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.