In the world of health and safety, we talk about a vast array of potential dangers and events that could result in harm to people. A lot of these incidents would result in injuries to people, or some type of damage or harm to equipment, assets, the environment and so on. Others, however, can ultimately result in people losing their lives.

Fires, explosions, exposure to harmful substances and natural disasters are all examples of these high-impact scenarios, but one of the most common that I want to talk about today is people losing their lives due to falling from height. According to the United Kingdom’s HSE (Health & Safety Executive) 40 out of 147 fatalities in 2018/2019 were caused by falls from height. That is roughly 28% of all fatalities, and does not include the data on the numerous injuries, costs etc associated with other work at height incidents.

There are many work-related tasks which involve putting workers “at height”. Some of these could be constructing a roof on top of a building under construction, cleaning windows on a high-rise building using a rope access system, or working on lighting in a warehouse from a MEWP (Mobile Elevated Working Platform). However, what some people do not realise is that other tasks such as working next to an open manhole or excavation, or working from a small ladder can also be classified as working at height. A person does not have to fall very far, for them to unfortunately lose their lives. Even a fall of only a few feet could result in a fatality, if the victim strikes their head on something on the way down, or lands head first on the floor surface. So how exactly should we define working at height?

Hazard or hazardous activity?

Working at height should actually be defined as a “hazardous activity”. This is because there is more than just the one hazard of height. Workers and colleagues usually identify this as the main hazard, but do not take into account other hazards of their work. These hazards include falling objects, slip and trip hazards and environmental hazards, particularly high winds. The height of the fall certainly contributes to the consequences of the fall, but does not actually trigger the fall itself. It is important to remember this when conducting any risk assessment to ensure all workers are protected. Falls can be caused by slipping or tripping on trailing cables or slippery surfaces, the collapse of a structure (such as a scaffold) or even a dynamic change in environment, such as a sudden increase in wind speed. Falling objects could land on people working below the workers with enough force to cause serious injury (this could include a person falling from height not having their landing cushioned just because they landed on another person).

The ideal thing to do with a task of working at height, is to use the Hierarchy of Control, and eliminate it. Through elimination, we get rid of the hazard altogether, which therefore means we also get rid of the associated risks. For example, we could use modern technology such as a drone fitted with a camera to inspect a tower or roof of a building, without having to physically send any people to the place we want to inspect. If there is nobody on the tower or roof, there is no potential for people to fall and suffer the consequences. However, this is a best case scenario. The real world does not always allow us to do the best and safest method, as much as we would all like to. So realistically, some tasks involving work at height will always be necessary. So what can we do to protect our workforce?

Protection against consequences

When work at height is necessary we need to competently conduct a risk assessment, and implement the appropriate control measures to that particular task. This will depend upon many factors, including the nature of the task, and the conditions the work is being carried out in. If we cannot use elimination, other parts of the Hierarchy of Control could be used, such as Engineering and Administrative Controls. As always, PPE should be the last thing to consider. Often workers are told to wear harness and lanyards systems as their only safeguard against a fall. Some workers are not even given this choice. As well as the generic hierarchy of control, there is a more specific hierarchy you can use for working at height. This is:

  1. Eliminate the work at height
  2. Prevent falls
  3. Minimise the distance and consequences of falls

The best thing to do as I have already mentioned is to totally eliminate the need to work at height; think of the drone example I mentioned earlier. If we cannot do this totally, why not limit the amount of work that needs to be done, or the amount of time that is needed to work at height. For example, when building and assembling giant mining vehicles (such as dump trucks and hydraulic excavators) on site, many of the pieces are put
together on the ground. When they are lifted into position, the workers only need to be at height for as long as it takes to secure the pieces into place (via bolting, welding, etc).

If workers must be at height, then the next best thing we can do is “prevent falls”. Having some form of barrier is one of the best ways to do this. These can include guardrails and toe boards on scaffolding, or raised walls on open roofs. You could also have your colleagues work “in-restraint”. These are systems that can look similar to a traditional harness and lanyards system. However, the combination of anchor point placement and minimal length of lanyard will prevent the workers from reaching any ledges or open areas they can fall into, hence no fall. Some workers may raise issues with these systems, saying that their movement or work area is restricted, so it is important to educate them on the benefits they are gaining.

Having done our best to prevent falls, our last line of defence is to “minimise the distance and consequence” of the fall. This is where the traditional harness and lanyard is usually used. However, these can be totally ineffective. For example, if workers are not trained on their use, they can fit them incorrectly. If a person falls and harnesses are fitted too loosely, this can result in people falling out of the harness, or leg straps causing serious injury to the groin area of the wearer. Harnesses fitted too tightly can cut into wearers. Workers may not use hooks correctly, rendering their harness useless. At relatively low heights, persons who fall can strike the ground before the deceleration pack on a lanyard has time to take effect. Most deceleration packs on lanyards require a “fall distance” of at least six metres to be effective. This information can be found on the pack itself. Other things you can consider are placing nets at various levels to catch falling people and objects, having “drop zones” below the work to prevent unauthorised personnel being struck by falling objects/people, or using “crash mats” and “airbags” to cushion falling people/objects.

Reacting to a fall

As health and safety professionals, we always try to plan for the worst, and hope for the best. So what happens if it all goes wrong, and we do have a fall from height? There are many occasions where a person has had a fall from height, and their harness and lanyard system has worked perfectly, preventing them from hitting the ground by stopping their fall. However, this now leaves the victim suspended in mid-air. If workers are suspended for any period of time, they can potentially suffer from harness trauma and other conditions and injuries.

“if workers are suspended for any period of time, they can potentially suffer from harness trauma and other conditions and injuries”

Harness trauma comes about through the pooling of blood in the lower part of the person’s body. This can feel like “pins and needles”, which can be very painful. Depending upon what research or advice you see, persons can be in a life-threatening situation as early as 15 minutes from the initial fall. This can be compounded when a person is lowered to the floor. Many victims are immediately laid down, or put into the recovery position by rescuers. This can cause a sudden surge of blood flowing to the heart causing heart attacks. As well as the injuries mentioned earlier, other injuries can occur during the fall itself through striking objects, or swinging into structures. The metal buckle on a chest-strap can also damage the wearer’s breastbone of their chest. Imagine striking someone in the chest with a hammer. The bone cracks and breaks, damaging the lungs, and causing them to fill with blood. Blood in the lungs causes the victim to lose the ability to breath, again, a nasty thing to happen! Another issue is that components of a fall prevention or arrest system can fail. For example damaged components can break, sharp metal edges can cut through webbing of straps, or the tie-off point, structure or equipment for the safety hook can fail. Ultimately, many persons have to be rescued by the emergency services, particularly the Fire and Rescue Authority. The danger here however is that the Fire and Rescue Authority do not always have the necessary information, training, instruction or equipment to carry out a rescue at height. This means that they put themselves at unnecessary risk, meaning there is the potential for avoidable additional casualties, or there will be a further delay as the necessary personnel and resources are brought in. So it is incredibly important not to be relaxed about seeing someone dangling in a harness and thinking they are safe. So how do we deal with such a nightmare scenario?

“working at height incidents can have severe consequences not only for the victim, but colleagues, emergency services and all other persons involved”


Whilst we do not want the fall to occur, let’s train our workforce on how to react, should a fall or emergency situation come about. You could have other work at height rescue scenarios. Imagine if a Tower Crane Operator fell ill in the cab of their machine. How do you get them down? Give the required specialist training to any potential members of your workforce who would need to perform rescues, and supply them with the equipment required. It is important to remember “Work at Height” training is not “Rescue from Height” training. There are many companies who can provide this specialist training and knowledge, or you could approach suppliers of rescue equipment. As always, however, it is
necessary for the users of any systems to be competent in their use. Often training companies will ask if you have rescue equipment already, and will base the training they deliver on the system you have. Otherwise, they will conduct training with a specific system, and then you will have to purchase that system. Include in your rescue plan any necessary response from emergency services that may be required to give specialist treatment to the victim, or bring in specialist rescue equipment, before transporting any victim/s to a medical facility. Liaise with these services, to see what expertise and equipment they have, where it is located, and what you would require should you need to utilize their services. Practice this plan wherever possible. Is it sufficient? Does anything need to change? Follow the PDCA principle (Plan, Do, Check, Act) until you are satisfied that the plan works as it should. Health and safety is a massive and varied field, which can include complex subjects such as recuse at height. Whilst lots of people possess general health and safety knowledge and experience, there are people and companies who specialise in one particular area or field. If you feel you lack the expertise in such matters or you have any doubts, approach these consultants and experts to help you become informed on what systems and controls you would need to put into place, for your particular industry, job or task. Remember, the only stupid question is the one left unasked.


Working at height incidents can have severe consequences not only for the victim, but colleagues, emergency services and all other persons involved. At best, the victim could develop a psychological condition, such as a fear of heights. At worst, we potentially lose a skilled, experienced and valued member of our team, maybe even a friend or loved one. Making sure everyone involved has been given the correct information, training and instruction on the work at height, and the necessary measures to be put into place (including use fall prevention and arrest systems and equipment), we can ensure that we do all what is necessary to eliminate falls from height, or at the very least, mitigate the severity of the consequences. Like many other important systems, equipment and training in health and safety, there is always going to be a monetary cost involved with trying to ensure the prevention, or decreasing the severity of, falls from height, and associated work at height incidents. This cost is minimal however compared to the psychological and human cost, of losing a colleague in an event that is entirely preventable. Remember, the best thing to do is eliminate the need to work at height at all. Invest in new working methods and technologies. Don’t forget to consult the workforce also, as they may have ideas no-one else has thought of. Lets make it “Safe for all, by stopping the fall”.