Prevention of Same Level Falls
A More Global Appreciation of This Type of Accident
by Sylvie Leclercq
Until the beginning of the 1990s, research into the prevention of same level falls
was particularly focused on slipping. This work is linked to methods for the measurement
of slip resistance. It pointed out the necessity to conduct studies on strategies
used by the subject in order to deal with the risk of falling or a loss of balance.
These more recent studies take into account a much wider range of events that occur
before and after the loss of balance. After briefly reviewing the motivation, objectives,
and obstacles to progress associated with slip resistance measurement, an overview
of studies on perturbed locomotion and posture is presented. Different contexts
where there is a risk of falling will be defined. Sensory information that allows
one to anticipate or to appreciate the risk of falling or to perceive a loss of
balance, as well as certain factors that modulate the treatment of this information
will be given for each of these situations.
Introduction
If all occupational sectors are taken together, same level falls represent at least
20% of all occupational accidents (Skiba, 1983; H.S.E., 1985; CNAM, 1995). In Sweden,
slipping is a contributory factor in 12% of occupational accidents (Strandberg &
Lanshammar, 1981). In France in 1993, 2% of fatal accidents involved same level
falls and 22% of days lost to temporary incapacitation were due to same level falls.
In Sweden, the average number of days lost to each non-fatal occupational accident
where slipping contributed is approximately 30 (Strandberg, 1983). Fractures are
the most frequently evoked injury in the case of a fall (Manning, 1983; Skiba, 1983;
Buck & Coleman, 1985; Gagey, 1994). The prevention of this type of accident
has been studied for more than 30 years at institutes specialized in the prevention
of accidents, as well as at universities mandated by these institutes.
The goal of this article is to briefly review the work in the area of slip prevention-a
detailed analysis of this work has been presented by Leclercq (1997)-and to show
that these studies have demonstrated the need for a more global approach to the
prevention of same level fall accidents. In this vein, studies have been carried
out where the authors did not concentrate solely on the event that triggered the
accident (slipping for example), but rather considered more broadly the succession
of events that occurred before and after the loss of balance (cf. schema of an accidental
fall in Figure 1). An analysis of these studies allowed us to define different contexts
for different occupational situations where there is a risk of falling. Sensory
information that allows one to anticipate or to appreciate the risk of falling or
to perceive a loss of balance, as well as certain factors that modulate the treatment
of this information will be shown for each of these situations.
© 1999 National Safety Council and Elsevier Science Ltd
