Ladder Use in Older People: Type, Frequency, Tasks and Predictors of Risk Behaviours
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Public Involvement
2.2. Demographic, Health, and Ladder Use Questionnaires
2.3. Vision, Physical, and Executive Function Assessments
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Faergemann, C.; Larsen, L.B. Non-occupational ladder and scaffold fall injuries. Accid. Anal. Prev. 2000, 32, 745–750. [Google Scholar] [CrossRef]
- Melmer, P.D.; Taylor, R.; Muertos, K.; Sciarretta, J.D. Stats and ladders: Injury risk and outcomes following falls from ladders. Am. J. Surg. 2020, 220, 1103–1107. [Google Scholar] [CrossRef] [PubMed]
- Schaffarczyk, K.; Nathan, S.; Marjadi, B.; Hsu, J.; Poulos, R. Non-occupational falls from ladders in men 50 years and over: Contributing factors and impact. Injury 2020, 51, 1798–1804. [Google Scholar] [CrossRef] [PubMed]
- Cabilan, C.; Vallmuur, K.; Eley, R.; Judge, C.; Cochrane, S.; Reed, C.; Riordan, J.; Roberts, K.; Thom, O.; Wood, G. Impact of ladder-related falls on the emergency department and recommendations for ladder safety. Emerg. Med. Australas. 2018, 30, 95–102. [Google Scholar] [CrossRef] [Green Version]
- Hsieh, T.-M.; Tsai, C.-H.; Liu, H.-T.; Huang, C.-Y.; Chou, S.-E.; Su, W.-T.; Hsu, S.-Y.; Hsieh, C.-H. Effect of Height of Fall on Mortality in Patients with Fall Accidents: A Retrospective Cross-Sectional Study. Int. J. Environ. Res. Public Health 2020, 17, 4163. [Google Scholar] [CrossRef]
- Ackland, H.M.; Pilcher, D.V.; Roodenburg, O.S.; McLellan, S.A.; Cameron, P.A.; Cooper, D.J. Danger at every rung: Epidemiology and outcomes of ICU-admitted ladder-related trauma. Injury 2016, 47, 1109–1117. [Google Scholar] [CrossRef]
- Spaniolas, K.; Cheng, J.D.; Gestring, M.L.; Sangosanya, A.; Stassen, N.A.; Bankey, P.E. Ground level falls are associated with significant mortality in elderly patients. J. Trauma Acute Care Surg. 2010, 69, 821–825. [Google Scholar] [CrossRef]
- Miu, J.; Dinh, M.M.; Curtis, K.; Balogh, Z.J. Ladder-related injuries in New South Wales. Med. J. Aust. 2016, 204, 302. [Google Scholar] [CrossRef]
- Scotti, S. Preventing elderly falls. NCSL Legisbrief 2016, 24, 1–2. [Google Scholar]
- Björnstig, U.; Johnsson, J. Ladder injuries: Mechanisms, injuries and consequences. J. Saf. Res. 1992, 23, 9–18. [Google Scholar] [CrossRef]
- Vallmuur, K.; Eley, R.; Watson, A. Falls from ladders in Australia: Comparing occupational and non-occupational injuries across age groups. Aust. N. Z. J. Public Health 2016, 40, 559–563. [Google Scholar] [CrossRef] [Green Version]
- Wu, W.; Gibb, A.G.; Li, Q. Accident precursors and near misses on construction sites: An investigative tool to derive information from accident databases. Saf. Sci. 2010, 48, 845–858. [Google Scholar] [CrossRef]
- Pliner, E.M.; Sturnieks, D.L.; Beschorner, K.E.; Redfern, M.S.; Lord, S.R. Individual factors that influence task performance on a stepladder in older people. Saf. Sci. 2021, 136, 105152. [Google Scholar] [CrossRef]
- Pliner, E.M.; Sturnieks, D.L.; Lord, S.R. Individual factors that influence task performance on a straight ladder in older people. Exp. Gerontol. 2020, 142, 111127. [Google Scholar] [CrossRef]
- Delbaere, K.T.; Smith, S.; Lord, S.R. Development and initial validation of the iconographical falls efficacy scale. J. Gerontol. Ser. A Biomed. Sci. Med. Sci. 2011, 66, 674–680. [Google Scholar] [CrossRef] [Green Version]
- Üstün, T.B.; Kostanjsek, N.; Chatterji, S.; Rehm, J. Measuring Health and Disability: Manual for WHO Disability Assessment Schedule WHODAS 2.0; World Health Organization: Geneve, Switzerland, 2010. [Google Scholar]
- Butler, A.A.; Lord, S.R.; Taylor, J.L.; Fitzpatrick, R.C. Ability versus hazard: Risk-taking and falls in older people. J. Gerontol. Ser. A Biomed. Sci. Med. Sci. 2015, 70, 628–634. [Google Scholar] [CrossRef] [Green Version]
- Lord, S.R.; Menz, H.B.; Tiedemann, A. A physiological profile approach to falls risk assessment and prevention. Phys. Ther. 2003, 83, 237–252. [Google Scholar] [CrossRef]
- Lord, S.R.; Ward, J.A.; Williams, P. Exercise effect on dynamic stability in older women: A randomized controlled trial. Arch. Phys. Med. Rehabil. 1996, 77, 232–236. [Google Scholar] [CrossRef]
- Ingram, L.A.; Butler, A.A.; Walsh, L.D.; Brodie, M.A.; Lord, S.R.; Gandevia, S.C. The upper limb Physiological Profile Assessment: Description, reliability, normative values and criterion validity. PLoS ONE 2019, 14, e02018553. [Google Scholar] [CrossRef]
- Schoene, D.; Delbaere, K.; Lord, S.R. Impaired Response Selection during Stepping Predicts Falls in Older People—A Cohort Study. J. Am. Med. Dir. Assoc. 2017, 18, 719–725. [Google Scholar] [CrossRef]
- Tombaugh, T.N. Trail Making Test A and B: Normative data stratified by age and education. Arch. Clin. Neuropsychol. 2004, 19, 203–214. [Google Scholar] [CrossRef]
- Lawton, M. Environment and Aging; Brooks/Cole Series in Social, Gerontology; Bengison, V., Ed.; Brooks/Cole Pub. Co.: Monterey, CA, USA, 1980. [Google Scholar]
- Safety, U.S.O.; Administration, H. Stairways and Ladders: A Guide to OSHA Rules; US Department of Labor, Occupational Safety and Health Administration: Washington, DC, USA, 2003. [Google Scholar]
- Kent, A.; Pearce, A. Review of morbidity and mortality associated with falls from heights among patients presenting to a major trauma centre. Emerg. Med. Australas. 2006, 18, 23–30. [Google Scholar] [CrossRef] [PubMed]
- Bedi, H.S.; Goldbloom, D. A review of nonoccupational ladder-related injuries in Victoria: As easy as falling off a ladder. J. Trauma Acute Care Surg. 2008, 64, 1608–1612. [Google Scholar] [CrossRef] [PubMed]
- Australian Competition and Consumer Commission. Ladder Safety Matters National Campaign. Available online: https://www.productsafety.gov.au/news/ladder-safety-matters-national-campaign (accessed on 24 June 2020).
- NSW Agency for Clinical Innovation. Steps to Home Ladder Safety. 2019. Available online: https://www.aci.health.nsw.gov.au/home-ladder-safety/home (accessed on 24 June 2020).
- Kim, S.C.; Ro, Y.S.; Shin, S.D.; Kim, J.Y. Preventive Effects of Safety Helmets on Traumatic Brain Injury after Work-Related Falls. Int. J. Environ. Res. Public Health 2016, 13, 1063. [Google Scholar] [CrossRef] [Green Version]
- Liddle, J.L.; Lovarini, M.; Clemson, L.M.; Jang, H.; Willis, K.; Lord, S.R.; Sherrington, C. Men’s perspectives on fall risk and fall prevention following participation in a group-based programme conducted at Men’s Sheds, Australia. Health Soc. Care Community 2017, 25, 1118–1126. [Google Scholar] [CrossRef]
Step Ladder | Straight Ladder | Fixed Ladder | |
---|---|---|---|
Below Average | 5 (4.9) | 18 (17.6) | 23 (22.5) |
Slightly Below Average | 12 (11.8) | 16 (15.7) | 13 (12.7) |
Average | 48 (47.1) | 42 (41.2) | 43 (42.2) |
Slightly Above Average | 19 (18.6) | 13 (12.7) | 9 (8.8) |
Above Average | 18 (17.6) | 13 (12.7) | 14 (13.7) |
Question | Step Ladder [n = 96] | Straight Ladder [n =56] |
---|---|---|
Common for me to | ||
Descend facing the ladder | 94 (97.9) | 54 (96.4) |
Descend not facing the ladder + | 4 (4.2) | 2 (3.6) |
Climb without using my hands + | 12 (12.5) | 0 (0) |
Climb with only one hand on the ladder | 32 (33.3) | 21 (37.5) |
Climb with both hands on the ladder | 67 (69.8) | 51 (91.1) |
Climb one step at a time | 72 (75.0) | 38 (67.9) |
Climb more than one step at a time + | 9 (9.4) | 6 (10.7) |
Climb without items in my hands | 43 (44.8) | 31 (55.4) |
Climb with items in my hands + | 72 (75.0) | 40 (71.4) |
Climb with a tool belt | 11 (11.5) | 8 (14.3) |
I climb | ||
A-frame ladders | 60 (62.5) | N.A. |
Step stool ladders (3 or less steps) | 84 (87.5) | N.A. |
On A-frame or straight ladder I have | ||
Stood higher than the recommended step height *+ | 41 (42.7) | 34 (60.7) |
Stood on the top cap/rung of the ladder | 15 (15.6) | 9 (16.1) |
Straddled the ladder | 13 (13.5) | N.A. |
On step stool ladders | ||
The guardrail was not present | 36 (37.5) | N.A. |
I held on to the guardrail | 37 (38.5) | N.A. |
I did not hold on to the guardrail | 15 (15.6) | N.A. |
Across all Ladders [n = 99] | ||
Common for me to stand | ||
With feet planted | 92 (92.9) | |
On my toes + | 15 (15.2) | |
With only one foot on the ladder + | 22 (22.2) | |
With my body in the middle of the ladder | 82 (82.8) | |
On the ladder while overreaching + | 34 (34.3) | |
Without someone holding the ladder + | 60 (60.6) | |
With someone holding the ladder | 47 (47.5) | |
With someone else on the ladder + | 3 (3.0) | |
I have moved a ladder by | ||
Hopping on the ladder + | 4 (4.0) | |
Climbing down and picking it up | 91 (91.9) | |
I have climbed a ladder when I was | ||
Fatigued | 14 (14.1) | |
Tired | 27 (27.3) | |
Dizzy | 0 (0) | |
Sick | 2 (2.0) |
Variable | Safe Ladder Users Mean (SD) | Unsafe Ladder Users Mean (SD) | |
---|---|---|---|
Age | 73.5 (6.1) | 72.9 (4.6) | t99 = 1.433 p = 0.155 |
Height | 1.69 (1.04) | 1.71 (0.84) | t99 = −1.304 p = 0.195 |
Weight | 71.7 (14.4) | 73.6 (11.9) | t99 = −0.707 p = 0.481 |
Trail-Making Test (B-A) (s) | 41.7 (20.6) | 44.2 (29.1) | t99 = −0.008 p = 0.994 |
Iconographical Fall Efficacy Scale | 15.4 (3.8) | 12.2 (2.7) | t99 = 5.220 p < 0.001 |
Everyday Risk-Taking Scale | 22.8 (4.8) | 26.7 (4.0) | t99 = −4.348 p < 0.001 |
WHO Disability Assessment Schedule 2.0 | 7.00 (6.45) | 3.36 (3.33) | t99 = 3.150 p = 0.002 |
Visual contrast sensitivity (dB) | 23.3 (1.3) | 23.4 (1.2) | t99 = 0.807 p = 0.422 |
Loop and Wire Test (errors) | 24.8 (13.6) | 17.8 (10.7) | t99 = 2.503 p = 0.014 |
Quadriceps Strength Test (kg) | 32.8 (13.8) | 38.8 (11.4) | t99 = −2.575 p = 0.011 |
Coordinated Stability Test (error score) | 5.8 (7.0) | 2.6 (3.7) | T98.9 = 2.687 p = 0.008 |
Choice Stepping Reaction Time Test (s) | 1.08 (0.14) | 1.03 (0.10) | T98.7 = 2.291 p = 0.024 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Hicks, C.; Pliner, E.M.; Lord, S.R.; Sturnieks, D.L. Ladder Use in Older People: Type, Frequency, Tasks and Predictors of Risk Behaviours. Int. J. Environ. Res. Public Health 2021, 18, 9799. https://doi.org/10.3390/ijerph18189799
Hicks C, Pliner EM, Lord SR, Sturnieks DL. Ladder Use in Older People: Type, Frequency, Tasks and Predictors of Risk Behaviours. International Journal of Environmental Research and Public Health. 2021; 18(18):9799. https://doi.org/10.3390/ijerph18189799
Chicago/Turabian StyleHicks, Cameron, Erika M. Pliner, Stephen R. Lord, and Daina L. Sturnieks. 2021. "Ladder Use in Older People: Type, Frequency, Tasks and Predictors of Risk Behaviours" International Journal of Environmental Research and Public Health 18, no. 18: 9799. https://doi.org/10.3390/ijerph18189799