Avoiding the Slippery Slope

LET’S ELIMINATE SLIP, TRIP AND FALL INJURIES

by James Pretty

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We have all seen the videos. A person stands on a loose shoelace or piece of clothing as they are walking, and falls flat on their face. In cold countries, we witness people helplessly falling over on an icy surface. In some movies and TV Shows, there is the classic “slipping on a banana” gag. Is this all just a bit of harmless fun? Unfortunately not.

What is seen as a trivial issue can actually be very serious, with the potential consequences from these incidents including life-changing injuries, even fatalities. So, we need to consider very carefully how to prevent these incidents occurring, or if they do, how we can protect our colleagues from the consequences of slips, trips and falls. First, let us look at the difference between the three terms – “slip”, “trip” and “fall”. Then we can take a deeper look at the causes and consequences, so we can outline the precautions and control measures you can use to help protect your business and colleagues.

Slips

A “slip” is an event where the human foot moves unintentionally due to loss of friction between the foot and footwear being used and the surface being walked or stood upon. There are many examples, such as the “slipping on ice” mentioned in the first paragraph, but it could also be due to people slipping on puddles of liquids (such as oil, water, grease, etc) or the surface itself (very smooth surfaces, shifting materials such as sand, etc).

Trips

A “trip” can be described as someone losing their balance due to their foot or another part of their leg coming into contact with an obstruction. As the person is moving, their momentum will continue to move the body forward, even though the foot or leg has stopped. Examples of this could be tripping over a trailing cable; accidentally kicking a solid object as you walk past it; or the toes catching the floor, uneven ground, or exposed edges.

Falls

A “fall” in this instance can occur due to one of the previous two events happening. This does not necessarily mean people fall from a height, as falls can occur on the same level, e.g. walking along a slippery floor that has just been mopped, slipping and falling to the ground. Again, not every fall will result in people hitting the ground, as they may hit, or rest upon, obstacles on their way down, such as grabbing a handrail whilst falling on stairs, or landing against a table in an office, and so on.

Getting statistical

So just how big is this problem? Well, according to the UK’s Health and Safety Executive (HSE) statistics for 201820191, of the 581,000 people who suffered a non-fatal injury, 29% – that’s 168,490 or just over 461 every day – were due to slip, trip, fall incidents (in this case the statistics only count falls on the same level). Bear in mind as well, these are only the numbers actually reported to the employer, the real number may be higher.

In 2017-2018, workplace injury was estimated to have cost the UK economy 5.2 billion GBP, a big hit to the bottom line no matter how profitable or large a business is.

Causes

So why do these events happen? Is it simply carelessness from people, or does poor practice and management play a part?

Obstructions

One of the most common reasons for slip, trip, fall incidents is the presence of obstructions in areas where people are moving or working. In homes with children, a big issue is toys being left on stairs, doorways and floors. Pets such as cats and dogs can often also inadvertently become an obstacle for their human family members. An example at work could be workers using lifting equipment such as forklifts having the intention of temporarily putting a load down somewhere and moving it into its proper place at a later stage. This means items can often be forgotten, and left in pedestrian walkways, emergency exits and so on. Another example is that there are many tasks that often involve the use of various pieces of equipment, which can lead to items such as electrical cables and hoses being left trailing across a floor or surface. This can lead to people kicking these items, or even falling over simply trying to get around/over them.

Uneven surfaces

Another common issue is problems with the surface that people walk upon.

Damage such as holes and cracks can not only cause the initial incident to happen, but also be the cause of injuries which may not have otherwise been suffered; for example, someone trips over damaged tiles, and the sharp edge of the damaged tiles cuts open the skin of the leg. Surfaces can also collapse under the weight of a person, due to a lack of strength; or maybe deterioration of integrity due to lack of maintenance, leading to falls into voids and open spaces. Common examples are people falling from height as they try to walk across a fragile roof, or people falling down stairways as the handrail they are using for balance fails. Surfaces can also be contaminated with dirt, grease, fluid and other materials that could cause people to slip over on what then becomes a frictionless surface.

Footwear

Footwear issues are another area of concern. Workers often use footwear that is not compatible with a surface, or they use footwear incorrectly. Sometimes laces or other fastenings on the footwear can come loose, becoming the cause of the slip/trip/fall. Poor quality footwear can also cause problems through rapid deterioration, with failures including grips and soles completely separating from the rest of the footwear, or parts of the foot being exposed to hazards due to holes and splits in the footwear. Ask yourself, would you rather spend $30 per employee for 100 employees for their boots, or be fined almost $300,000 for breaking law by having these employees get hurt?2

Carrying too much

Carrying objects is also a common problem that leads to slip, trip, fall incidents. This can be because people are trying to carry too much, and therefore cannot see where they are putting their feet, e.g. carrying three boxes one stacked on top of another. It can also be due to people dropping items, leading to the person falling over those items. Workers being distracted by use of mobile phones and other electronic devices whilst they are walking and moving is a very modern cause of slips, trips and falls.

Working environment

The working environment can also directly contribute to the issue of slip, trip, fall incidents. Poor lighting can hide obstructions and dangerous areas, which could also be hidden due to the presence of mists, fogs and vapours in the atmosphere. Cold temperatures can cause ice to build up on surfaces, whereas hot temperatures can lead to problems with workers having difficulty concentrating through fatigue. Layout can also be a problem. Offices, rooms, corridors and so on can be too narrow and congested for the number of people using them. Stairways can be very steep (such as on a ship), or individual steps can be too small to place a full foot on them.

Consequences

So, what are the potential consequences of these incidents? As I mentioned earlier, even though we can look up some statistics, the real number of these occurrences may be higher than we think. This could be due to some workers suffering these types of incidents with little to no harm occurring, in other words, “near misses” that they deem not worth reporting. It could be they suffer from nothing more than “hurt pride”, a seemingly embarrassing incident they would rather keep to themselves. Common injuries associated with slips, trips and falls include sprains and strains of muscles; dislocations of knees, ankles and other joints; back injuries; broken bones, or worse. As I alluded to earlier in this article, the consequences of these incidents can be dramatic to say the least.

Take the case of Alison Hockday, a former Occupational Therapist.3

She had two slip incidents in the space of six years. In the first incident, she slipped on some leaves covering some concrete steps, suffering from a quite serious knee injury, which ultimately required surgery. Surgical intervention for any injury is already a serious business, with the best case being employees only have a small scar or mark as a reminder, let alone all the stress and worry of the operation, recovery period and so on. So she had already been through quite an ordeal when the second incident happened. This time Alison slipped on a wet floor, and the surgery she had was not to fix the issue. She damaged her ankle so badly that it was not healing, and doctors ultimately had to amputate her leg just above the ankle. It might seem like I have used quitean extreme example, but what if Alison had fallen on her head, not just her ankle? The consequences do not bear thinking about.

“ask yourself, would you rather spend $30 per employee for 100 employees for their boots, or be fined almost $300,000”

Controlling the risks

So now we know how some of these issues occur, and potentially how bad they can be, what can we do to solve them? Well there are many options open to us, depending upon our business’ specific circumstances with regards to budget, knowledge and so on. Let us explore some of these controls.

First, as with any health and safety issue, risk assessment should be your first port of call. Working with your safety team and other experts, examine the potential slip, trip, fall hazards, and the risks they pose to your colleagues and others who may be on site. Then have a look at what control measures you already have in place, so you can evaluate their effectiveness. When you are happy, make sure to record all of your findings, regularly reviewing the assessment to make sure the information is still valid and has not been affected by any changes; not forgetting that “suitable and sufficient risk assessment” is a legal requirement in the health and safety legislation for most countries.

Some of the real world measures you could take include making any floor or work surface slip, trip and fall resistant.

You could do this by:

  • Using different flooring materials, e.g. carpet instead of tiles
  • Installing drainage or “cambering” surfaces to allow rainwater and other fluids to drain away
  • Making sure the surfaces remain in good condition with no damage such as holes, cracks or loose pieces being present

You might even install coverings, such as roofing, over walkways in outside areas. You could also look at issuing the workforce with footwear that has slipresistant materials on the sole, or other means to help give “grip”, such as the spikes or “crampons” sometimes found on hiking boots.

Design and layout of your worksite is also something you could look at. Other than flooring materials as we just talked about, ask yourself:

  • Are work areas and walkways wide enough for the people using them? Are there enough of them?
  • Are loading, unloading and storage areas separated from other work areas? • Are stairways large enough, and at the correct angle, with steps being large enough to place a foot down properly (maybe you could even use ramps and lifts as an alternative)? • Are your walkways unnecessarily twisty and lengthy, or do they provide a direct, safe path?

For particularly large workplaces, maybe you could install travellators, such as those found at airports. These give people short breaks from walking, but still help them move along. Ensure that there is plenty of lighting to give workers the best chance possible of seeing any potential slip, trip, fall issues they come across, and ensure good temperature control to limit issues around fatigue (too hot) or ice build-up (too cold).

As mentioned previously, you may have a lot of equipment which requires cabling and hoses. So, an easy anecdote to slip, trip, fall issues could be to use wireless or cordless (battery operated) equipment. This totally eliminates the cabling, therefore eliminating the risk. If this is not possible, can you install more plug sockets around the site? This will give workers more options for choosing where to plug in equipment, and can help minimise how much cabling you will need, as they may be closer to the area they need to work in. If you still cannot get rid of cabling, can you use engineering and have the cabling installed and run under floors, and through walls and roof spaces? Maybe you could purchase cable “guards”. These come in various shapes and sizes, and whilst primarily designed to allow vehicles to drive over cables without causing damage, they also help lessen the slip, trip, fall risks. Cable stands which allow you to keep cabling temporarily off the floor are also another good idea to consider. When choosing which of these options you should use, also consider whether the equipment is to be used in that location temporarily, or permanently. By analysing this, you can usually pinpoint what the best options are for that particular scenario.

“suitable and sufficient risk assessment is a legal requirement in the health and safety legislation for most countries”

Housekeeping is also a good weapon of choice in this area. Have a good cleaning regime both indoors and outdoors, to prevent contaminants building up on floor surfaces. Of course, ensure floors are dry before allowing people to use them again. Also, keep floors and walkways free of obstructions. This is something any and every employee can keep an eye out for, not just cleaning staff. If items are too heavy to move by hand, provide the workforce with any manual or powered lifting equipment required to safely move them to an appropriate area. Regularly inspect areas for damage also, so that dangerous areas can be cordoned off until repairs are made.

Training, just like risk assessment, is a legal requirement in most places around the world, so is something you should employ. Manual handling training will provide workers with the skill and knowledge to able to move most items safely, using the correct techniques and equipment. This will again help prevent items being left in areas where people can trip over them. You could also employ team-lifting, where tasks requiring items to be carried by hand are performed by multiple people. This ensures the load can be gripped properly, and the weight of the load distributed between people, vastly decreasing the chance someone drops and trips over something (a good example would be a policy of items weighing 25kg+ being a minimum of a two-person lift). Other polices you might employ include asking people to hold handrails whilst using stairs and exposed overhead walkways, and not allowing the use of mobile phones and electronic devices in certain areas, so people can concentrate on where they are going.

“tread carefully so you can avoid the slippery slope of the consequences of slips, trips and falls”

These scenarios are just examples, based on my experiences in Europe, The Middle East, South East Asia and other parts of the world. A good source of information on these control measures, real-life “case studies” and other information can be found on the Health and Safety executive website.4

Remember, slip, trip, fall incidents can have an impact on a business, just like any other safety issue. Besides the injuries and economic costs already mentioned, do not forget the potential for being issued enforcement notices, fines or imprisonment for breaching legal requirements. Also consider the impact on morale of employees, and damage to reputation caused by incidents being seen in the public eye. Tread carefully so
you can avoid the slippery slope of the consequences of slips, trips and falls.

References

1 www.hse.gov.uk/statistics/overall/ hssh1819.pdf
2 www.hulldailymail.co.uk/news/hulleast-yorkshire-news/councils230000-bill-after-worker-2128334
3 www.hse.gov.uk/slips/experience/ leg.htm
4 www.hse.gov.uk/slips/casestudies.htm

Author Details

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James Pretty

HSE professional, holding Technician status with the Institute of Occupational Safety & Health (TechIOSH). James is an approved NEBOSH and IOSH Trainer, and specialises in Materials Handling Equipment Training, for which he is a qualified instructor through ITSSAR (International Trading Standards Scheme and Register), and RTITB (Road Transport Industry Training Board).

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