Slip, Trip, and Fall Prevention

According to the National Safety Council, approximately 8.9 million emergency room visits each year result from Slips, Trips, or Falls. A top contributor to these issues is moisture on walking surfaces. 

Slips, Trips, and Falls – Causes and Solutions

Slips, trips, and falls (STFs) are commonly used as comedy material for television sitcoms, movies, and online videos. In reality, STFs can lead to injuries, permanent disability, and death. According to the National Safety Council, STFs account for 8.9 million visits to emergency rooms and 25,000 fatalities each year. OSHA lists STFs as the leading cause of workplace accidents. STFs are no laughing matter.

Prevention

For years, the National Safety Council and the Occupational and Safety Health Administration have identified Slips, Trips and Falls as one of the two leading causes of injury, both at home and in the workplace. Since walking is generally done without conscious thought, it’s an activity that is often taken for granted and may not command the attention it deserves. However, many organizations have improved their STF outcomes through a modest investment of time and risk improvement effort.

Causes

While a number of risk factors can contribute to a slip, trip, or fall, these can generally be grouped together into 4 main causes:

1.  Walking surface condition – is it slippery, uneven, or do surface conditions vary?

• Friction of surface, change in friction, and quality of walking surface are of most concern

• Walking surfaces with low friction, such as polished terrazzo, can contribute to a slip and fall

• Changes in surface friction can result in a slip or a trip. Walking from a smooth surface to a rough one, such as sealed-coated asphalt to rough sidewalk, can lead to a trip. Walking from a rough surface to a smooth one can lead to a slip

2.  Level changes – including stairs, ramps, curbs, or other designed changes in walking surface elevation

• Level changes pose challenges to individuals with diminished physical capacity and create obstacles to individuals who are distracted, such as pedestrians who are on their mobile phone

• Non-uniform step dimensions, ramps with excessive slopes, lack of handrails, and moving walkways also cause increased risk

3.  External conditions – including poor visibility, adverse weather, foreign substances, and obstructions

• Poor lighting or anything reducing visibility of walking conditions increase risk to STFs

• Rain, hail, ice, and even high winds can reduce friction, create uneven walking surfaces, or distract individuals enough to cause a STF

• Oil, water, wet leaves, mud, even powders will reduce friction and create a slip and fall hazard

• Filing cabinets, planters, construction zones, excess storage, even fallen tree branches or parking lot wheel stops create obstructions which may lead to trips, ankle turns, and falls

4.  Human conditions – including people with reduced physical capabilities, type of footwear, distractions – such as mobile phone use, maneuvering around other people/pets/bicycles, etc.

• The previous three risk factors become amplified for individuals with limited physical capabilities

• The type and condition of footwear worn can be the difference in whether or not a STF incident occurs or not. While footwear of clients and guests is largely outside of an organization’s control, it is something to be aware of

• A variety of conditions or actions can distract an individual enough to result in a STF

Solutions

There are a number of measures that organizations can take to control their exposure to Slips, Trips and Falls. Measures can be grouped into the following 6 solution categories:

 Increase Friction or Traction

• Implement walking surfaces with higher co-efficients of friction, such as grit-impregnated paint, slip resistant tile, slip resistant tape, or stair treads

• Choose a surface with a minimum co-efficient of 0.5 when dry; ramps should be 0.8 per ADA

• Choose surfaces that do not significantly lose their traction when wet

• Use cleansers and finishing solutions that improve friction

• Use a 2-bucket floor cleaning process to remove dirt and spills effectively

Keep Surfaces Clean, Dry, and Clear of Foreign Substances

• Install awnings or porticos at entrances

• Provide walk-off mats inside entry areas – at least 10’ in length; 15’ or more for more heavily trafficked areas

• Provide mats at areas where water is commonly present: kitchen sinks, water fountains, etc.

• Have preventative maintenance up to date, to prevent spills or leaks occurring in the first place

• Reduce or eliminate the need for liquids or foreign substances to pass near walking surfaces

• Drain water away from outside walking paths: downspouts, splash guards, ground drains

Implement Spill/Ice/Substance Response Program

• Implement a written plan with clear responsibilities (including documentation) for a spill/ice/foreign substance removal program

• Have resources readily available, including buckets and mops, shovels, salt, absorbent granules or absorbent socks, cleansers, cones, and mats

• Maintain logs for inspection, cleaning, ice removal, etc. – documentation is critical

• Clean up spills/foreign substances immediately; train multiple people to fill this role

• Leaves, fallen branches, acorns, pine cones, trash, and other outdoor refuse should be identified and cleared away regularly

Keep Surfaces Flat, Predictable, and Open

• Repair cracks, carpet snags, or other uneven spots

• Intended level changes of ½ inch or less should be beveled; changes greater than ½ inch should be transitioned by a ramp or stairway, where possible, according to applicable building code

• Ensure mats, rugs, floor/ground drains, electrical cords, and other ground/floor objects do not create a tripping hazard

• Remove obstructions that restrict the flow of foot traffic or pose a trip hazard, including planters, furniture, signage, and excess storage

• Balance architectural creativity with safe and clear walking conditions

Install Physical Controls

• Use barricades to restrict passage through construction areas or through walking areas with significant hazards, such as uncovered holes

• Install handrails for any stairs with 3 or more steps or 3’ in total height

• Ensure that handrails, stairs, ramps, and other walkway features comply with local building code

• Use physical guides, such as planter boxes, handrails, hedges, etc. to restrict foot traffic from unintended shortcuts Install visual cues

• Paint crosswalks in parking lots

• Provide signage to draw attention to hazards, such as steps, ramps, no passage, construction zones, speed bump, slippery when wet, wet floor, etc.

• Use contrasting colors (paint, tape, etc.) or lighting to draw attention to changes in walking conditions – ramps, curbs, steps, surface changes, etc.

Implement Self-Inspection and Training

• Use a checklist regularly to identify STF hazards that need improvement

• Document and be diligent on corrective action responsibilities and completion

• Train all individuals to watch out for and to report STF hazards

• During annual budgeting, allocate funds to implement STF prevention ideas Implement a response plan to STF incidents

• Implement a written plan with clear responsibilities and documentation requirements

• Have materials readily available – cones/yellow tape, first aid, mops & buckets, accident investigation form, etc.

• Train employees who are expected to respond to a STF incident 

 Snow and Ice Removal for Slip, Trip, and Fall Prevention

Each winter cold, inclement weather conditions set the stage for slips, trips, and falls throughout the United States.  The risk for outdoor slips, trips, and falls has also increased due to the aging of the U.S. population and because of increased expectations for business and consumer services to be available 24/7/365.

While some local ordinances may allow for up to 24 hours for snow and ice to be removed from sidewalks, organizations should operate with “best practices” in mind, rather than “minimum legal requirements.” If your employees, clients, and visitors need and expect a safe walking surface, the best practice is to accomplish this as soon as reasonably possible. Moreover, compliance with a local ordinance does not fully protect your organization from slip, trip, and fall liability.

Who is responsible?

Typically, property owners and/or property managers are responsible for snow and ice removal. However, tenants may share responsibility depending upon their lease. Also, regardless of liability, tenants can be named in lawsuits, resulting in time and legal expense. It is in everyone’s best interest to prevent these incidents in the first place. What should the plan entail? An effective snow and ice removal plan should cover preparation, responsibilities, supplies, removal processes, documentation, and monitoring. See the attached checklist for a more comprehensive listing.

Where are the high risk areas?

• Spaces between cars in parking lots where snow/ice may accumulate while cars are parked

• Changes in elevation (such as curbs, wheel stops, ramps, and stairs) that may be obscured due to snow

• Along common walking paths – both on pavement and on unmarked but frequently used shortcuts

• Around drains or low spots where water runoff may accumulate and freeze

• Near gutters and downspouts where water may drain off of roofs, or icicles may melt and then re-freeze along walkways

• Around construction zones where the normal walking path is already obstructed

• At entrances into your building(s)

When should actions be taken?

Be alert 24 hours before ambient temperatures are predicted to be below 40 degrees F and/or when inclement weather is expected. That is when snow/ice removal supplies and equipment should be checked and responsibilities reviewed. Apply de-icing products prior to or immediately at the time of the first snowfall/ precipitation. Check on snow/ice removal contractors while they are working and immediately after they are completed. Monitor accumulations and repeat steps for removal during snowfall/precipitation – the frequency should be based on the rate of accumulation.

How should snow and ice be removed?

If a 3rd party removal service is used, be sure to use good contractor controls – obtain certificates of insurance, be named as an additional insured, and the contract should hold your organization harmless for their work. Identify fire hydrants and other critical services so that they are not damaged by snow plows or buried under snow piles. Be cautious of creating additional hazards, such as blind corners in high traffic areas for cars & pedestrians, or placing snow in a location that causes increased slip hazards due to melting & refreezing.

Why is this a concern?

Slips, trips, and falls are identified as one of the two leading causes of injury, both at home and in the workplace, by the National Safety Council and the Occupational Safety and Health Administration. The risk for slips, trips, and falls rises dramatically when snow and ice are involved. Organizations need to take smart, effective steps for employees, customers, and guests to safely access their premises or be prepared to deal with the consequences of slip-ups, literally.

Additional Links for Business Owners

• Toolbox Talk: Extension Ladder Safety

• Toolbox Talk: Step Ladder Safety

• Toolbox Talk: Slips, Trips and Falls

• JJ Keller Video On Demand Training and JJ Keller On-Line Training

• OSHA Construction Standard – Ladders

•  OSHA Construction eTool

• OSHA Extension Ladder Fact Sheet

• OSHA Stepladder Fact Sheet

• OSHA General Industry Standard

• NIOSH Ladder Safety App