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Workplace Hazards - Slips ,trips and fall<\/p>\n\n

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1. Introduction & scope<\/p>\n

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Slips, trips and falls (STFs) are among the most common causes of injury worldwide across settings (community, workplace, and healthcare). They range from minor injuries to major trauma and death; fall-related injuries are a major public-health burden, especially for older adults, and STFs account for a substantial share of occupational injuries and lost-work time. <\/p>\n\n

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2. Epidemiology<\/p>\n\n

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Globally, hundreds of thousands of deaths and many millions of nonfatal injuries result from falls each year; mortality is concentrated in older adults and low-\/middle-income regions. <\/p>\n\n

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In occupational settings, STFs on the same level are a leading contributor to nonfatal workplace injuries and account for significant economic cost (lost workdays, medical costs). Healthcare, construction and service sectors are frequently reported as high-risk. <\/p>\n\n

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3. Mechanisms & biomechanics<\/p>\n\n

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STFs occur when balance\/stability is disrupted. For slips, sudden low friction between shoe and floor produces a rapid relative motion; for trips, an unexpected obstruction or insufficient foot clearance interrupts gait. The body\u2019s ability to detect\/slowing down, adapt gait, or execute corrective stepping determines whether recovery or a fall occurs. <\/p>\n\n

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Laboratory and modeling studies describe kinematic (step length, foot velocity), kinetic (ground reaction forces), neuromuscular (EMG responses) and sensory contributions to recovery vs. fall outcomes. These studies underpin design of slip-resistance tests and interventions (flooring, shoe tread, gait training). <\/p>\n\n

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4. Risk factors<\/p>\n\n

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Risk factors are multi-level and interact:<\/p>\n\n

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Environmental \/ engineering<\/p>\n\n

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Low coefficient of friction (contaminated or wet floors), uneven surfaces, poor lighting, transitions between surfaces, clutter, stairs without handrails. <\/p>\n\n

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Human \/ individual<\/p>\n\n

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Age (older adults: balance, vision, strength decline), gait impairments, footwear choices, fatigue, distraction, cognitive impairment, medication effects. <\/p>\n\n

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Organizational \/ task<\/p>\n\n

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Inadequate housekeeping, rush\/production pressure, insufficient training, poor reporting systems, and lack of maintenance increase STF risk. Workplace culture and hazard surveillance matter. <\/p>\n\n

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5. Measurement and assessment<\/p>\n\n

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Objective measures: Coefficient of friction (COF) tests, tribometers, slip-resistance standards (vary by jurisdiction), instrumented gait labs for biomechanics.<\/p>\n\n

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Observational \/ administrative: Hazard inspections, incident\/near-miss reporting, workplace safety audits, checklists, and video analysis. These complement lab measures because real-world slipping depends on behaviour, contaminants, and context. <\/p>\n\n

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6. Interventions & evidence of effectiveness<\/p>\n\n

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Interventions are typically grouped as engineering, administrative\/behavioural, and personal protective strategies. Systematic reviews and major guidance emphasize multi-component approaches.<\/p>\n\n

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Engineering controls<\/p>\n\n

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Flooring selection (higher slip resistance in wet areas), proper drainage, anti-slip treatments, well-designed stairs, and non-slip mats in targeted zones reduce environmental risk. Evidence supports effectiveness when implemented appropriately, but outcomes vary with context and maintenance. <\/p>\n\n

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Footwear<\/p>\n\n

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Appropriate slip-resistant footwear reduces slip risk, especially in occupational settings with contaminants. Effectiveness depends on fit, tread design, and compatibility with the surface\/contaminant. <\/p>\n\n

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Housekeeping & maintenance<\/p>\n\n

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Regular cleaning, prompt spill response, good signage and floor maintenance consistently appear in effective prevention programs. Several workplace intervention studies report reductions in incidents when housekeeping and inspection protocols are strengthened. <\/p>\n\n

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Administrative \/ training<\/p>\n\n

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Worker training, awareness campaigns, hazard identification programs, and improved reporting\/feedback systems can reduce incidents\u2014especially when combined with engineering controls. However, training alone typically produces smaller or short-lived effects compared to multifactorial programs. <\/p>\n\n

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Multifactorial programs<\/p>\n\n

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The strongest and most consistent evidence supports multifactorial interventions (combining engineering changes, footwear, housekeeping, training, and organizational systems). Reviews and guideline documents recommend integrated programs tailored to setting and population. <\/p>\n\n

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7. Best-practice guidance<\/p>\n\n

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WHO, NIOSH and recent global guidelines emphasize: (1) use of risk assessments and surveillance data, (2) prioritizing engineering fixes, (3) targeted training and behaviour support, and (4) monitoring and continuous improvement. Tailoring interventions by workplace type (e.g., healthcare vs. construction vs. retail) is essential. <\/p>\n\n

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8. Gaps in the literature & research needs<\/p>\n\n

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Real-world effectiveness: Many lab studies show promising mechanisms, but more pragmatic trials and long-term, controlled evaluations of large-scale multifactorial programs are needed. <\/p>\n\n

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Context sensitivity: Heterogeneity in surfaces, contaminants, footwear, and behaviours makes generalization difficult\u2014studies must report context details and maintenance protocols. <\/p>\n\n

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Older adult interventions outside clinical settings: Most fall research focuses on community\/clinical settings; cross-application to workplaces and public spaces needs more evidence. <\/p>\n\n

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Implementation science: Better understanding of how to implement, scale and sustain multifactorial programs (cost-effectiveness, organizational barriers) is limited. <\/p>\n\n

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9. Practical recommendations (based on the evidence)<\/p>\n\n

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1. Conduct regular hazard assessments and robust incident\/near-miss reporting to target high-risk zones. <\/p>\n\n

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2. Prioritize engineering controls (appropriate flooring, drainage, lighting, handrails) before relying on training alone. <\/p>\n\n

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3. Use slip-resistant footwear where appropriate and ensure footwear is compatible with workplace surfaces and tasks. <\/p>\n\n

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4. Implement multifactorial programs (housekeeping, signage, training, maintenance schedules) and measure outcomes over time. <\/p>\n\n

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5. Evaluate interventions with clear context reporting and follow up to confirm sustained impact. <\/p>\n\n

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10. Conclusion<\/p>\n\n

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The literature shows a mature understanding of the biomechanics and environmental contributors to STFs, and consistent evidence that multifactorial, prioritized engineering interventions plus organizational systems reduce STF risk. However, implementation and long-term, real-world effectiveness require further high-quality, context-rich evaluation.<\/p>\n\n

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References <\/p>\n\n

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Chang WR, et al. State of science: occupational slips, trips and falls on the same level. 2016. <\/p>\n\n

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Montero-Odasso M, et al. World guidelines for falls prevention and management for older adults (Lancet\/Special Collection). 2022. <\/p>\n\n

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Redfern MS. The biomechanics of slips. Review (2001). <\/p>\n\n

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Dyreborg J, et al. Safety interventions for the prevention of accidents at work. Systematic reviews (2022). <\/p>\n\n

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NIOSH. Slip, trip, and fall prevention resources and reports. (NIOSH guidance & reports). 2008\u20132024. <\/p>\n\n

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WHO. Falls fact sheet and Global report on falls prevention in older age. 2007\u20132021.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"7db479da-8bf3-4608-bac7-4e2976c3a355"},"useSeparator":"auto"}]}

Slips , Trips and falls in a community centre

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Angela