A Multi Factorial Analysis of the epidemiology of Injuries from Falls from Heights

Abstract

Background:Fall from height is a common cause of morbidity and mortality in suburban population in India. These cases are either domestic or workplace injuries with different causative factors. We analyzed different aspects of these falls to identify their risk factors.Materials and Methods:We conducted prospective and retrospective epidemiological study to identify various causative, contributory factors, and resultant injuries in cases of fall from height. The study group comprised of semiurban population and involved both domestic and workplace injuries presenting to a tertiary care hospital.Results:There were 208 cases of workplace (112) and domestic (96) fall from height. In domestic cases absence of parapet on roof was the commonest cause, most of falls occurred during summer and rainy season. Alcohol consumption prior to fall was commonest associated factor in adult males. Children mostly fell while playing on roof and climbing trees. Among workplace cases, civil construction site injuries were commonest and absence of any protective gear and long working and evening hours were commonest associated factors. Mean injury severity score was 10.86 in domestic cases and 14.87 in workplace cases. There were 17 mortalities with head injury being commonest associated cause. Only difference in incidence of alcohol consumption and permanent disability was statistically significant between workplace and domestic falls.Conclusion:Different factors are responsible for domestic and workplace cases of fall from height. Most of these cases are potentially preventable.

Falls from height: A retrospective analysis

“…The majority of injuries are to the skin and subcutaneous tissues and head. [5,7,9,17] In our series, similar to the literature, skin and subcutaneous tissue (37.4%) and head (25.4%) injuries were most frequent. Of those who died, 73.1% [19] had head injuries and 50% also had subarachnoid hemorrhages.…”

“…[5,[7][8][9] Generally, men are exposed to trauma and falls more often than women because boys are more active than girls at early sites. In the construction sector and other workplaces, sufficient measures must be taken to prevent falls, competent workers should be employed, and adequate training must be given to reduce the number of workplace accidents.…”

Falls from flat roofed house in and around the city of Rewa, Madhya Pradesh: a study from central India

“…Elderly people who get up in night for micturition, those sleeping near corner of roof and children who get up early in morning and start playing without any supervision likely to suffer from injury. 11,16,19 The types of injuries we encountered were similar to those described in other studies of falls from height. 2,9,11,[21][22][23][24][25] The head injury was the most common injury (51%) involving parietal bone (linear fracture).…”

“…16,19,20 In present study majority of cases occurred during summer season between 4:00 pm to midnight because of vacation kite flying which is very common during this season and secondly absence of parapet in house in rural areas leading to increased number of fall cases in children and also adult group, another important factor for injury during kite flying was running for catching the broken or cut kite from one roof to another because houses in present setting were in close proximity to each other without any gap leading to serious injury from fall due loss balance. 16,19 Sleeping on roof during summer season to avoid heat of interiors is another reason for fall injuries from roof lacking protective barriers. Elderly people who get up in night for micturition, those sleeping near corner of roof and children who get up early in morning and start playing without any supervision likely to suffer from injury.…”

“…9,11,[16][17][18] The age group most commonly affected and with highest mortality rate with accidental falls were 11-30 years which is most productive population. 16,19,20 In present study majority of cases occurred during summer season between 4:00 pm to midnight because of vacation kite flying which is very common during this season and secondly absence of parapet in house in rural areas leading to increased number of fall cases in children and also adult group, another important factor for injury during kite flying was running for catching the broken or cut kite from one roof to another because houses in present setting were in close proximity to each other without any gap leading to serious injury from fall due loss balance. 16,19 Sleeping on roof during summer season to avoid heat of interiors is another reason for fall injuries from roof lacking protective barriers.…”