Ladder accidents account for nearly 5% of all reported occupational ac
cidents in the Swedish construction industry. Eighty-five ladder accid
ent victims were interviewed to obtain detailed information about fact
ors contributing to their accidents. Accidents were almost equally div
ided between straight ladders (N = 39) and step- ladder (N = 33). The
majority of accidents occurred while the victim was working from the l
adder. Climbing up and, particularly, down straight ladders was associ
ated with numerous accidents. For straight ladders, sliding at the bas
e was the most common event preceding the injury. Low angle of inclina
tion was a common contributing factor. For step-ladders, tipping sidew
ays was the most common preceding event. Misstepping the final step wh
ile descending accounted for 10% of all accidents. More than 90% of th
e victims fell from less than 4 m. The interviews provided detailed in
formation which served as a basis for proposals for alternatives to po
rtable ladders; a step-scaffold adjustable for work at levels up to 3
m and a portable scaffold for work at levels of 1-3 m. These alternati
ves are under development. In addition, proposals for improving the st
ability of current portable ladders are made.