Stairway visual contrast enhancement to reduce fall-related events

Abstract

Falls on stairs occur frequently and pose a significant health and financial risk. Laboratory research has found that fall frequency can be reduced through contrast enhancement of the stairs by applying vinyl striping to the first and last steps' faces, and all the steps' top edges. Here we sought to determine if such step contrast enhancement can reduce the probability of fall-related events such as loss of balance, slips, trips, and falls in public university staircases. Cameras were used to capture stair users' ascent and descent on contrast enhanced (striped) and control stairways. Observed age group, observed gender, traverse direction (ascent, descent), fall-related events, and walking speed (m/s) were recorded. Fall-related events were reduced for the striped stairway compared to the control stairway (odds ratio = 2.87, average marginal effect = 0.002, p = .023) when controlling for observed gender, age category, and traverse direction. These results suggest contrast enhancement of first and last steps' face and all steps' edges may reduce fall-related events in public settings. Adding contrast enhancement to public stairways is a simple and cost-effective way to reduce the loss of balance, slips, and trips that could lead to catastrophic falls on stairs as well as the health and financial burden associated with such falls.

Inter-step Variations of Stairways and Associations of High-Contrast Striping and Fall-related Event Observations

“…Here we sought to evaluate whether an intervention, namely the addition of black stripes to the top, front edge of each step, could counteract the impact of inter-step inconsistencies on the number of observed slips, trips, and falls (fall-related events). As described previously (Harper, 2022), Elliott, Foster, and colleagues have demonstrated that vertical, monochrome striping on the face of the bottom and top steps can increase vertical foot clearance (Elliott et al, 2015;Elliott et al, 2009;Foster et al, 2016;Foster et al, 2015a;Skervin et al, 2021). Adding highcontrast visual strips along the top front edge of all the steps (Cohen & Sloan, 2016;den Brinker et al, 2005;Elliott et al, 2015;Foster et al, 2014a;Thomas et al, 2021;Zietz et al, 2011) could lead to increases in heel clearance.…”