Falls in and around homes are very common and often have the potential for life altering consequences. Irrespective of where they happen, falls are considered to be the leading cause of injury for hospital emergency room treatment. Irrespective of sex, race, and ethnicity, the mortality from falls increases dramatically with age. Often, among persons over the age of 65 years, they are also the primary cause for accidental deaths. Falls account for about 70% of the accidental deaths in persons over 75 years of age.
In 2009, 2.2 million older adults had experienced injuries from falls that required treatment in emergency rooms. Of this total, over 581,000 required hospitalization (CDC, 2011). Injuries from falls were found to be the leading cause of deaths among seniors over 72 and the second leading cause for those who are between 60-72 years of age (NSC, 2011). Falls are most common among children and adults over 65 years of age or older. Compared with children, seniors who fall are 10 times more likely to be hospitalized and eight times more likely to die as a result of a fall (Range, 1993).
More than 90% of the hip fractures are caused by falls and invariably these fractures occur in persons over 70 years of age. In 1996, more than 250,000 adults in the U.S. suffered fractured hips. The cost of hospitalization resulting from these injuries was in excess of $10B.
Available data clearly illustrate the direct cost associated with falls in and around the homes is staggering. The data reinforces the fact that the elderly among us are the most vulnerable to such falls. Significant reduction in the number of falls minimizing the hospital expenditures, hardship, and possibly deaths are possible with the adoption of simple preventive measures. The overall goal of this fact sheet is to make the general public aware of the causes of falls and the precautionary steps they can take to prevent falls in and around the homes.
Those who experience falls may be placed in one of three groups – children, adults of all ages in the work place, and adults (mostly elderly) in and around their homes. All falls may be placed in one of the two categories -- fatal or nonfatal.
Most fatal injuries result from falls from higher elevations. These types of falls are rare in and around homes. However, they are much more common in work places and workers in different types of industries account for a large majority of the fatal falls.
Nonfatal falls occur under varied circumstances in and around the homes and in the work places. In recent years, strict enforcement of new and existing regulations together with improved building codes have helped reducing the number of falls in work places.
Two groups that experience falls the most are children and seniors. These falls generally occur at the same level and usually they are nonfatal. However, hospitalization following falls is very common among seniors as discussed earlier. In and around the homes, falls from a higher elevation do occur periodically. Often these are due to varying reasons such as improper selection and use of equipment, and negligence. Even though falls in and around the homes may cause severe injury and hospitalization, they are rarely fatal.
The causes of falls may depend on where they happened and who has experienced the fall. To a large extend, it depends on whether the fall occurred in a work place or elsewhere. While a few of the causes associated with falls may be the same, they can be drastically different depending on whether the fall occurred in a work place or at home. The following are the possible causes of falls in and around the homes:
Nonfatal falls may cause injury to multiple or isolated body parts. Approximately 20% of such falls results in multiple body part injuries and the rest in the injury of isolated body parts. The body parts that are most frequently affected are backs, hips, knees, ankles, and wrists. Most common injuries resulting from nonfatal falls include the following:
There are number of simple steps one can take to prevent falls in the home surroundings and they are listed below. This section also discusses the use of Assistive Technologies (AT) for preventing falls.
Falls are the leading cause of injuries that require treatment in emergency rooms. For people over 65, falls are the primary cause of accidental death. Significant reduction in treatment costs and hardship are possible with the adoption of simple preventive steps.
CDC (Centers from Disease Control and Prevention). 2011. Preventing Falls: What Works: A CDC Compendium of Effective Community-based Interventions from Around the World. http://www.cdc.gov/HomeandRecreationalSafety/images/CDC_Guide-a.pdf
Grisso, R.D., J. Perumpral, S.C. Mariger, D.E. Suttle, K. Funkenbush, and K. Ballin.2007. Arthritis and Farming. Virginia Cooperative Extension, Publication Number 442-083, http://pubs.ext.vt.edu/442/442-083/442-083.html
Kendzior, R.J. 2010. Fall Aren’t Funny: America’s Multi-Billion-Dollar Slip-and-Fall Crisis. Government Institutes, Lanham, MD, pp224.
NSC (National Safety Council). 2011. Protecting Ourselves from Slips, Trips and Falls. http://www.nsc.org/safety_home/Resources/Pages/Falls.aspx
Range, J.W. 1993. The cost of injury. Emergency Medical clinic North America. 11:241-253
National Resources (Accessed July 7, 2011):
AgrAbility National Project. http://agrability.org/
Disabled Dealer. http://www.disableddealer.com
Life Essentials. http://www.lifeessentialsweb.com/controls.html
Foundation for Rehabilitation Equipment & Endowment (FREE). http://www.free-foundation.org/
National Center for Chronic Disease (CDC) Prevention and Health Promotion. http://www.cdc.gov
Virginia Resources (Accessed July 7, 2011):
Centers for Independent Living (CIL's) http://www.brilc.org/
Department of Rehabilitative Services (DRS) http://www.vadrs.org/
Easter Seals UCP North Carolina & Virginia http://nc.eastersealsucp.com/
Virginia AgrAbility Project http://www.agrability.ext.vt.edu
Virginia Assistive Technology Partnership (VATS) http://www.vats.org/
Virginia Disability Service Agencies http://www.vadsa.org/
Virginia Farm Bureau Safety (FB) http://www.vafb.com/
Woodrow Wilson Rehabilitation Center (WWRC) http://www.wwrc.net/
The authors would like to express their appreciation for inputs from: John Massale, Biological Systems Engineering and Jeremy Smith, Mechanical Engineering, at Virginia Tech. This fact sheet resulted from an Extension Project (project number 2006-41590-03436) supported by the Cooperative State, Research, Education, and Extension Service (CSREES) of U.S. Department of Agriculture.
Different types and styles are readily available in stores. One must recognize that all shoes sold in stores are not slip resistant. For example, shoes with rubber sole with treads will be more slip resistant than shoes with leather sole. Selecting the right kind of shoes particularly for seniors can make a big difference in preventing slips and falls.
When selecting shoes for the work place, one should consider the protection they can provide in addition to their slip resistance. The foot wear selected should be compatible with the type of work as well as the work surroundings. Shoes or boots worn when engaged in agricultural operations should have the following features:
The cleat-design is ideal on slippery surfaces because of the suction or squeezing action it can provide. The softer soles are better on slippery indoor surfaces. For outdoor uses, harder soles with more rugged cleats are preferred.
A ladder is one of the simplest most easy-to-use tools in the construction industry. However, accident data show that more than 160,000 people make emergency-room visits annually due to ladder accidents alone. Misuse and abuse of ladders in the workplace by working men and women in America have been identified as the primary causes of these accidents. Most ladder accidents can be avoided with proper selection of ladders and by strictly adhering to ladder safety rules. The following are general safety rules for all ladders:
For a more detailed listing of ladder safety rules, review: http://www.elcosh.org/en/document/163/d000170/ladder-safety.html
Virginia Cooperative Extension materials are available for public use, re-print, or citation without further permission, provided the use includes credit to the author and to Virginia Cooperative Extension, Virginia Tech, and Virginia State University.
Issued in furtherance of Cooperative Extension work, Virginia Polytechnic Institute and State University, Virginia State University, and the U.S. Department of Agriculture cooperating. Alan L. Grant, Dean, College of Agriculture and Life Sciences; Edwin J. Jones, Director, Virginia Cooperative Extension, Virginia Tech, Blacksburg; Jewel E. Hairston, Administrator, 1890 Extension Program, Virginia State, Petersburg.
July 29, 2011