents pose a significant problem to industry both in terms of human suffering and economic losses. Overall, workers in transportation and public utilities industry, construction industry, and wholesale and retail trade industry had the big risk for nonfatal workplace slip and fall injuries. Compared to other source of injury or illness, fractures and bruises were most frequently occurring injuries due to fall accident, and sprains and strains were dominant injury due to slip accident. Floors, walkways or ground surfaces were the major source of injuries causing the fall-related injuries, and bodily motion or position was leading cause of slip-related injures. The body part most affected include, trunk, shoulder, and back. Lower extremities were the second most injured body parts associated with slips and falls. Overall, operators, fabricators and laborers had the most fall- and slip-related injuries. However, for the “fall on same level” and “slip” cases, workers in the service area exhibited the highest rate of the injury. Workers between ages 35 and 44 had the most fall- and slip-related injuries, and workers in the 55–64 age group, exhibited more frequent slip-related injuries compare to all events. The workers over 65 age groups showed higher injury percentage in fall on same level cases than other events. In terms of the labor costs, over one-quarter of overall fall-related injuries resulted in 31 days or more workdays being lost, costing US economies nearly $10 billion/year.

Fig. 3
Proportion of industries in fall to lower level related injuries.
Fig. 13
Percentage of gender of the injured due to fall and slip in 2000.

References

  • Bureau of Labor Statistics. United States Department of Labor; 1999–2001. http://www.bls.gov/iif/oshcdnew.htm.
  • Courtney TK, Sorock GS, Manning DP, Collins JW, Holbein-Jenny MA. Occupational slip, trip, and fall-related injuries—can the contribution of slipperiness be isolated? Ergonomics. 2001;44 (13):1118–1137. [PubMed]
  • Liberty Mutual Research Institute for Safety. Annual Report of Science Activity. 2002.
  • National Safety Council. Report on injuries in America 2002. 2002. www.nsc.org/library/report_injury_usa.htm.
  • Pilla SD. Slip and Fall Prevention; A Practical Handbook. Lewis Publishers; 2003.