Ladders: accidents waiting to happen
Tsipouras, S.; Hendrie, J.M.; Silvapulle, M.J.
Medical Journal of Australia 174(10): 516-519
2001
ISSN/ISBN: 0025-729X PMID: 11419772 Document Number: 540309
Objectives: To examine the nature, severity and outcomes of injuries sustained from ladder falls. Design: Retrospective survey of medical records. Patients and setting: Patients who presented after a fall from a ladder to the emergency department of a tertiary hospital in Melbourne, Victoria, between January 1994 and December 1997. Main outcome measures: Demographic characteristics; height and mechanism of fall; injury site and Injury Severity Score (ISS); rate of hospital admissions. Results: 163 patients presented after ladder falls. They were aged 2.5 to 86 years (mean age, 48 years); 83% were male, and 78% were injured in non-occupational settings. Almost half the accidents (43%) were caused by ladder instability (ladder sliding from position or tilting sideways). Most patients had mild or moderate injuries (usually of the extremities), but 13% had an ISS gtoreq 16 (indicating severe trauma), usually with head, chest or spinal injuries; 42% were admitted to hospital. Multiple regression analyses showed that ISS increased significantly with height of fall and age (P < 0.05 for both), although a substantial amount of variation was not attributable to these variables. Likelihood of hospital admission increased linearly with increasing ISS to an ISS of 8 and remained high thereafter. Conclusions: Ladder falls resulted in significant morbidity, with men undertaking non-occupational activities comprising most of those injured. New strategies to encourage safe ladder use are needed.