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Results for “fall from height”

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PubMed1992

Are hearing loss and balance dysfunction linked in construction iron workers?

The objective was to determine whether an association existed between hearing loss and balance dysfunction in construction workers exposed to noise. Screening pure tone audiometry and balance testing were performed using a sound emitter and dual microphone system to evaluate 78 iron workers who were compared with 128 histology technicians. Most iron workers showed hearing loss at frequencies below 3000 Hz. Their sway speeds were significantly faster both with the eyes open (1.05 (SD 0.39) v 0.91 (SD 0.22) cm/s) and with eyes closed (1.66 (SD 0.82) v 1.31 (SD 0.51) cm/s) than those of histology technicians. Coefficients for sway speed with the eyes closed and hearing loss in the left ear were significantly correlated at 500 to 8000 Hz. They were also correlated with the sway speed, eyes open, at low and high Hz. It is concluded that the use of air impact power tools in an inordinately noisy work environment makes iron workers prematurely deaf and impairs their balance. Falls may be related to balance dysfunction and impaired equilibrium. Falls from height injure and kill iron workers. Further investigations will determine whether injuries from falls are linked to these impairments.

Accidental Falls↗

PubMedDate not supplied

Fatalities and serious injuries.

The construction industry has major fatality problems relating to falls from heights, electrical contact, reversing vehicles, trench wall collapses, and workers being struck by falling or moving objects. Serious-injury problems relate to housekeeping, manual materials handling, direct installation activities, and on-site in-transit activities. They vary from one construction trade to another and from one type of project to another. Each of the these problems can be reduced through the application of better site management, better training, and improved work practices. In some instances, changes in materials, tools, or equipment can be beneficial in reducing the incidence of fatal or serious injuries.

Accidents, Occupational↗

PubMed1998

[When children fall].

Second only to traffic accidents, accidental falling is the most significant cause of death in children. Included in this category is a special group of accidents--falling from a height--where preventative measures would give good results. Cases of child abuse have also been found in this group. From 1989 to 1994 64 children, 19 girls and 45 boys, were treated in our surgical department after accidental falls. There were 99 injuries in all, most of them caused by falls from heights less than 2.5 m. Only two children suffered penetrating injuries. Two of the 64 children died from cerebral injuries after falling from great heights. One child died from heart tamponade, caused by rupture of the right auricle after falling down a steep staircase. One child survived a fall from a great height despite multiple injuries. In such cases, treatment is dependent on a multiple trauma team being available on a 24-hour basis. Measures to prevent falls in the home, as well as in children's playgrounds and in kindergartens are not only very important, but also easy to apply. Suspicion of child abuse must be raised where unusual injuries are observed in children who have reportedly fallen from low heights.

Accidental Falls↗

PubMed2004

Nonfatal occupational injuries from slips, trips, and falls among older workers treated in hospital emergency departments, United States 1998.

BACKGROUND: Falls are a leading cause of injury among older adults. As the workforce demographics shift to an older population, the dearth of information on occupational falls among older adults must be addressed. METHODS: A national probability sample of hospital emergency departments (EDs) (National Electronic Injury Surveillance System) was utilized to characterize falls at work. RESULTS: Older workers were found not to be at increased risk of a fall injury, but were more likely than younger workers to be hospitalized post-injury. Same-level falls were the most common type of incident among older workers. Falls from height were more prevalent among men than women. The narrative case descriptions for same-level falls to the floor primarily implicated floor contamination and tripping hazards. CONCLUSIONS: Fall prevention programs targeted to older workers must examine extrinsic sources of falls, particularly surface traction, contaminant control, and footwear.

Accidental Falls↗

PubMed2005

Evaluation of hip fracture risk in relation to fall direction.

The purpose of this study is to evaluate hip fracture risk in relation to fall direction, and to elucidate factors that influence the impact force in falls on the hip. Eight healthy volunteers performed deliberate falls in three directions (lateral, posterolateral and posterior) on a force platform covered by a mattress of 13 cm thickness. Fall descent motions and impact postures were examined by a three-dimensional analyzer. The maximum ground force reaction, velocity of the greater trochanter at impact, and activity of quadriceps and gluteus medius were measured. In all trials of lateral and posterolateral falls, but not of posterior falls, the subjects hit their greater trochanter directly on the mattress. The impact forces were between 2,000 N and 4,000 N. Posterolateral falls showed significantly higher velocity at impact than did posterior falls. The height and the lower limb length exhibited positive correlations with the impact force in all directions of fall. In the lateral fall, there was a positive correlation between the activity of quadriceps and the impact force. In view of the impact point, force, and velocity, the posterolateral fall seemed to carry the highest risk of hip fracture.

Accidental Falls↗

PubMed2005

Injuries from slips and trips in construction.

Construction injuries preceded by a slip or trip were documented using data from the building of the Denver International Airport (Denver, Colorado, USA), the largest construction project in the world at the time. Slips and trips occurred at a rate of 5/200,000 h worked accounting for 18% of all injuries and 25% of workers' compensation payments, or more than $10 million. Slips contributed to the vast majority (85%) of same-level falls and over 30% of falls from height, as well as a significant number of musculoskeletal injures sustained after slipping or tripping but without falling. The injury burden would have been under-recognized in analyses of most coded compensation records. In contrast to other types of injuries, the most common contributing factors were environmental in nature including conditions of walking and working surfaces, terrain and weather. Due to the very dynamic nature of construction work, reducing slips and trips will require a focus on environmental and organizational solutions that evolve as the site changes and the construction project evolves.

Accidental Falls↗

PubMed2004

Analysis of text from injury reports improves understanding of construction falls.

OBJECTIVE: We combined payroll data, coded workers' compensation (WC) data, and text descriptions of injuries from the construction of Denver International Airport to create a more comprehensive picture of falls from height (FFH) than is typically available from WC data. Text descriptions were coded to identify circumstances surrounding falls. Slips/trips preceded one third of FFH, often involving motor vehicles or heavy equipment. Another third involved movement or collapse of work surfaces, usually ladders or scaffolds. CONCLUSIONS: The significant contribution of motor vehicles and heavy equipment to FFH, particularly those preceded by slips/trips, was not apparent from coded data. Heavy equipment engineering modifications are called for and workers in street/roadway construction/site development need fall protection training. Text analyses allow exploration of factors not identified at the time of data collection and better understanding of the context in which injuries occur.

Accidental Falls↗

PubMedDate not supplied

[Factors increasing life threat in patients with lesions of the spinal cord].

Mortality of spinal cord trauma has been analysed. An analysis included 3,486 patients treated early after spinal trauma in 1965-1989. Life threat in patients, who underwent trauma to the spinal cord embraces several factors. The most important is are: the level and degree of the lesion to the spinal cord, certain causes precipitating severe lesions to the nervous system, advanced age, and--to some degree--accompanying lesions, way of therapy, advances in medical technology, and intensive treatment technics. Available data indicate that the life of patients admitted to the hospital with symptoms of complete interruption of the cervical segment of the spinal cord is threatened to the highest degree. Falls from heights (scaffolding, roofs etc.), and certain road accidents are particularly dangerous. A special group of accidents is fall from the horse carriage in which advanced age of the victims plays the most important role. Mortality rate in the elderly is about tenfold higher, than in the group of subjects under 20 years with the same degree of lesions to the spine.

Accidents↗

PubMed1997

Growth monitoring with the British 1990 growth reference.

AIM: To provide a simple method for assessing centile change based on the British 1990 growth reference. STATISTICAL METHOD: The change in SD score over a period of time has SD square root of 2(1-r), where r is the correlation between the first and second SD score. This leads to an SD score for centile change. DATA: Annual height measurements from 2 to 9 years for 318 children from the French longitudinal growth study. RESULTS: The correlations between heights at different ages are higher for shorter measurement intervals and at older ages. The chance of a child's height centile falling one centile band width is correspondingly smaller for shorter measurement intervals and at older ages. An increase in height measurement error reduces the correlations and dramatically increases the chances of centile crossing. CONCLUSIONS: Quantitative height monitoring based on centile change is provided for whole year periods between 2 and 9 years of age. Effective monitoring requires the measurement error to be as small as possible.

Age Distribution↗

PubMed2006

Distribution and circumstances of injuries in squatter settlements of Karachi, Pakistan.

OBJECTIVES: This research was conducted to study incidence, distribution, type, causes, severity and circumstances of injuries among people living in squatter settlements in Karachi, Pakistan. METHODS: Trained interviewers sought a 2 weeks recall for minor injuries for which no health care was sought, 2 months recall for major injuries for which a health provider was consulted and 1 year recall for hospitalization, disability and death from every third household in five squatter settlements in Karachi between May and August 1995. For understanding the injury circumstances 250 in-depth interviews of the injured or the close relatives were also conducted. RESULTS: Among 1182 households, having 9891 residents, 84 minor, 42 major injury episodes, 7 hospitalizations, 0.6 permanent disabilities and 0.3 deaths per 1000 person years were reported. Including all injury episodes, the common types of injury were cutting or piercing (n = 532), falls (n = 382) and burns (n = 235) estimating to 54, 38 and 23 injury episodes per 1000 person years. Injury mainly resulted from a piece of glass (n = 367), falling from height (n = 98) and knife (n = 97) estimating to 37, 10 and 10 injury episodes per 1000 person years, respectively. Fall (n = 32, 3.2/1000 person years) was the major reason for hospitalizations and all permanent disabilities resulted from closed injuries. Medically trained providers were mostly contacted (n = 339, 34/1000 person years), but traditional healers were preferred in bone injury. CONCLUSION: Injuries are a major cause of morbidity and mortality in Pakistan and the national health and development agenda should include assessment and prevention of injuries.

Adolescent↗

PubMed1996

Pattern of acute head injuries in Kuwait.

Of two hundred and six consecutive head injuries, 28% had fallen from heights, and 58% had been involved in road traffic accidents, mainly pedestrians (50%). Head injury preventive measures in Kuwait should be directed to road traffic accidents and falls from heights.

Accidental Falls↗

PubMed2003

Work-related injuries in residential and drywall carpentry.

Findings are reported on the first two years of an active injury surveillance project designed to test the utility of active injury investigations in identifying causes of injury among a large cohort of carpenters who did residential building and drywall installation. Occupational Safety and Health Administration recordable injuries were reported by participating contractors. Injured union carpenters were interviewed by experienced journeymen trained in a standard questionnaire protocol. Enumeration of workers and hours worked were provided by the union. These data allowed the definition of a dynamic cohort of 4429 carpenters, their hours worked, detailed information on the circumstances surrounding recordable injuries, and possible preventive measures from the perspectives of the injured worker and an experienced journeyman investigator. The overall estimated injury rate (16.9 per 200,000 hours worked) was considerably higher than recent Bureau of Labor Statistics rates despite less than complete ascertainment of injuries. Injuries most commonly involved being struck by or against something, manual materials handling injuries, and falls. Manual materials handling injuries often involved very heavy objects or tasks and were injuries carpenters most often reported needs for adequate help and coordinated team work to prevent. Falls from heights occurred from a variety of surfaces and were not just injuries of inexperience. Carpenters reported the need for more attention to common fall protection practices, such as the use of more toe boards and guardrails. Poor housekeeping was involved in the majority of same level falls, as well as some manual materials handling injuries.

Adolescent↗

PubMed2003

Homicide-suicide in Hong Kong, 1989-1998.

This study provides the first systematic research of homicide-suicide (HS) in a Chinese society. Data were drawn from the HK Homicide Monitoring Data-base computer file derived from investigation and death reports held by the HK Police Force and the Coroner's Court. During the 10-year study period, 56 events involving 133 deaths were identified. The majority of offenders were males (75%) and most victims were female (64%). The mean age of offenders and victims were 41.9 and 32.3 years, respectively. Spouses and lovers comprised the majority of victims (46.4%) followed by child victims (36%). Most HS events were motivated by separation or termination of marital or sexual relations (39%), economic reasons (25%) and other domestic disputes (20%). The most frequent modes of killing were strangulation/suffocation (26%), stabbing/chopping (24%), followed by gassing/poisoning (14%) and falling from a height (14%). The commonest method of suicide was falling from a height (48%). It was followed by gassing/poisoning (22%) and strangulation/suffocation (13%). Depression (18.3%) was found to be the commonest mental disorder. Most offenders were from low-socio-economic background. Two-third were unemployed and 76.6% had 9 or less years of education. HS in HK were distinguished from those reported in the western literature in respect to the high relevance of economic factors, the absence of mercy killing between old couples, a higher percentage of pedicide-suicides and the infrequent use of firearms.

Adult↗

PubMed1997

Injury severity associated with nonfatal construction falls.

This study evaluated injury severity in a group of construction workers who sustained nonfatal falls at work. The sample consisted of 255 adults who were identified from Doctor's First Reports (DFRs) submitted to the California Department of Industrial Relations. For those that fell from heights (n = 195), the mean height of fall was 9.2 feet (SD = 7.1). The mean number of lost work days was 44.3 days (SD = 58.6) and the median was 10 days. Two measures of injury severity were used--the Injury Severity Score and the disability section of the Health Assessment Questionnaire (HAQ). Seventeen participants (7%; 95% CI, 4-10%) were deemed permanently disabled. A simultaneous multiple regression model, using five independent variables, explained approximately 21% of the variance in HAQ scores. Nonunion status and safety climate scores indicating increased risk were positively correlated with higher functional limitation as measured by HAQ scores, as were greater heights and impact on concrete surface. Higher scores on both injury severity measures were significantly and moderately associated with a greater number of days lost from work. These findings suggest that injury severity and permanent disability associated with falls in construction are notable, and identify key target areas for intervention and prevention.

Accidental Falls↗

PubMed2003

Falls in residential carpentry and drywall installation: findings from active injury surveillance with union carpenters.

Active injury surveillance was conducted with a large, unionized workforce of residential and drywall carpenters over a 3-year period. Injured carpenters were interviewed by trained carpenter investigators and sites were visited where falls occurred. Qualitative information was collected on exposures, risk perception, training, and mentoring. Falls accounted for 20% of injuries. Same-level falls were often related to weather, carrying objects-sometimes with an obstructed view-housekeeping, terrain of the lot, and speed of work. Falls from height occurred from a variety of work surfaces and involved ladders, scaffolding, roofs, work on other unsecured surfaces, unprotected openings, speed, and weather conditions. Recognized fall protection strategies, such as guardrails, toe boards, tying off to appropriate anchors, and guarding openings, would have prevented many of these falls; these practices were not the norm on many sites.

Accidental Falls↗

PubMed2000

Delayed presentation of abdominal bleeding in a teenage boy after a fall.

The delayed presentation of an abdominal bleed in a victim of a fall is a rare occurrence. In the multiple injured patients, even with an intact sensorium, competing pain from associated injuries may mask the pain from a occult injury. Although a rare occurrence of abdominal injury in an asymptomatic neurologically intact patient, in the patient requiring a computed tomography scan of a spinal fracture, it may be worthwhile to image the abdomen and pelvis as well to rule out a concomitant occult abdominal injury. Current literature regarding injuries associated with falls from height are discussed that support this position and the delayed manifestation of an abdominal bleed in a 17-year-old boy 1 day after a fall is presented.

Accidental Falls↗

PubMed1999

Analysis of blunt trauma injuries: vertical deceleration versus horizontal deceleration injuries.

There are several similarities found in blunt trauma injuries to humans sustained as a result of vertical deceleration (falling) and those sustained as a result of deceleration in a horizontal plane (automobile accidents). However, examination of the patterns of traumatic skeletal injuries can distinguish those injuries associated with falling from heights from those associated with automobile accidents. While there is considerable variation within each type of blunt trauma injury dependent on the angle at which one falls or is struck, there are several characteristic skeletal features associated with each type of trauma. In this study we review both the current literature and human skeletal remains from the University of New Mexico's Documented Collection known to have been subjected to blunt trauma. This collection is used to characterize and differentiate the pattern of skeletal injuries to various parts of the body for each type of trauma. These assessments are applied to investigate the traumatic skeletal lesions observed in a forensic case where the manner of death is unknown. Analyses suggest two possible scenarios that would explain the death of the individual investigated, with death most likely related to a vehicular-pedestrian accident.

Accidental Falls↗

PubMed2005

The role of pelvic fractures in the course of treatment and outcome of trauma patients.

BACKGROUND: Pelvic fracture poses a complex challenge to the trauma surgeon. It is associated with head, thoracic and abdominal injuries. As pelvic fracture severity increases so does the number of associated injuries and the mortality rate. OBJECTIVES: To report our experience in the treatment of pelvic fractures. METHODS: Between October 1998 and September 2001, 78 patients with pelvic fractures were admitted to our hospital. The age range of the 56 male and 22 female patients was 16-92 (mean 42 years). The cause of injury was road accident in 52 patients, fall from a height in 15, a simple fall in 9, and gunshot wounds in 2 patients. The Glascow Coma Scale score on arrival at the hospital was 3-15 (average 12). Twenty-five patients (32%) were admitted to the intensive care unit, 38 (48%) to the orthopedic department, 5 (6.4%) to neurosurgery and the remainder to a surgical department. RESULTS: Twenty-six patients (33.3%) received blood transfusion in the first 24 hours. Of the 25 patients with associated head trauma, 6 had intracranial bleeding (32%); 29 patients (37%) had associated chest trauma, 28 (35.9%) had associated abdominal trauma, 16 (20.5%) had vertebral fractures and 40 (51.2%) had associated limb fractures. Pelvic angiography was performed in 5 patients (6.4%), and computed tomography-angiography of the cervical arteries and chest was performed in 1 and 5 patients respectively. Overall, a CT scan was performed in 56 patients (71.8%), of whom 25 (32%) had a pelvic CT on admission. Injury Severity Score was 4-66 (median 20). Laparotomy was performed in 14 patients (18%), spinal fusion in 5 (6.4%), limb surgery in 16 (20.5%), cranial surgery in 4 (5.02%), pelvic surgery in 10 (12.8%), chest surgery in 3 (3.85%), and facial surgery in 2 patients (2.56%). Seven patients (9%) died during the course of treatment. CONCLUSIONS: Pelvic fracture carries a high morbidity rate. Associated chest, abdomen and limb injuries are often encountered. A multidisciplinary approach is needed to improve survival and outcome in patients with pelvic fractures.

Adolescent↗