CAUSES AND PATTERNS OF INJURY FROM LADDER FALLS

Objectives: To review all ladder fall injuries seen in a community ED and to identify patterns of injury, factors that contribute to falls, and what pre-event and event factors could have reduced the likelihood of a fall or a resulting injury. Methods: This was a retrospective, o bservational study involving patients who presented to a community hos pital ED from January 1993 through December 1995 with injuries from a ladder fall. The medical records of all patients were reviewed. Patien ts then underwent a structured telephone interview to provide addition al information about the circumstances of the fall, Results: There wer e 59 patients who sustained injuries relating to ladder falls. All wer e adults, aged >18 years (mean 42.9 +/- 16.2 years), were predominantl y male (93%), and had fallen a distance of 1-15 feet (mean 7.2 +/- 3.6 feet). Thirteen percent were admitted to the hospital, and there was 1 death. Fractures were observed in 21 patients (36%) and usually invo lved an extremity (77%), There was no relationship between the distanc e fallen and the occurrence of fracture. Other primary injuries includ ed sprain (27%), contusion (24%), laceration (10%), abrasion (3%), and subdural hematoma (2%). Of the 59 patients, 42 (71%) were contacted d irectly. Most falls (79%) resulted from excessive reaching or incorrec t ladder placement. Fifty percent of the described falls were occupati onally related. Conclusions: Falls from ladders, both in the occupatio nal and nonoccupational settings, often result in significant injury. Simple safety measures may have prevented the majority of falls in thi s study. Public health efforts should emphasize education on safe ladd er practices and techniques to reduce the possibility of injury in the event of a fall.