April 2003

Slips, Trips, and Falls
Public enemy No. 1

By Joe Deering

Each one of us has heard about someone having a serious accident as a result of a slip, trip, or fall. But, unless it has happened to us, we are inclined to maybe pat ourselves on the back (while crossing our fingers) properly thankful that it didn’t happen to us and hoping that it never will. SORM’s data indicates that slips, trips, and falls occurring in Fiscal Year 2002 represented nearly 24 percent of all workers’ compensation claims and 31 percent of all claims costs. What can we all do as state employees to recognize that this is more than a trivial problem and that affects all of us? This article will attempt to state a case that all state agencies should develop a slip, trip, and fall prevention program and that two basic principles of safety management are ever present. These two principles are: “every accident announces that it will happen before it happens;” and “if it might happen, it will happen – eventually.”

Most of us are experienced walkers. After all, we’ve been walking almost all of our lives. So why is it that simply putting one foot in front of the other to get from place to place results in so many injuries? Everyone has experienced a close call, one that could have resulted in an injury, including me.

Let’s try to answer this question by examining the main point in that a close call is a serious accident announcing in advance that it is coming, sooner or later, unless you and I take corrective steps. Take a look at statistics for accidents in general and let’s summarize them in what is called the Heinrick accident triangle. At the base of the triangle we have 100,000 hazards, or unsafe conditions. There will be 1,000 recordable accidents, perhaps a strain from falling on stairs that have worn tread or a spill that caused someone to slip and fall with a resulting broken arm, and so on.

Heinrick Accident Triangle

Turning this around, if you had three accidents last year that were serious enough to be reported, you also had 300 unsafe conditions that you did not know about and, therefore, could not correct.

This concept is very straightforward. Every accident and every close call represents a large number of other causes that are unknown or unrecognized. Our task is to discover and eliminate every one of these unknowns to the extent that is possible. For this task, let’s look at the causes of slips, trips, and falls.

Most same-level falls are the result of slipperiness caused by faulty housekeeping or defects of the floor surface. Faulty housekeeping is described as dirt, grease, water, or contaminates on the floor. Defective floors are described as floors with slippery floor finishes, inappropriate floor surface materials for the type work being conducted, surface wear, and uneven or damaged surfaces.

Other factors that increase the likelihood of slips, trips, and falls on floor surfaces include poor lighting, unexpected changes in environment, including transitions from tile to carpet, concrete to tile, hot to cold, and dry to humid. Placement, maintenance, and inspection of floor mats and inappropriate footwear are the causes of many workplace slip and fall injuries. Also, transitions in height can be a problem. Slips, trips, and falls from stairs have similar causes, in addition to poor tread design and lack of handrail protection. Carrying items that can obstruct your vision and impair your balance, and moving too fast, increases the likelihood that you will misjudge a step or encounter a hazard before you have a chance to notice it. Inattention and distraction interfere with your awareness of all these hazards and increase your risk of injury.

Preventing slips, trips, and falls require a comprehensive approach that considers the multiple factors involved that cause these type of injuries. Prevention must be directed toward these factors. In summary, prevention is the key and a prevention program that addresses a reduction in the number of slip and fall incidents and their associated costs is critical. Development of any prevention-based program must include floor cleaning protocols and the training of maintenance personnel. Apply the following four rules for identifying hazards and we will be well on our way to preventing slips, trips, and falls.

Rule 1: Investigate all accidents, incidents, and near incidents thoroughly from a cause and prevention standpoint.

Rule 2: Look for the root cause(s) of accidents.

Rule 3: Do periodic accident reviews to determine trends in the causes of slip, trip, or fall accidents.

Rule 4: Do periodic self-inspections to look for slip, trip, and fall hazards or risk factors. Make a checklist listing your cause factors based on your accidents. Eliminate exposures before they cause an accident.

Remember to focus on performance issues (slip-resistant footwear, cleaning procedures, clean-as-you-go policy) and correction of physical defects affecting the slip resistance of your flooring (worn or broken tile, worn or missing grout, damaged carpet, poor drainage, etc.) in measuring the effectiveness of a slip, trip, and fall prevention program.

Joe Deering is a risk management specialist in the Risk Assessment and Loss Prevention division.