In 2007, the Bureau of Labor Statistics reported that the incidence rate of lost workday injuries from slips, trips and falls (STFs) on the same level in hospitals was 35.2 per 10,000 full-time equivalents (FTE), which was 75% greater than the average rate for all other private industries combined (20.2 per 10,000 FTEs). The objectives of this 10-year (1996-2005) longitudinal study were to: 1) describe occupational STF injury events in hospitals; 2) evaluate the effectiveness of a comprehensive programme for reducing STF incidents among hospital employees. The comprehensive prevention programme included analysis of injury records to identify common causes of STFs, on-site hazard assessments, changes to housekeeping procedures and products, introduction of STF preventive products and procedures, general awareness campaigns, programmes for external ice and snow removal, flooring changes and slip-resistant footwear for certain employee subgroups. The hospitals' total STF workers' compensation claims rate declined by 58% from the pre-intervention (1996-1999) rate of 1.66 claims per 100 FTE to the post-intervention (2003-2005) time period rate of 0.76 claims per 100 FTE (adjusted rate ratio = 0.42, 95% CI: 0.33-0.54). STFs due to liquid contamination (water, fluid, slippery, greasy and slick spots) were the most common cause (24%) of STF claims for the entire study period 1996-2005. Food services, transport/emergency medical service and housekeeping staff were at highest risk of a STF claim in the hospital environment. Nursing and office administrative staff generated the largest numbers of STF claims. STF injury events in hospitals have a myriad of causes and the work conditions in hospitals are diverse. This research provides evidence that implementation of a broad-scale prevention programme can significantly reduce STF injury claims.
Objective:The authors investigated the effect of boot weight and sole flexibility on spatiotemporal gait characteristics and physiological responses of firefighters in negotiating obstacles.Background: Falls and overexertion are the leading causes of fire ground injuries and fatalities among firefighters. There have been few in-depth studies conducted to evaluate the risk factors of falls and overexertion associated with firefighter boots.Method: For the study, 13 female and 14 male firefighters, while wearing full turnout clothing and randomly assigned boots, walked for 5 min while stepping over obstacles. The independent variables included boot weight, sole flexibility, gender, and task duration. Spatiotemporal measures of foot trajectories and toe clearance were determined. Minute ventilation, oxygen consumption, carbon dioxide production, and heart rate were measured.Results: Increased boot weight was found to significantly reduce trailing toe clearance when crossing the 30-cm obstacle. Significant increases in lateral displacement of the foot were found near the end of the 5-min walk compared with the beginning of the task. Increased boot weight significantly increased oxygen consumption. There were significant decreases in oxygen consumption for more flexible soles.Conclusion: Firefighters were more likely to trip over obstacles when wearing heavier boots and after walking for a period of time. Boot weight affected metabolic variables (5% to 11% increases per 1-kg increase in boot weight), which were mitigated by sole flexibility (5% to 7% decrease for more flexible soles).Application: This study provides useful information for firefighters and boot manufacturers in boot selection and design for reducing falls and overexertion.
Construction workers often use stilts to raise them to a higher level above ground to perform many tasks, such as taping and sanding on the ceiling or upper half of a wall. Some epidemiological studies indicated that the use of stilts may place workers at increased risk for knee injuries or may increase the likelihood of trips and falls. In the present study, we developed an inverse dynamic model of stilts walking to investigate the effects of this activity on the joint moments and musculoskeletal loadings in the lower limbs. The stilts-walk model was developed using the commercial musculoskeletal simulation software AnyBody (version 3.0, Anybody Technology, Aalborg, Denmark). Simulations were performed using data collected from tests of four subjects. All subjects walked without or with stilts through a 12-m straight path. The moments of the knee, hip, and ankle joints, as well as forces in major muscles or muscle groups in the lower limbs, for stilts walking were compared with those for normal walking. Our simulations showed that the use of stilts may potentially increase the peak joint moment in knee extension by approximately 20%; induce 15% reduction and slight reduction in the peak joint moments in ankle plantar flexion and hip extension, respectively. The model predictions on the muscle forces indicated that the use of stilts may potentially increase loadings in five of eight major muscle groups in the lower extremities. The most remarkable was the force in rectus femoris muscle, which was found to potentially increase by up to 1.79 times for the stilts walking compared to that for the normal walking. The proposed model would be useful for the engineers in their efforts to improve the stilts design to reduce musculoskeletal loadings and fall risk.
Subjective rating of slipperiness tests were conducted for 12 male industrial workers on three slippery surfaces, with poor or good lighting conditions, and with new or workers' own old shoes. A strain gauge force platform was used to evaluate dynamic coefficient of friction (COF) of shoes for the same surface conditions representing objective measurements. The shoe wear, available tread pattern, and hardness of old shoes were determined by instruments including a digital caliper, a digitizer, and a durometer, respectively. The surface effect was found to be highly significant on subjective ratings as well as dynamic COF (p < 0.0001). The correlation between dynamic COF values and subjective ratings was significant only for old shoes under medium oily conditions (r = 0.55, p < 0.04). For a slightly oily surface, decreasing the percent of tread available significantly increased dynamic COF values (p < 0.016). In addition, the effect of increased shoe hardness significantly increased the available tread pattern when only the data from the most deteriorated old shoes were included in the analyses (p < 0.004). These results emphasize the need to consider subjective assessment of slipperiness as a valid way to evaluate floor slipperiness. Further study is needed to (1) evaluate the effects of physical fatigue due to workload on subjective assessment of slipperiness and workers' ability to assess slipperiness during task performance; (2) consider the effect of available shoe tread on COF values and slip potential; and (3) determine if guidelines should be developed regarding when work shoes should be replaced to reduce slip and fall injuries.
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