To determine if the contribution of slipperiness to occupational slip, trip and fall (STF)-related injuries could be isolated from injury surveillance systems in the USA, the UK and Sweden, six governmental systems and one industrial system were consulted. The systems varied in their capture approaches and the degree of documentation of exposure to slipping. The burden of STF-related occupational injury ranged from 20 to 40% of disabling occupational injuries in the developed countries studied. The annual direct cost of fall-related occupational injuries in the USA alone was estimated to be approximately US$6 billion. Slipperiness or slipping were found to contribute to between 40 and 50% of fall-related injuries. Slipperiness was more often a factor in same level falls than in falls to lower levels. The evaluation of the burden of slipperiness was hampered by design limitations in many of the data systems utilized. The resolution of large-scale injury registries should be improved by collecting more detailed incident sequence information to better define the full scope and contribution of slipperiness to occupational STF-related injuries. Such improvements would facilitate the allocation of prevention resources towards reduction of first-event risk factors such as slipping.
Surface roughness has been shown to have substantial effects on the slip resistance between shoe heels and floor surfaces under various types of walking environments. This paper summarizes comprehensive views of the current understanding on the roles of surface roughness on the shoe and floor surfaces in the measurement of slipperiness and discusses promising directions for future research. Various techniques and instruments for surface roughness measurements and related roughness parameters are reviewed in depth. It is suggested that a stylus-type profilometer and a laser scanning confocal microscope are the preferred instruments for surface roughness measurements in the field and laboratory, respectively. The need for developing enhanced methods for reliably characterizing the slip resistance properties is highlighted. This could be based on the principal understanding of the nature of shoe and floor interface and surface analysis techniques for characterizing both surfaces of shoe and floor. Therefore, surface roughness on both shoe and floor surfaces should be measured and combined to arrive at the final assessment of slipperiness. While controversies around the friction measurement for slipperiness assessment still remain, surface roughness measurement may provide an objective alternative to overcoming the limitations of friction measurements.
To test our hypothesis that the onset of the menopause would be associated with an increased number of underfoot accidents in the female population for both fracture and non-fracture injuries, we analysed 90061 accidents recorded by the Home Accident Surveillance System and classified them as to (a) whether a fracture resulted, and (b) whether they were 'underfoot'. We defined 'underfoot' accidents to have an event such as a trip, slip, missed footing, twisted or turned ankle, on the level or on stairs. All other accidents, including falls from or off structures, or falls caused by medical conditions were classified as 'not underfoot'. Overall, 51.3% of women and 32% of men were injured in underfoot accidents. There was an increase with age in the percentage of fractures in both men and women, mainly due to an increased risk of fracture in underfoot accidents: underfoot accidents caused 75.9% of all fractures in women and 55.4% in men. The number of women who had fractures following underfoot accidents increased sharply after the age of 50 years, and the number continued to rise up to 80 years. The number of non-fracture injuries in elderly women from underfoot accidents also increased with age. Osteoporosis on its own does not explain our result, and changes in muscle strength and reaction time, with age in both men and women, and at a greater rate in postmenopausal women, may be an important factor in underfoot accidents.
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