slip and trip consequences

Slips, Trips, And Falls Hazards | How To Prevent Them

Every year, countless individuals experience the unexpected mishap of a slip, trip, or fall. These incidents occur across all age groups and settings, from homes and public spaces to workplaces. While often brushed off as minor inconveniences or embarrassments, slips, trips, and falls can lead to serious injuries and significant financial and emotional costs.

The key to tackling this pervasive issue lies in understanding the factors contributing to these accidents and implementing effective prevention measures. In this blog, we delve into the causes of slips, trips, and falls, their impact, and, most importantly, how we can prevent them.

By understanding these risks, we empower ourselves to create safer environments, whether looking at the comfort of our homes, the safety of public spaces, or the well-being of employees in a workplace. This guide aims to heighten awareness, encourage preventive action, and highlight our shared responsibility in reducing the risks and consequences of slips, trips, and falls. Join us as we navigate through this important topic step by carefully step.

The Importance of Preventing Slips, Trips, and Falls

The impact of slips, trips, and falls can be highly significant, from bruised shins to broken bones. These incidents aren’t just about physical injury. The repercussions can ripple outwards, affecting an individual’s quality of life, workability, and mental well-being. In the workplace, such accidents can lead to significant downtime, loss of productivity, and even legal implications for businesses. It’s estimated that the annual costs associated with occupational falls run into billions of dollars globally, impacting not just individuals but entire economies. Therefore, it’s clear that these everyday accidents are anything but trivial and that preventing them should be a top priority for everyone.

Basic Understanding of Slips, Trips, and Falls

To prevent these incidents, we first need to understand them. So, what exactly are slips, trips, and falls? A slip occurs when there is too little friction or traction between your footwear and the walking surface, leading to a loss of balance. A trip happens when your foot or lower leg hits an object, and your upper body continues moving, resulting in loss of balance. A fall can result from a slip or trip but can also occur due to other factors, like poor lighting, lack of handrails, or sudden illness.

Each of these incidents can occur under various circumstances. While some common causes include wet or uneven surfaces, poor footwear, and cluttered walkways, there can also be less obvious contributors, like insufficient training or awareness. This article aims to delve deeper into the world of slips, trips, and falls, elucidating their causes, impacts, and, most importantly, the strategies for prevention. The goal is not to instill fear but to inspire a culture of safety, vigilance, and proactive measures to keep everyone safe.

Definition and Differences: Slips, Trips, and Falls

While the terms ‘slips,’ ‘trips,’ and ‘falls’ are often used interchangeably, they refer to distinct occurrences. As we’ve already discussed, a slip occurs when there is insufficient traction between your foot and the walking surface. This lack of grip may cause an imbalance, leading you to fall.

Trips, on the other hand, occur when your foot contacts an object in its path or drops unexpectedly, causing you to lose balance. A trip might occur due to clutter, an obstacle in the pathway, or an uneven walking surface.

Finally, a fall is a sudden, uncontrolled descent for various reasons, including slips, trips, loss of consciousness, or other health-related issues. Falls can occur on the same level (for example, falling on the floor) or from one level to another (like falling down the stairs or from a ladder).

Common Causes of Slips, Trips, and Falls

Understanding the common causes of these incidents is the first step toward prevention. Below are some major factors that often contribute to slips, trips, and falls.

• Wet or Oily Surfaces: One of the most common causes of slips is the presence of wet or oily surfaces. This might occur in areas prone to spills or leaks, such as kitchens, bathrooms, and certain industrial environments.
• Uneven Surfaces, Irregularities, and Obstacles: Uneven walking surfaces or irregularities such as potholes, cracks, or abrupt transitions can cause trips. Obstacles might include clutter, cords, open drawers, and other items that haven’t been stored properly.
• Poor Lighting Conditions: Inadequate lighting can make it difficult to see and avoid potential hazards like spills, obstacles, or changes in level. This can lead to both trips and falls.
• Weather Hazards: Outdoor slips and falls often increase during bad weather conditions such as rain, snow, or ice, which make surfaces slippery and vision less clear.
• Human Factors: Rushing, distraction, fatigue, or lack of proper training can also contribute to slips, trips, and falls. These can often be mitigated through awareness and training.
• Improper Footwear: Footwear unsuitable for the work environment or the current weather conditions can increase the risk of slips, trips, and falls. For example, smooth-soled shoes might not provide enough traction on a wet or oily surface, leading to slips.
• Loose or Unsecured Mats or Rugs: Unsecured mats, rugs, or carpets can shift underfoot or present tripping hazards with their edges.
• Improper Use of Equipment: This might involve using chairs instead of ladders, climbing on shelves, or not using safety equipment correctly, all of which can lead to falls.
• Poor Housekeeping: If work and walkway areas are not kept clean and orderly, they can contribute significantly to slips, trips, and falls. Examples include cluttered workspaces, cables across walkways, or spills not promptly cleaned up.
• Lack of Safety Training: Employees not properly trained on the correct job procedures, including safety equipment, can be at higher risk for accidents.
• Inadequate Maintenance: Neglecting maintenance can lead to hazards such as leaky pipes (leading to wet surfaces), potholes, or uneven flooring, which can cause slips, trips, and falls.
• Poorly Designed Walkways: Walkways with sudden drops, absence of handrails, sharp turns, or inadequate space can increase the risk of falls.
• Medical Conditions: Certain conditions like poor vision, balance disorders, or mobility problems can also increase the risk of slips, trips, and falls.
• Age: Both the very young and the elderly are at an increased risk for falls, partly due to factors such as lack of coordination, decreased strength, or reduced balance.

Remember, while this list of causes is extensive, it is not exhaustive. There may be other contributing factors depending on the specific circumstances or environment. That’s why it’s crucial to carry out regular risk assessments to promptly identify and address potential hazards.

Impact and Consequences Of Slips, Trips, And Falls

The impacts of slips, trips, and falls extend beyond the immediate event and can have lasting effects on the individuals involved and the organizations they belong to. These incidents can result in physical injuries, financial costs, and psychological distress.

Physical Injuries: From Minor to Severe

Physical injuries resulting from slips, trips, and falls can range from minor to severe. Minor injuries may include bruises, abrasions, or sprains. At the same time, more severe cases can lead to fractures, concussions, or even life-threatening injuries such as traumatic brain injuries or spinal cord damage.

In some cases, these incidents can lead to chronic pain or long-term disability, affecting the individual’s ability to perform daily activities or return to work. Falls, in particular, can be especially dangerous for older adults, leading to hip fractures or other serious injuries that significantly impact their independence and quality of life.

Financial Implications: Costs of Accidents

The financial implications of these incidents are also considerable. For individuals, this can include medical expenses, rehabilitation costs, and lost wages during recovery. Additionally, they might face expenses related to modifying their home for accessibility if the fall leads to a long-term disability.

For businesses, the financial costs can be substantial. There are indirect costs besides direct costs like medical expenses and workers’ compensation claims. These can include lost productivity due to employee absence, costs related to training replacement employees, and potential increases in insurance premiums. In severe cases, businesses may also face legal fees if they are negligent in providing a safe environment.

Psychological Implications: Fear and Anxiety After a Fall

The psychological impacts of slips, trips, and falls should not be underestimated. People who have experienced such an incident may develop a fear of falling again. This fear can limit their activities, reduce their independence, and decrease their quality of life.

Anxiety, depression, and social isolation can also result from the fear of falling or the consequences of an injury, such as disability. Employees may experience stress or anxiety about returning to work, especially if they feel the environment is unsafe.

Understanding these impacts highlights the importance of preventive measures to ensure safe environments, reducing the risk of slips, trips, and falls. The following sections will explore strategies to identify potential hazards and implement effective control measures.

Slips, Trips, And Falls Hazards Risk Assessment

Risk assessment is critical in preventing slips, trips, and falls. It involves identifying potential hazards, evaluating their risks, and determining appropriate control measures. A thorough risk assessment should consider all areas and activities in a given environment, from the home to the workplace.

Identifying High-Risk Areas in the Home or Workplace

High-risk areas vary depending on the setting. These might include staircases, bathrooms, and kitchens in the home, where wet surfaces are common. Outdoor areas like driveways or walkways can also present risks, especially in adverse weather conditions. Any area without sufficient support structures could be risky for older adults or those with mobility issues.

In the workplace, high-risk areas could be those with heavy foot traffic, wet or uneven surfaces, or places with lots of equipment and machinery. Industrial kitchens, construction sites , warehouses, and healthcare facilities are examples of workplace environments that often have high-risk areas.

Key Considerations for Risk Assessment

A comprehensive risk assessment should consider various factors. These include:

• The Environment: Assess the condition of the floors, lighting, staircases, and walkways. Look for hazards like wet surfaces, uneven floors, poor lighting, or lack of handrails.
• Human Factors: Consider the behavior and health of individuals in the environment. Are they rushing? Are they carrying heavy items that may obstruct their view? Do they have any health conditions that increase their risk?
• Tasks: Evaluate the tasks being performed. Does the job involve working at height, handling hazardous substances, or heavy physical labor? Are workers exposed to distractions or time pressure?
• Footwear and Clothing: Assess whether appropriate footwear and clothing are worn for specific environments and tasks.
• Previous Incidents: Look at the history of slips, trips, and falls in the environment. A pattern might indicate a persistent problem that needs addressing.

Importance of Regular Safety Audits

Regular safety audits are essential to maintain a safe environment. These audits involve routinely inspecting the environment and practices to ensure that safety measures are up-to-date and effectively implemented. They help identify new or overlooked hazards and assess the effectiveness of current control measures.

Regular audits also demonstrate a commitment to safety, which can encourage individuals to take responsibility for their safety and that of others. This fosters a proactive safety culture where hazards are promptly reported and addressed, further reducing the risk of slips, trips, and falls.

Prevention and Control Measures For Slips, Trips, And Falls

Once potential hazards have been identified through risk assessment, it’s crucial to implement prevention and control measures to mitigate these risks. This involves a range of strategies, from good housekeeping practices to installing safety features.

Housekeeping Best Practices

Proper housekeeping is one of the most effective ways to prevent slips, trips, and falls. Here are some best practices:

• Regular Cleaning: Clean floors regularly and immediately clean up any spills. Ensure to put up “wet floor” signs until the area is dry.
• Declutter: Keep walkways and work areas clear of clutter and obstacles.
• Proper Storage: Store materials and equipment properly when not in use.
• Maintenance: Promptly repair any damages to walkways and work areas, like cracks or uneven surfaces.

Installing Safety Features (Handrails, Non-Slip Mats, etc.)

Installing safety features can greatly reduce the risk of accidents. Here are a few examples:

• Handrails: Install sturdy handrails on all staircases and other areas where individuals may need extra support.
• Non-slip Mats: Use non-slip mats in areas prone to wet or slippery conditions.
• Guard Rails: Install guardrails around elevated platforms, mezzanines, and other fall hazards.
• Visible Markings: Use reflective tape or other visible markings to highlight changes in floor level or other hazards.

Appropriate Footwear for Different Surfaces

Wearing the right footwear can significantly reduce the risk of slips, trips, and falls. Choose shoes with good traction, especially for wet or slippery surfaces. Protective footwear should be worn in workplaces where specific hazards are present, such as construction sites.

Prompt Removal or Correction of Identified Hazards

Address identified hazards as quickly as possible to prevent accidents. If a hazard cannot be immediately removed or corrected, ensure it is clearly marked, and individuals are informed about it until it can be addressed.

Adequate Lighting

Ensure all areas have sufficient lighting to allow individuals to see and avoid potential hazards. This is particularly important for stairways, hallways, and outdoor paths. Replace burnt-out bulbs promptly and consider installing automatic lights in often-used areas.

By implementing these prevention and control measures, you can greatly reduce the risk of slips, trips, and falls, promoting a safer environment for everyone. In the next section, we’ll explore additional strategies and considerations specific to the workplace.

Workplace-Specific Considerations

While many of the principles of slips, trips, and falls prevention apply universally, certain considerations are particularly relevant to workplaces. These involve safety training, employer responsibilities, and industry-specific hazards.

Importance of Safety Training and Awareness Programs

Safety training is vital to workplace safety . Regular training sessions can ensure that employees are aware of potential hazards and the best practices for avoiding them. Training should cover topics such as proper use of equipment, safe handling of materials, and emergency procedures.

Awareness programs, too, can play a crucial role in maintaining a safe work environment. These programs could include regular safety reminders via bulletins, emails, or meetings, encouraging employees to be vigilant and proactive about safety.

Employer Responsibilities and Employee Rights

Employers have a responsibility to provide a safe work environment. This involves conducting regular risk assessments, addressing identified hazards promptly, and providing necessary safety training and equipment. They should also have procedures in place for reporting accidents or hazards and ensure that employees feel comfortable using these procedures without fear of retaliation.

Employees, on the other hand, have the right to a safe workplace and the right to speak up about safety concerns. They also have a role in maintaining safety by following established procedures, using provided safety equipment, and promptly reporting any hazards or incidents.

Industry-Specific Hazards and Control Measures

Every industry has its unique set of hazards, so it’s important to consider these when planning prevention and control measures. For example, spills and hot surfaces might be major hazards in a restaurant kitchen. Measures could include non-slip mats, appropriate footwear, and caution signs. In a construction site, falls from a height might be the primary concern, necessitating guardrails, safety harnesses, and fall arrest systems.

In conclusion, slips, trips, and falls are common but preventable incidents. By understanding their causes and impacts, conducting regular risk assessments, and implementing effective prevention and control measures, we can significantly reduce these accidents, fostering safer homes, workplaces, and communities.

Preventing slips, trips, and falls is no small task, but it is a crucial one. As we’ve explored in this guide, these incidents are far from trivial, carrying the potential for serious physical injuries, significant financial costs, and profound psychological impacts. Yet, armed with the knowledge of what causes these incidents and understanding their impacts, we’re already halfway towards prevention.

The steps to creating safer environments—at home, in public spaces, or at workplaces—aren’t overly complex. They begin with recognizing the potential hazards and involve a thoughtful blend of risk assessment, implementing practical measures, and fostering a culture of safety awareness. From basic housekeeping to installing safety features, each action reduces the risk.

It’s important to remember that the responsibility of preventing slips, trips, and falls doesn’t rest on a single individual or group—it’s a collective effort. Employers, employees, homeowners, and public facility managers all have roles to play. And in our various roles, we all contribute to a larger, shared goal: creating safer environments for everyone.

Preparing for and preventing these incidents can seem daunting in a world where the unexpected is expected. But, as we’ve seen, it’s not only possible; it’s a critical part of our commitment to safety for ourselves and others. Let this guide serve as a reminder and resource for that commitment, helping us make each step we take a safer one. Thank you for joining us on this journey towards safer environments and greater awareness. Let’s continue to take steps, big and small, toward a safer tomorrow.

• Weill Cornell Medicine

Slips, Trips, and Falls: Understanding, Preventing, and Mitigating Risks

By Gian Joseph, Safety Advisor

As we enter the rainy and cold season, we face several risks , which include slips , trips, and fall s in our day-to-day activities. It is important t o be aware of hazards around us and learn how to properly identify and assess any risks with each step.  

Slips, trips, and falls (STFs) are common accidents that can lead to severe injuries. These incidents occur in various settings, from homes and workplaces to public spaces , and i t is essential to understand the causes, consequences, and , most importantly, strategies for prevention and mitigation.   

1. Understanding the Dynamics of STFs. STFs are caused by the following .  

Insu fficient friction between the shoe and the walking surface. Common causes include wet or greasy floors, spills, and loose debris (Slip and Fall Accidents, 2021).  

When a person's foot collides with an object or an uneven surface, it caus es them to lose balance. Typical trip hazards include cluttered walkways, electrical cords, uneven flooring, and damaged or upturned mats (Slip and Fall Accidents, 2021).  

2. The Impact of STFs  

Slips, trips, and falls have far-reaching effects, affecting individuals and society . Personal i njuries range from minor cuts , bruises, sprains , and abrasions to fractures, dislocations, and head injuries (National Safety Council, 2021). The medical expenses associated with treating STF-related injuries can be substantial , including hospital stays, surgeries, rehabilitation, and ongoing care (National Safety Council, 2021). STFs can result in missed workdays and reduced productivity for both individuals and employers. Workers' compensation claims and absenteeism contribute to economic costs (National Safety Council, 2021). Lastly, t he physical and psychological consequences of STFs can limit mobility, independence, and overall quality of life, especially among older adults ( Sahyoun et al., 2020).  

3. Prevention and Mitigation Strategies  

Preventing and mitigating STFs involves a combination of awareness, environmental modifications, and education . H ere are some ways you can take precaution s against STFs in your daily activities;  

Clear Pathways: Maintain clear, unobstructed walkways by removing clutter and tripping hazards such as cords, toys, and loose rugs (Occupational Safety and Health Administration [OSHA], 2002).  

Adequate Lighting: Ensure proper lighting in all areas, both indoors and outdoors, to improve visibility and reduce the risk of tripping over obstacles (OSHA, 2002).  

Slip-Resistant Flooring: Install slip-resistant flooring materials, especially in areas prone to moisture, like bathrooms and kitchens (OSHA, 2002).  

Footwear: Encourage the use of proper footwear with good traction, especially in environments where slip hazards are prevalent ( Sahyoun et al., 2020).  

Handrails and Guardrails: Install and maintain handrails and guardrails on stairs, ramps, and elevated platforms to provide support and prevent falls (OSHA, 2002).  

Warning Signs: Use signage to alert individuals to potential hazards, such as wet floors or uneven surfaces (OSHA, 2002).  

Education and Training: Promote awareness and provide training to individuals on recognizing and avoiding STF hazards (National Institute for Occupational Safety and Health [NIOSH], 2015).  

Workplace Safety: Employers should implement safety protocols and conduct risk assessments in the workplace, addressing potential STF risks (NIOSH, 2015).  

Regular Maintenance: Routinely inspect and maintain buildings, walkways, and outdoor areas to identify and address potential hazards promptly (NIOSH, 2015).  

4. A Holistic Approach to STF Prevention  

Preventing and mitigating STFs require a collaborative approach involving individuals, organizations, and communities:  

Individuals : Exercise caution when walking, especially in unfamiliar or potentially hazardous environments. Wear appropriate footwear and take your time, especially in wet or slippery conditions ( Sahyoun et al., 2020).  

Employers: Create a safe work environment by identifying and mitigating STF risks. Provide training to employees on safety protocols and the proper use of equipment (OSHA, 2002).  

Property Owners and Managers: Ensure properties are well-maintained and free from hazards. Regularly inspect and address issues promptly (NIOSH, 2015).  

Government and Local Authorities: Enforce building codes and regulations that promote safety, especially in public spaces and commercial buildings (OSHA, 2002).  

Conclusion  

Slips, trips, and falls are preventable accidents that carry substantial personal, economic, and societal costs. By comprehending the causes, consequences, and prevention strategies, we can significantly reduce the incidence of STFs and mitigate their impact. Whether at home, at work, or in public spaces, prioritizing safety and fostering awareness about STFs is crucial for the well-being of individuals and communities. Let us strive collectively to create environments where everyone can move safely and confidently, free from the fear of falling.  

References:  

National Institute for Occupational Safety and Health (NIOSH). (2015). Preventing Slips, Trips, and Falls in Wholesale and Retail Trade Establishments. https://www.cdc.gov/niosh/docs/2015-100/pdfs/2015-100.pdf  

National Safety Council. (2021). Injury Facts. https://injuryfacts.nsc.org/work/overview/work-safety-introduction/work-...  

Occupational Safety and Health Administration (OSHA). (2002). OSHA Publication 3151-12R. Preventing Slips, Trips, and Falls in Wholesale and Retail Trade Establishments. https://www.osha.gov/Publications/osha3151.pdf  

Sahyoun , N. R., Pratt, L. A., & Lentzner , H. (2020). The Changing Profile of Nursing Home Residents: 1985-1997. Journal of Aging and Health, 12(3), 336-363.  

Slip and Fall Accidents. (2021). InjuryClaimCoach.com. https://www.injuryclaimcoach.com/slip-and-fall-accidents.html  

Please note that the sources cited are accurate as of the time of writing this article. For the most current information, consult authoritative sources and local health authorities.  

Go to the staff directory for individual contacts within EHS. You may also use the Weill Cornell Medicine online directory to search for faculty and staff.

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Weill Cornell Medicine Environmental Health and Safety 402 East 67th Street Room LA-0020 New York, NY 10065 Phone: (646) 962-7233 Fax: (646) 962-0288

• Uncategorised

The 10 most common injuries caused by slips, trips, and falls in the workplace

• October 8, 2020

We’ve all become a bit more aware recently of the potential dangers lurking in the workplace. Things we never thought of as hazardous before like making a cup of tea, sharing an elevator, or even sharing a desk, now give us cause for concern.

However, you may not know that in recent years, the most common cause of non-fatal workplace injuries, accounting for nearly a third, are slips, trips, and falls. When you include falls from height, the percentage increases even further. Whilst you might imagine these to be dramatic incidents involving scaffolding, ladders, or trees, falls from the same level accounted for over 20,000 injuries at work in 2018/19. This could be tripping over a box left where it shouldn’t be, or slipping on a wet floor.

Injuries caused by slips, trips and falls

The most common injuries from these types of accidents, unsurprisingly, are fractures and dislocated joints. These are most commonly to the ankle or wrist, but fractures to fingers are also common. Shoulder dislocation and knee injury can also commonly occur. After fractures are sprains and superficial cuts and bruises. Next are lacerations and open wounds, followed by burns and scalds. While it’s reassuring to note that most falls at work don’t lead to serious injuries, 2% of fatal injuries in the workplace are in fact caused by falls from the same height, and a much higher 25% by falls from height. Falls and slips can in rare cases also lead to traumatic brain injuries or spinal cord damage .

Health and Safety legislation

So, what is there to protect workers from this type of incident befalling us? Well, employers are under a statutory duty to protect their employees against injury. The Health and Safety at Work Act 1974 states that employers must do all that is ‘reasonably practicable’ to ensure the safety of their employees. This includes putting in provisions to avoid slips and trips.

All employers must carry out a risk assessment of the workplace and identify any hazards. If hazards are identified they must assess how high the risk is that injury may be caused and take action to address the risk where possible. There are also regulations dealing specifically with the risk of falls and trips for example, one regulation states that floors must be kept in good condition and free of obstructions.

Some risks are straightforward and easy to spot, such as the risk of spillages in a kitchen. A measure to reduce the risk of falls could be ensuring that all spillages are cleaned up as soon as they occur. While an employer may not be able to prevent spillages entirely, there is no excuse for them not to put in place measures to reduce the risk of injury. Risk assessments also need to be kept up to date, particularly if there have been any near misses or accidents, or if the workplace has made any changes.

Health and Safety Executive

  Some accidents at work must be reported to the Heath & Safety Executive. All fatalities must be reported as well as certain types of injury; generally, the more serious the injury the higher the likelihood that it should be reported. The HSE can prosecute an employer if it considers they have breached their health and safety requirements. However, even where the HSE doesn’t take any further action, an injured employee may be able to bring a civil claim against their employer for compensation.

Claiming Compensation

  It is important to remember, however, that compensation isn’t automatic and not all workplace injuries are the fault of the employer. It depends on whether the employer did everything they could to reduce the risk of injury, and whether they complied with the regulations. Just producing a risk assessment isn’t proof that they fulfilled their obligations though. They may have produced the paperwork, but did they put in place the measures identified to reduce the risk of injury?

In a workplace injury claim, this is where evidence of day to day working practices is very important. Useful evidence can be witness statements from employees or former employees, photographs of the workplace, memos from the employer or emails sent to staff. For example, an employer might have identified a risk of injury from wet floors and have a risk assessment saying that the floor must be kept dry. However, the day to day reality may have been very different.

Also important is whether the employee received the correct training for the task they were doing when the accident occurred. Even if it seems like the employee ’caused’ the accident, perhaps by not positioning a ladder correctly before climbing it, or by failing to wear a hard hat, if the employer didn’t give them sufficient training to do the task safety or provide them with the correct PPE to keep them safe, the employer could be the one at fault, not the employee who may have been trying their best in difficult circumstances.

Employers are also usually vicariously liable for the negligent actions of their employees so if an employee injures a colleague, the employer is likely to be liable (although as always there are exceptions particularly when the individual acts outside the scope of their role). This usually makes it easier for an injured party to obtain compensation as the employer will be insured, unlike the majority of individuals.

It is important if you are injured whilst at work to seek expert advice. It can be particularly tricky if you want to continue to work for the company but at the same time are struggling with an injury, and it can be difficult to know whether your employer can be held responsible or whether it was an unavoidable accident.

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Our serious injury team have helped so many clients who were injured while working for an employer that wasn’t meeting their workplace safety obligations. Contact us today to find out more about how we can help you.

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Migrated Content

Why is dealing with slips and trips important, what do employers have to do, how can they do it.

• Prevent floors from getting wet or contaminated in the first place.
• Have procedures in place for both routine and responsive cleaning.
• If a spillage does happen, clean it up quickly.
• If floors are left wet after cleaning, stop anyone walking on them until they are dry and use the right cleaning methods and products.
• Look out for trip hazards, such as uneven floors or trailing cables, and encourage good housekeeping by your workers.
• Make sure workers wear footwear that is suitable for the environment they are working in.
• Make sure your flooring is suitable, or floors likely to get wet are of a type that does not become unduly slippery.
• Slips and Trips eLearning Package (STEP) This is designed to help readers assess and manage slip and trip hazards in the workplace. STEP is a great introduction to slips and trips, and covers how they are caused, why preventing them is important and how to tackle them.It includes easy-to-follow guidance, case studies, videos, animations and quizzes. These are designed to give information needed to set up and maintain a safer way of working.
• HSE’s slips and trips  
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Prevention of Slips, Trips and Falls

On this page, how do falls happen, how to prevent falls due to slips and trips, what can you do to avoid falling at work.

Statistics show that the majority (67%) of falls happen on the same level resulting from slips and trips. The remaining 30% are falls from a height. This document will summarize information on "falls on the same level" (slips and trips). Falls from an elevation, such as falls from ladders, roofs, down stairs or from jumping to a lower level, etc., is discussed in other documents since each type of fall must be assessed as part of a fall prevention program .

Slips happen where there is too little friction or traction between the footwear and the walking surface. Common causes of slips are:

• wet or oily surfaces
• occasional spills
• weather hazards
• loose, unanchored rugs or mats
• flooring or other walking surfaces that do not have the same degree of traction in all areas

Trips happen when your foot collides (strikes, hits) an object causing you to lose balance and, eventually fall. Common causes of tripping are:

• obstructed view
• poor lighting
• clutter in your way
• wrinkled carpeting
• uncovered cables
• bottom drawers not being closed
• uneven (steps, thresholds) walking surfaces

Both slips and trips result from unintended or unexpected change in the contact between the feet and the ground or walking surface. This fact shows that good housekeeping, quality of walking surfaces (flooring), selection of proper footwear, and appropriate pace of walking are critical for preventing fall incidents.

Housekeeping

Good housekeeping is the first and the most important (fundamental) level of preventing falls due to slips and trips. It includes:

• cleaning all spills immediately
• marking spills and wet areas
• mopping or sweeping debris from floors
• removing obstacles from walkways and always keeping walkways free of clutter
• securing (tacking, taping, etc.) mats, rugs and carpets that do not lay flat
• always closing file cabinet or storage drawers
• covering cables that cross walkways
• keeping working areas and walkways well lit
• replacing used light bulbs and faulty switches

Without good housekeeping practices, any other preventive measures such as installation of sophisticated flooring, specialty footwear or training on techniques of walking and safe falling will never be fully effective.

For more information about effective housekeeping, visit the OSH Answers document on Workplace Housekeeping - Basic Guide .

Changing or modifying walking surfaces is the next level of preventing slip and trips. Recoating or replacing floors, installing mats, pressure-sensitive abrasive strips or abrasive-filled paint-on coating and metal or synthetic decking can further improve safety and reduce the risk of falling. However, it is critical to remember that high-tech flooring requires good housekeeping as much as any other flooring. In addition, resilient, non-slippery flooring prevents or reduces foot fatigue and contributes to slip-prevention measures.

In workplaces where floors may be oily or wet or where workers spend considerable time outdoors, prevention of fall incidents should focus on selecting proper footwear. Since there is no footwear with anti-slip properties for every condition, consultation with manufacturers is highly recommended.

Properly fitting footwear increases comfort and prevents fatigue which, in turn, improves safety for the employee. For more information on footwear visit the OSH Answers document on Safety Footwear .

You can reduce the risk of slipping on wet flooring by:

• taking your time and paying attention to where you are going
• adjusting your stride to a pace that is suitable for the walking surface and the tasks you are doing
• walking with the feet pointed slightly outward
• making wide turns at corners

You can reduce the risk of tripping by:

• keeping walking areas clear from clutter or obstructions
• keeping flooring in good condition
• always using installed light sources that provide sufficient light for your tasks
• using a flashlight if you enter a dark room where there is no light
• making sure that things you are carrying or pushing do not prevent you from seeing any obstructions, spills, etc.
• Fact sheet last revised: 2023-03-28

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Prevent Workplace Slips, Trips, and Falls—8 Safety Tips

Mopping up a spill or double-checking a guardrail might seem like simple common sense, but slips, trips, and falls are the second most common cause of death at work. These are life-saving procedures. Keep reading for practical tips to prevent workplace accidents.

• Slip, Trip, and Fall Hazards Listed
• Clarifying OSHA Standards
• Prevent Workplace Slips, Trips, and Falls

These are familiar scenarios at home: slipping on a wet floor in the kitchen and tripping over a toy left out by the kids. While annoying, these accidents are typically minor hazards in the home. You might stub your toe, but rarely are there severe consequences.

In the workplace, it’s a different and far more serious story. Slips, trips, and falls account for over 200,000 workplace injuries per year. In 2020, nearly one in five accidents leading to missed work was due to a slip, trip, or fall. They’re also the second-leading cause of workplace fatalities.

As a safety leader, you’re responsible for your company’s duty of care and for providing a safe workplace . This blog post will examine common hazards leading to slips, trips, and falls and the steps you can take to minimize injury risks for your team.

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What are slip, trip, and fall hazards in the workplace.

Accidents involving slips, trips, and falls are often grouped together. While they’re similar, it’s important to understand the distinction since they each have different causes and consequences.

Slips occur when someone’s footwear loses traction with the surface they’re on, causing a loss of balance. Under some circumstances, slipping can lead to a fall.

Trips happen when someone hits their foot or lower leg on an object. As their upper body continues moving forward while their lower body remains stationary, the person may lose their balance in the process.

Falls often result from slips or trips, but they can also happen on their own. For example, a worker on a ladder or scaffolding can lose their balance and fall without slipping or tripping. Falls are also possible on flat surfaces and can still cause serious injuries.

Once you understand the hazards that lead to each type of accident, you can identify and mitigate risks in your workplace. Here are some of the most common causes of slips, trips, and falls in the workplace:

Slip Hazards

• Spills of wet or dry substances
• The cleaning process during spill removal
• Employees rushing or not paying attention to workplace conditions, especially while carrying objects
• Slippery floor surfaces such as marble or laminate
• Wet surfaces
• Poor lighting that obscures hazards
• Inappropriate footwear for the environment
• Transitioning between different types of surfaces

Trip Hazards

• Objects or obstructions in walkways
• Uneven surfaces on flooring or concrete
• Cables, cords, and hoses that aren’t properly secured or organized
• Unmarked steps or ramps
• Irregular stairs or stairs without railings
• Carpet, rugs, or mats with wrinkles or lifted edges

Fall Hazards

• Improperly used or poorly maintained ladders
• Elevated surfaces without guardrails
• Floor and wall openings
• Working in elevated environments without a safety harness
• Ill-fitting or improperly used PPE, such as helmets and safety lines

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Are There OSHA Standards Related to Slips, Trips, and Falls?

Despite how common these injuries are, there is no specific OSHA standard on slips, trips, and falls. However, several OSHA rules indirectly address the same hazards.

The most important regulation to be aware of is 29 CFR 1910 Subpart D, which covers walking and working surfaces. OSHA updated the standard in 2017, introducing many upgrades to fall protection system requirements, improved employer-provided inspection guidelines, and a greater emphasis on safety training for employees.

For the construction industry, 29 CFR 1916 contains numerous fall-related regulations. Subpart M specifically addresses fall prevention, but other sections, such as Subpart L (scaffolds) and Subpart E (personal protective and lifesaving equipment), are also relevant. OSHA used 29 CFR 1916 as guidance when revising 29 CFR 1910, so the two guidelines now reflect many of the same OSHA violations .

As with any other workplace hazard or accident, OSHA recordkeeping requirements still apply in the event of a slip, trip, or fall incident. Internally, the reporting process is also an opportunity to review the details of the incident and determine how you can update your workplace safety policy to prevent similar accidents in the future.

How to Prevent Slips, Trips, and Falls in the Workplace

Many hazards that cause slips, trips, and falls are inevitable. However, injuries and accidents are not. To prevent slips, trips, and falls, train your employees to follow a three-step process:

• Recognize the hazard: Identify conditions that could lead to a slip, trip, or fall.
• Evaluate the hazard: Examine the situation and determine what level of risk it presents and who it affects.
• Control the hazard: Avoid the risk by removing the hazard (such as mopping up a spill) or implementing safety equipment and procedures (such as installing handrails on an elevated platform).

Here are eight workplace safety tips to prevent falls, trips, and slips.

1. Teach situational awareness

Since many causes of slips, trips, and falls are foreseeable, situational awareness in the workplace is one of the best preventative measures. Encourage your employees to pay attention to their surroundings and the risks they present:

• Look at walking surfaces for spills, obstacles, or other potential hazards
• Watch for signage that warns of increased hazards
• Be aware of conditions such as weather or time of day that might increase the risk of an accident
• Take shorter and more cautious steps on slippery surfaces

2. Encourage proper footwear

Like any other form of PPE, proper footwear can significantly reduce the risk of accidents. Research has found that slip-resistant shoes can reduce injury claims by 67% in environments with slippery work surfaces.

Employees should regularly inspect their shoes and make sure the soles aren’t worn out, as the lack of tread increases the danger of slipping. Additionally, anyone who works in conditions exposed to winter weather hazards should wear insulated boots. Cold temperatures can decrease muscle function, increasing the risk of slipping, tripping, or falling.

3. Utilize signage

Signage is an effective warning system for many workplace risks, but it can be especially effective in preventing slips, trips, and falls. There are two types of signs you can use to increase occupational safety:

• Temporary: Use warning signs while addressing a new hazard, such as cleaning up a spill, repairing a handrail, or replacing a ripped carpet. While temporary signage can help prevent injuries, you still need to address the actual hazard as quickly as possible.
• Permanent: For unavoidable hazards, such as slippery surfaces, a permanent sign can help warn employees to be careful. Use these sparingly, though, as it’s easy for people to ignore signs they see every day.

4. Keep floors clear and clean

Good housekeeping can help prevent most slips, trips, and falls. The details of keeping walking areas clean will vary widely by work environment, but there are a few common themes to encourage workplace safety:

• Report spills immediately, and warn nearby employees until someone can clean the contaminated surface
• Keep walkways clear of obstacles, loose objects, and anything that someone could trip over
• Place mats at entrances and exits so people can dry their shoes and avoid tracking water or other substances around the workplace
• Install handrails on stairways and elevated walkways

5. Apply non-slip mats and coatings

In some situations, keeping floors from becoming slippery is nearly impossible. Whether it’s liquid splashing or steam condensing, you must focus on mitigating the risk rather than avoiding it altogether.

For smaller or less demanding settings, non-slip mats can help employees maintain traction while walking around. In other cases, treating the floor with a permanent coating can help reduce slipping risks, even in the constant presence of liquids.

Who is at risk for slips, trips, and falls?

While all industries have some level of risk for a slip, trip, or fall, there are some industries where the risk is much higher, and the potential result could be much more dangerous. Here are some of the highest-risk industries:

• Construction
• Manufacturing
• Transportation/shipping/logistics
• Outdoor maintenance/groundskeeping
• Foodservice/hospitality

6. Ensure proper lighting

To identify slip, trip, and fall hazards, your employees need to be able to see their surroundings. Make sure that all of your work areas have proper lighting, especially in areas that are more prone to unsafe conditions.

While this can be a challenge in outdoor work environments, especially at night, it’s even more critical in those situations. Environmental conditions can lead to increased risks, and employees need to be able to see and avoid them. Adequate lighting should also extend to parking lots and walking areas around your facilities.

7. Develop safety programs

Your company’s safety plans and programs should include specific guidelines for preventing slips, trips, and falls. There are a few key topics to consider when developing these policies:

• The types of surfaces employees work and walk on and whether they present extra risks
• Seasonal or regional conditions that could heighten hazards, such as winter weather threats
• Specific OSHA regulations that apply to your workplace
• Potentially hazardous equipment training such as ladder safety
• Regular inspection plans to ensure your team is maintaining a safe work environment
• Policies to report hazards using your company’s two-way communication platform
• First aid training , so employees are prepared to respond safely should injuries occur

8. Provide Slips, Trips, and Falls Training

Lastly, training your employees to avoid slips, trips, and falls will help keep them safe. Provide specific guidance on the environments they’ll work in and the hazards they’ll face. For example, a slips, trips, and falls safety talk for food service workers should focus on wet floors and walking safely in crowded, fast-paced environments. Conversely, office workers could use extra reminders to watch for stray power cords and keep walkways clear of boxes, files, and other tripping hazards.

Working slips, trips, and falls into your safety topics for meetings is also helpful. Regular safety talks or safety moments are an excellent opportunity to remind your team about seasonal risks or update them on newly installed safety measures.

Don’t Let Your Safety Standards Slip

Slips, trips, and falls are some of the most common workplace injuries. Fortunately, you can usually prevent them with proper planning and safety measures.

By making slip, trip, and fall prevention a part of your company’s safety culture, you can ensure your employees are aware of their surroundings and ready to look out for each other’s safety. Enable them to report hazards easily, address risks quickly, and train them to avoid situations that are likely to cause injury.

With the right planning and prevention, even the most intense work environments can be as safe as a walk in the park.

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25th July, 2023

14 Causes Of Slips Trips And Falls In The Workplace

Around 30% of workplace injuries are caused by slips, trips and falls on the same level. But what's causing this huge amount of accidents at work? Here are 14 causes of slips trips and falls that led to around 170,000 injuries in the UK last year.

Slips, trips and falls on the same level might not seem like a major issue. You don't have that far to fall. So apart from the obvious embarrassment if other people are watching - where's the harm?

It's estimated around 170,000 injuries in the UK in 2021/22 were from slips, trips and falls on the same level - 30% of all non-fatal injuries - according to HSE statistics . And over 18,000 of those are reported injuries.

That's more than a little embarrassment. Did you have a nice trip? No, I'm in agony. I spent 9 hours in A&E and I'll be off work for a month.

It's not just minor injuries that result from slips, trips and falls. Reported injuries are generally more serious injuries involving things like broken bones, dislocations, or more than seven days off work.

So what's causing these accidents? Here are 14 common causes of slips and trips at work:

• Slippery floors
• Dusty floors
• Loose mats and floor coverings
• Unsuitable footwear
• Icy conditions
• Loose flooring
• Uneven flooring
• Obstructions
• Trailing cables
• Bad lighting
• Poor housekeeping

The causes of slips, trips and falls are often easy, and cheap, to fix. Simple quick actions, like cleaning up a spillage, or moving a cable, can eliminate the risk.

Removing a slip or trip hazard is often all it takes to stop the problem before someone gets hurt.

Causes of slips

Slips can be caused by a variety of things, not just the obvious spillages. Let's look at some common examples you might find in your workplace.

1. Wet floors

Wet floors can be caused by a variety of things. Spillages are an obvious culprit. Cleaning activities can also create wet floor surfaces.

When it's raining outside, entrance areas can become wet as rain travels in from people's shoes and clothing.

Poorly maintained buildings may also leak and let rain and wet weather conditions in from the outside.

2. Slippery floors

Glossy, polished floor tiles can be a slip hazard if they are used in an unsuitable place, like a bathroom or entrance, where the floor may become wet.

If footwear with smooth soles, or socks are worn, the flooring may be slippy even in dry conditions.

3. Dusty floors

It's not just liquids that can cause slips. Dusty surfaces can also create a slip hazard, preventing shoes from gripping the floor.

Some work activities like sawing wood or breaking up materials can generate loose fragments or dust that create a slippery surface on top of the floor.

4. Loose mats and floor coverings

Some mats create a slip hazard if they don't grip well with the surface underneath. Step on it in the wrong way and it can slide from under you. Ouch!

Workers might also try to temporarily protect a new floor with sheets or cardboard. If floor protection is not secured to the surface, it can also slip and slide underneath you.

5. Unsuitable footwear

Ever tried running in slippers, or socks? It's not recommended.

Shoes with a slippery sole aren't going to help you avoid slip hazards. They become one.

6. Icy conditions

Working outdoors in winter, or in cold environments?

Ice is a slippery surface, even for the most robust footwear. Make sure you consider the possibility of ice forming on surfaces causing a slip hazard .

7. Wet ground

Speaking of working outside, in wet weather the ground can become slippery, especially in grassy or muddy areas.

In autumn, wet leaves on paths can also increase the risk of slips.

Causes of trips

Now you know what to look out for when it comes to causes of slips, but what about trips? Trip hazards can happen in any type of work environment, and it's not just cables you need to look out for.

1. Obstacles

Leaving materials, tools or equipment lying around, especially in walkways, are a common cause of trips at work. You need to use tools to work, but placing a tool or material in the wrong place can be unexpected to someone else.

Packaging and waste materials are also common causes of trip hazards at work.

2. Loose flooring

So we mentioned loose mats and floor coverings can be a slip hazard. They can also be a trip hazard.

• a rug curled up at the corners
• a loose floorboard sticking up
• an unsecured tile lifting up
• a temporary floor covering

3. Uneven flooring

When you are walking along a familiar pathway, looking forward, you might not notice uneven flooring ahead of you.

Potholes, broken slabs, cracked surfaces, and uneven paving on footpaths can create trip hazards where you don't expect them.

4. Obstructions

Obstructions are like obstacles but fixed rather than temporary. Examples of obstructions include:

• floor-mounted socket covers left open

You might not realise an obstruction is there until you trip up - that's what makes it a trip hazard. And it's why you see those yellow mind-the-step signs, that you also didn't see until it was too late.

5. Trailing cables

Electricity is everywhere, or at least it feels like we need it everywhere. But unless you are using wireless equipment, you need to plug it in.

And, that cable that you use, might just get in someone else's way. Be mindful when using mobile cabled equipment, because when you're moving around, so does the cable.

6. Bad lighting

Obstacles and obstructions are worse if you can't see them. If you can't see them, you can't avoid them.

Hopefully, they won't be there to begin with, but good lighting helps identify hazards and gives you a chance to clear them away before they cause an accident.

Lighting can also be used to help highlight changes in floor level.

7. Poor housekeeping

Poor housekeeping is a leading cause of slips, trips and falls at work because if you don't clean up after yourself, you get more of those obstacles we talked about earlier.

Removing waste and cleaning up regularly can help keep your workplace free from slip and trip hazards.

Now you know the causes, it's easy to see how a quick tidy-up of spillages and obstacles can prevent many slips and trips from happening. Our simple guide to slips and trips at work can help you spot slip and trip hazards and fix them before they cause an accident.

Reducing the risk of slips, trips and falls at work is not a one-time thing. But regular housekeeping can keep you on top of those hazards.

Regular maintenance will help remove broken, loose or frayed floor coverings, and highlight when flooring needs replacing.

Highlighting changes in floor levels or surfaces, and providing handrails can also increase safety where slip and trip hazards can't be fully removed.

Keeping your workforce aware of the dangers can also help increase compliance with housekeeping practices, cleaning up spillages, removing obstacles and wearing the right footwear. Download the free slip and trip toolbox talk to help raise awareness in your workplace.

This article was written by Emma at HASpod . Emma has over 10 years experience in health and safety and BSc (Hons) Construction Management. She is NEBOSH qualified and Tech IOSH.

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Slips, trips & falls

Slips, trips, and falls put workers at risk of sprains, strains, bruises, concussions, and fractures. Falls often result from slipping or tripping.

Slips happen where there is not enough grip or traction between the footwear and the walking surface. This can be a result of water, oil, grease, or dust on the floor. Loose rugs or mats, floors with varying traction, and the wrong footwear can also cause slips.

Trips and falls can happen when people lose their balance after their feet collide with objects. Common tripping hazards in the workplace include:

• Damaged or worn carpets, rugs, and mats
• Uneven flooring
• Cluttered walkways
• Uncovered cables
• Poor lighting
• Obstructed views

See our resources for information about reducing the risk of slips, trips, and falls.

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• Slips, trips, and falls are B.C.’s costliest workplace incidents: WorkSafeBC Published on: October 24, 2023

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7 Commonly Overlooked Slip, Trip, and Fall Hazards

• Prevent Slip & Fall
• 7 Commonly Overlooked Slip, Trip,…
• By Safeguard
• July 27, 2020

Some slip, trip, and fall hazards are obvious — such as wet floors and working at heights.

But what about those lesser-known hazards that can result in a painful and costly accident? Many of the dangers that cause workers to lose their footing are surprisingly easy to forget or ignore completely.

Let’s take a closer look at 7 of the most commonly overlooked slip, trip, and fall hazards that could be hiding in your workplace.

1. Loose floor coverings

According to the National Floor Safety Institute , hazardous walking surfaces account for over half (55%) of all slips, trips, and falls. Loose floor mats, rugs, and stair covers play a big part in many of these accidents.

Entryway rugs that curl up at the corners can catch a foot and cause a bad fall. Similarly, peeling anti-slip tape can actually do more harm than good by contributing to unsafe walking conditions.

The solution is simple. Make sure floor coverings are the right size for the space, lay flat, and are properly secured. Replace curled mats or worn tape with anti-slip covers that are made to size and can be secured over existing surfaces to ensure they never become a tripping hazard.

2. Contaminants

Contaminants on the floor create the perfect conditions for a slip and fall. Drilling fluid, oil overspray, dust, grease, and even spills from the water cooler can make walking surfaces slippery. Studies suggest that contaminants are responsible for at least 80% of the injuries resulting from slips.

Good housekeeping can eliminate many of the dangers posed by contaminants on the floor surface. When contaminants can’t be completely avoided or eliminated — as is often the case in food processing plants, water treatment facilities, and factories — anti-slip mats are a good solution. They’re designed to provide friction to prevent slips and falls, even in wet or oily conditions.

3. Cracked concrete

Cracks in concrete are normal. Over time, floors, walkways, stairs, and sidewalks can shrink or settle and become uneven. When this happens, they can become a serious tripping hazard.

Replacing cracked concrete is the obvious solution, but it may not be in the budget. In that case, anti-slip step and walkway and ramp covers are a quick and relatively inexpensive solution to safely extend the life of your existing concrete.

4. Temporary walkways

Construction ramps and walkways on worksites such as oil fields are an accident waiting to happen. Because they’re new and temporary, they tend to get overlooked when designing safety procedures and controls.

Portable anti-slip rolls are a good solution for temporary walkways. Simply unroll them wherever you need them, then roll them up and store them away when you’re done. They can be reused over and over to ensure slip, trip, and fall hazards are controlled.

5. Distracted walking

We’ve all been there or seen someone awkwardly stumble while looking down at a cell phone. According to the National Safety Council , distracted walking caused over 11,000 injuries between 2000 and 2011 — and those numbers are on the rise. What’s more, over 80% of these injuries were due to falls.

Most people are unaware of the dangers of distracted walking or believe they are not at risk. As such, preventing these types of injuries starts with awareness. Employees must be reminded to focus on the task at hand and controls must be implemented to eliminate potential distractions.

6. Not following safety procedures

Safety procedures can go a long way toward preventing slips, trips, and falls — but they’re only effective if employees follow them every single time. Let’s say, for example, you have a procedure in place that forbids employees from stepping on a certain piece of equipment. All it takes is one shortcut or misstep to cause a serious injury.

Many times, accidents can be avoided by simply posting signs alerting employees to potential dangers and reminding them to follow safety procedures. Anti-slip covers printed with safety messages like “No Step” are one such example that can keep employees on solid footing.

7. Seasonal hazards

While some slip, trip, and fall hazards are present all the time, others can change depending on the season. During the summer, for example, you might prop a door open for better airflow — but this can also allow rain to blow in and make floors slippery. Or, in the winter, rock salt used to melt ice can get tracked inside where it can become a slip and fall hazard.

No matter the season, it’s important to be aware of all potential hazards. Simply keeping an eye out for dangerous conditions can help keep workers safe year-round.

Your next steps

Now that you know these commonly overlooked slip, trip, and fall hazards, you’ll be in a better position to prevent injuries and accidents at your company.

If you are in need of anti-slip products, get in touch with our experts today. We can help you select and install the right solutions to keep your employees safe.

Contact our team to request a quote or sample, or to learn more about your options.

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Slips, trips and falls

Each year slips, trips and falls cause thousands of preventable injuries.

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The most common ones are: 

• musculoskeletal injuries (injuries to muscles, nerves, tendons, joints, cartilage and spinal discs)
• bruises 
• fractures 
• dislocations. 

More serious injuries and deaths can also happen. 

Slip, trip and fall hazards 

Some things that can cause you to slip are: 

• the wrong footwear 
• polished, wet or greasy floors. 

In most cases, people trip on low obstacles that are hard to spot, such as: 

• uneven edges in flooring 
• loose mats 
• open drawers 
• untidy tools, or 
• electrical cables. 

Falls can result from a slip or trip, but many occur from low heights. For example: 

• steps 
• stairs 
• kerbs, 
• holes 
• ditches, or 
• wet or slippery surfaces. 

WHS duties  

As a person conducting a business or undertaking (PCBU), you must always aim to eliminate the risk of slips, trips and falls, so far as is reasonably practicable. If that is not possible, you must minimise risks so far as is reasonably practicable. 

You must identify hazards, and assess and control risks. Think about your: 

• work areas 
• work procedures 
• tools 
• equipment.  

Consulting with workers can help you find better and easier ways to identify and minimise risks. You should also review control measures to ensure they are working as planned.  

Workers also have duties, including taking reasonable care for their own health and safety. 

Managing risks  

The best way to manage the risk of slips, trips and falls is to eliminate hazards at the design stage of the workplace.  

If you can’t eliminate the risk, you must minimise it so far as is reasonably practicable. 

Designing safe workplaces 

In designing floors, stairs, lighting, drainage and storage: 

• keep floors at a single level and use slip-resistant floor coverings 
• install extra power points to avoid trip hazards from trailing cords 
• ensure all areas are well lit, particularly stairwells 
• have good drainage and slip resistant grates 
• have lots of storage, so things aren’t left in walkways. 

Safe work procedures 

Work procedures can also impact on the incidence of slips, trips and falls. Have clear procedures to: 

• remove rubbish to avoid trip hazards 
• return tools and other items to their storage areas after use 
• report and clean spills 

Keep the workplace clean 

All workers share responsibility for keeping the workplace clean and tidy.  

Make sure you: 

• have adequate rubbish and recycling bins 
• have cleaning schedules in place 
• dry floors after cleaning 
• don’t have cords on walkway or work area floors. 

Training  

Training helps workers become more aware of slip and trip hazards and helps to prevent injuries.  

Training should include:  

• awareness of slip and trip hazards 
• identifying effective control measures 
• duties of workers. 

Using personal protective equipment (PPE) 

As a PCBU, you should only use PPE: 

• after you have implemented all other possible control measures. 
• as an interim measure until you can use a better control measure 
• as a backup in addition to other control measures. 

Slip-resistant footwear 

Slip-resistant footwear is a type of PPE. 

Slip-resistant footwear should be appropriate for the work and workers must wear it properly. 

In wet conditions, the shoe sole tread should: 

• be deep enough to help penetrate the surface water 
• make direct contact with the floor. 

In dry conditions, the shoe sole tread: 

• pattern should be a flat bottom construction 
• should grip the floor with maximum contact area. 

Types of slip-resistant footwear 

Urethane and rubber soles are more slip resistant than vinyl and leather soles.  

Sole materials that have tiny cell like features are slip resistant. 

Supporting information

• Model Code of Practice: How to manage work health and safety risks  
• Model Code of Practice: Managing the work environment and facilities 
• Slips and trips at the workplace fact sheet  
• The interactive safe work method statement (SWMS) tool provides information on preparing, using and reviewing SWMS for high risk construction work.

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State of science: occupational slips, trips and falls on the same level *

Wen-ruey chang.

a Liberty Mutual Research Institute for Safety , Hopkinton, MA, USA

Sylvie Leclercq

b French National Research and Safety Institute (INRS) , Vandoeuvre, France

Thurmon E. Lockhart

c School of Biological and Health Systems Engineering, Ira A. Fulton Schools of Engineering , Arizona State University , Tempe, AZ, USA

Roger Haslam

d Loughborough Design School , Loughborough University , Loughborough, UK

Occupational slips, trips and falls on the same level (STFL) result in substantial injuries worldwide. This paper summarises the state of science regarding STFL, outlining relevant aspects of epidemiology, biomechanics, psychophysics, tribology, organisational influences and injury prevention. This review reaffirms that STFL remain a major cause of workplace injury and STFL prevention is a complex problem, requiring multi-disciplinary, multi-faceted approaches. Despite progress in recent decades in understanding the mechanisms involved in STFL, especially slipping, research leading to evidence-based prevention practices remains insufficient, given the problem scale. It is concluded that there is a pressing need to develop better fall prevention strategies using systems approaches conceptualising and addressing the factors involved in STFL, with considerations of the full range of factors and their interactions. There is also an urgent need for field trials of various fall prevention strategies to assess the effectiveness of different intervention components and their interactions.

Practitioner Summary : Work-related slipping, tripping and falls on the same level are a major source of occupational injury. The causes are broadly understood, although more attention is needed from a systems perspective. Research has shown preventative action to be effective, but further studies are required to understand which aspects are most beneficial.

1.  Introduction

Occupational slips, trips and falls on the same level (STFL) are a serious problem, with substantial injury and economic consequences reported worldwide. Although the scale of the problem has been recognised over several decades (Strandberg and Lanshammar 1981 ; Buck and Colman 1985 ; Leamon and Murphy 1995 ; Kemmlert and Lundholm 1998 ; European Agency for Safety and Health at Work (EU-OSHA) 2001 ; European Commission 2008 ; Nenonen 2013 ; Yeoh, Lockart, and Wu 2013 ), STFL persist as a major source of workplace injuries. The most recent data from the Liberty Mutual Workplace Safety Index, for example, showed that the direct cost of disabling workplace injuries in 2012 due to falls on the same level in the US was estimated to be approximately US$9.19 billion or 15.4% of total injury cost (Liberty Mutual Research Institute for Safety 2014 ).

STFL have received the concerted attention of safety researchers, with progress made in understanding their mechanisms and circumstances. The complexity of the interacting causal factors, however, intrinsic and extrinsic, close to or upstream from the injury genesis, presents a considerable challenge in designing and implementing effective prevention strategies. This state of science article first considers relevant definitions and establishes the scope of the review, proceeding to describe occupational STFL from different disciplinary perspectives. This consists of a discussion of the factors involved, examining epidemiological, biomechanical, perceptual (i.e. psychophysical), tribological and organisational aspects. The review concludes by summarising the current state of knowledge regarding STFL prevention and the areas where further research is required. The review is structured to reflect the critical research approaches that have been brought to bear on the STFL problem over the past three decades.

2.  Definitions and scope

Falls on the same level, on stairs and from heights are endemic throughout society, afflicting all ages. Likewise, falls occur widely during home and leisure pursuits as well as those related to work. The scope of this paper, however, is limited to occupational STFL as a particular class of injuries. The distinction between occupational and non-occupational slips, trips and falls, and falls on the same level vs. falls on steps and stairs or from heights, is significant when incidents are considered from a systems perspective. Different causal factors are dominant in occupational slips, trips and falls compared with falls among the elderly, for example, with different patterns of causation leading to different approaches to prevention. Further justification for limiting the scope of this review to occupational STFL is that the distinction also reflects the practice of different communities of researchers, practitioners and their disciplinary backgrounds.

Early research in the field used the expression ‘slipping, tripping and falling accidents (STFA)’ which, as far as we are aware, was first introduced in the early 1980s at a dedicated international conference held in the United Kingdom (Davis 1983a ). Later, the concatenated ‘slips, trips and falls (STF)’ entered widespread use (e.g. Haslam and Stubbs 2006 ; Chang 2008 ), embracing falls on the same level, falls from height and falls from some other action (e.g. movement of the standing surface). It is notable that slipping has been a particular area of attention, forming a large part of the discussions at STF symposia over the years, for example, at the Liberty Mutual Research Institute for Safety international symposium on the measurement of slipperiness (Courtney et al. 2001a ). Some researchers have, however, suggested that use of the ‘slips, trips and falls’ terminology and the tendency to focus on slipping fail to give sufficient recognition to other important causes of injuries on level surfaces involving loss of balance (Lortie and Rizzo 1999 ) or movement disturbance (Leclercq, Monteau, and Cuny 2010 ; Leclercq et al. 2014 ; Leclercq et al. 2015 ).

Slipping occurs when the friction between the foot or shoe sole and the floor surface provides insufficient resistance to counteract the forward or rearward forces that occur during the stepping process, i.e. interaction between human (foot or shoe sole) and floor. Leamon and Li ( 1990 ) described three categories of slips when walking based on the length of a slip. A ‘microslip’ is a slip shorter than 3 cm, a ‘slip’ is as long as 8–10 cm, and a ‘slide’ describes uncontrolled movement of the heel, which typically arises when a slip length exceeds approximately 10 cm. Microslips generally pass unnoticed; a slip will result in instinctive efforts to regain postural control; a slide is likely to lead to a loss of balance resulting in a fall. A trip occurs when the swing phase of the foot is interrupted unexpectedly due to inadequately clearing the ground. Irregularities of as little as 5 mm in the walking surface may be sufficient to cause a trip (Begg, Best, and Taylor 2007 ). Loss of balance leading to falls can also arise due to unexpected, forcible contact with something or someone. Similarly, unexpected, forcible movement of the floor, as may happen when standing in a moving vehicle, may cause a loss of balance sufficient to result in a fall on the same level.

The notion of ‘stumbling’ has been present in commentaries on falls and accident classifications (e.g. Strandberg 1983 ; European Commission 2013 ). The European Commission ( 2013 ) has ‘injured person slips, stumbles or falls on the same level’ as one of the deviation codes in the European Statistics on Accidents at Work. In this context, however, ‘stumbles’ is not defined and appears to be used in place of ‘trips’, which does not appear in the classification scheme. For the purposes of this review, it is assumed that stumbling is a consequence of slipping, tripping or other loss of balance event and refers to the process of falling and subsequent attempts to regain balance, rather than being a triggering event for a fall incident.

Situations referred to as ‘stepping into air’ when walking and missing a low, unmarked step down, for example, are regarded for the purposes of this paper as falls on steps or stairs and beyond the scope of the current focus on STFL. Likewise a fall arising from slipping on the lower rungs of a ladder or a slip or trip on scaffolding leading to a fall from height is excluded. Slips, trips and falls when walking on a slope (ramp, hill etc.) involve a change of height and have different biomechanics, tribology and loss of balance characteristics to STFL, so they are not covered. Falls arising from the collapse of an individual due to intrinsic factors, such as a health condition, are also not considered in the present review. Although patient and older person falls in hospitals or other health or social care environments can occur in a workplace setting, these are omitted from this review as a category of falls in their own right, with a distinct pattern of causal factors and a distinct body of research to match (e.g. Cameron et al. 2012 ).

3.  Epidemiology

Examining patterns of occurrence of STFL aids understanding of the distribution of STFL risks across different industries, occupations and worker groups. Firstly, however, it is appropriate to comment on limitations with the available data. Such data, whether collected as part of national, industrial sector or company occupational injury monitoring schemes, rely on classification systems that vary and are necessarily restricted in their categories. Strandberg ( 1983 ) highlighted the distortion of data that can arise with reporting schemes requiring classification of an incident into a restricted number of groupings, compounded further by coding choices having to be made by registration personnel based on their subjective judgements. Strandberg’s analysis found that slipping and falling incidents to have been seriously underestimated with the reporting scheme applied in Sweden at the time.

Some incidence reporting schemes may fail to differentiate between falls on the same level and falls from height (Lortie and Rizzo 1999 ). With the most recent occupational injury data available in Great Britain, for example, ‘slips, trips and falls on the same level’ and ‘falls from height’ are presented and discussed together as ‘slips, trips and falls’, as the information collected does not allow a consistent distinction to be made between them (Health and Safety Executive 2014 ). Another point to note is that variation exists in the precise classifications used by different reporting schemes for incidence data relevant to STFL. The variation in the terminology in the following sections reflects that used by different reporting agencies and researchers.

3.1. Scale of STFL problem

The European Commission ( 2008 ) presented an analysis of 3,983,881 non-fatal accidents at work occurring during 2005, involving more than 3 work days absence. Of these, ‘slipping – stumbling and falling – fall of person – on the same level’ was the largest category, amounting to 14.4%. A further 4.4% were recorded as ‘treading badly, twisting leg or ankle, slipping without falling’. In the US, data from the Bureau of Labor Statistics (BLS) ( 2014 ) showed that among 1,162,210 non-fatal occupational accidents and diseases recorded in 2013 at private companies and government agencies, 17.4% were a fall on the same level resulting in a median 10 work days lost. A further 4.4% of the reports were slips or trips without a fall but leading to an injury (e.g. back injury), resulting in a median 11 work days lost. Thus, two important data collection agencies indicate that STFL internationally amount to approximately 1 in 5 of reported non-fatal work-related accidents. Reliable occupational injury data are only available for a limited number of countries, but the data that do exist indicate that occupational injury rates are much greater in countries beyond those classified as ‘established market economies’ (Hämäläinen, Takala, and Saarela 2006 ). Even with the caveats that apply in extrapolating data available from industrially developed countries, we can be confident that the global toll of injury from STFL is immense.

In industrially developed countries, the overall number of work-related injuries has shown a decline, whereas injuries from STFL as a proportion have increased. Examination of occupational accidents with work days lost at companies operating within the French general social security system, for example, revealed an overall reduction of 13.6 accidents/1000 employees between 1987 and 2011 (CNAMTS 1988, 2012 ). For injuries triggered by a slip, trip or any other movement disturbance, excluding falls from height, however, the reduction was only 1 accident/1000 employees. Similarly, analysis of Liberty Mutual Workplace Safety Index data revealed that the cost of falls on the same level increased by 42.3% between 1998 and 2010, after adjusting for inflation, while the overall costs of disabling workplace injuries decreased 4.7% over the same period (Liberty Mutual Research Institute for Safety 2012 ). There is a broad indication that, although there has been much success with wider workplace injury prevention, the prevention actions have not addressed STFL as effectively as other accidents at work.

3.2. Sectorial variations

The incidence of STFL varies with the nature of work, the context in which it is undertaken and consequent variation in exposure to STFL hazards. An early analysis by Buck and Coleman ( 1985 ) showed that the frequency rate for STFL per 10,000 employees in 30 industrial sectors varied between 227 in mining and quarrying and 4 in banking and insurance. Significant variations were also observed in the groups within each industrial sector. Leclercq and Thouy ( 2004 ) and Leclercq, Thouy, and Rossignol ( 2007 ) showed that employees were differently affected by STFL leading to work days lost, depending on their occupation and even on the type of equipment with which they worked: rail ticket inspectors were differently affected (by a factor of 1 to 10), depending on the type of train in which they were operating. Gaudez, Leclercq, and Derosier ( 2006 ), in an analysis of 2002 data for companies operating within the French general social security system, found that in 9 industrial sectors, the rates relating to STFL leading to days lost were highest in the building and civil engineering sectors. In comparison, rates were approximately 5 times lower in service sectors. Analysis of US BLS data for 2011 by Yeoh, Lockart, and Wu ( 2013 ) revealed that workers with an occupation of ‘healthcare support’ and ‘transportation and material moving’ were the most affected by same level falls leading to one or more days away from work at 40.6 accidents and 31.6 per 10,000 workers, respectively. On the contrary, employees in the office and administration industrial sector were the least affected at 10.2 accidents per 10,000 workers.

3.3. Age, gender and obesity

Several studies have investigated the relationship between age and occupational STFL; the findings reported in the literature are sometimes contradictory. Buck and Coleman ( 1985 ) found that the frequency rate for STFL increased with employees’ age (between 16 and 60 years). Yeoh, Lockart, and Wu ( 2013 ) found a similar trend of incidence increasing with age, but with a slightly higher incidence rate in the youngest workers (between 16 and 19 years old) than in the workers aged between 20 and 44 years old. Kemmlert and Lundholm ( 1998 ) observed that workers older than 45 years were more often victims of slips, trips and falls than younger workers.

On the other hand, at a more detailed level examining company records for a particular occupation, mail delivery workers, Bentley and Haslam ( 1998 ) did not find any significant relationship between age and the occurrence of slip, trip and fall accidents. Similarly, research reported by Kong, Suyama, and Hostler ( 2013 ) for US and Polish firefighters found slips, trips and falls not to be associated with age. At three of four companies studied by Leclercq and Thouy ( 2004 ) and Leclercq, Thouy, and Rossignol ( 2007 ), younger employees experienced more STFL than their older counterparts. In a prospective investigation of slips among workers in fast food restaurants, Courtney et al. ( 2013 ) found that slipping occurrence decreased with increased age. In addition to being at variance with the pattern observed in the larger incidence data-sets above, these contradictory findings might be considered unexpected in view of the literature dealing with the association between age, health, physical condition and balance. This literature, however, mostly addresses falls among older people (65+) in the non-working population (e.g. Pyykkö, Jantti, and Aalto 1990 ; Alexander et al. 1992 ; Perrin and Lestienne 1994 ). The study of Bentley and Haslam ( 1998 ) may indicate that increased susceptibility to STFL with ageing only becomes a factor in older workers who have had a certain level of age-related changes regarding fitness, strength and balance. It is also possible that some types of work may require a certain level of fitness, beneficial in alleviating susceptibility to STFL regardless of age. This may be coupled with individuals not attaining or maintaining this level of fitness moving out of the occupation. Another possibility could be that the difference with age in some work situations is accounted for by influences such as experience, environmental familiarity, reduced risk taking and the nature of work tasks allocated (Leclercq and Thouy 2004 ) and Leclercq, Thouy, and Rossignol ( 2007 ).

With regard to gender differences in incidence, Yeoh, Lockart, and Wu ( 2013 ) analysis of US BLS 2010 data found female workers had a higher rate of same level falls leading to one or more days away from work than male workers (21.7 vs. 12.1 per 10,000 workers). Examining European accident data, Nenonen ( 2013 ) found that when compared with other accidents at work, the proportions of female workers experiencing slipping, stumbling or falling was higher. The pattern with gender differences when considering particular occupations is less clear. Bentley and Haslam ( 1998 ) found an incidence rate among mail delivery workers approximately 50% greater among females than their male colleagues (12.8 vs. 8.2 per 10,000 workers). Courtney et al. ( 2013 ), however, found no difference between male and female workers in a prospective study of slips in fast food restaurants. One explanation for possible gender differences in STFL incidence is the gender variation in the composition of the workforce for different occupations and corresponding variation in exposure to STFL risk. Another reason might relate to differences in stature and strength, with females operating at a greater percentage of their capacity for more strenuous tasks. Indeed in the study by Bentley and Haslam ( 1998 ), the postal delivery task involved carrying a heavy asymmetric load (mail pouch). It is possible this acted as a greater encumbrance for female workers, having a greater effect on balance and ability to recover balance in the event of an STFL initiating event.

Another physical attribute that appears to have an influence on STFL is body mass. Being overweight was found to be related to falls on the same level among male construction workers (Chau et al. 2004 ). Similarly, Koepp, Snedden, and Levine ( 2015 ) found obesity to be related to slip, trip and fall injuries among workers at an applied engineering facility. A recent gait experiment involving young obese adults suggests that slip-induced fall risks are higher along the transversal direction due to wider step width (Wu, Lockhart, and Yeoh 2012 ). Miller, Matrangola, and Madigan ( 2011 ), however, found no differences in balance recovery from small externally applied perturbations between obese and normal participants.

3.4. Injury outcomes

Fortunately, fatalities are a rare consequence of STFL. Nevertheless, Buck and Coleman ( 1985 ) emphasised that injuries from STFL are far from trivial, with 17% of those in their examination of published data on workplace accidents in Great Britain resulting in fractures. A further 17% were classified as ‘contusions and crushing’ and 36% as ‘sprains and strains’. Bentley and Haslam ( 1998 ), in a study of postal delivery workers working outdoors, found that the ankle was the most frequent site of injuries (23%), followed by the knee (17%) and back (16%). They also found that almost 50% of days lost were due to ankle and back problems; ankle injuries resulted most often from trips and back injuries from slips. For US workers experiencing injuries requiring days away from work, Yeoh, Lockart, and Wu ( 2013 ) found that extremities, which included the knees, feet and toes, were the most affected body parts injured in falls on the same level, comprising 30.7%. The trunk, which included shoulder and back, was the second most injured at 25.6%. Workers with multiple injured body parts ranked third with 21.8% of overall injuries.

In the industrial environment, back injury is the most frequent cause of workers’ compensation claims in the United States (Guo et al. 1999 ). The prevalence of low-back pain in a life-time has been reported to be between 55% and 87% (Videman et al. 1984 ; Riihimäki 1985 ). Low-back pain has been shown to be associated with slips and falls (Rohrlich et al. 2014 ). Epidemiological studies have indicated that sudden loading to the trunk is associated with acute low-back pain and may be a primary risk factor for chronic low-back pain development (Manning and Shannon 1981 ; Manning, Mitchell, and Blanchfield 1984 ; Rohrlich et al. 2014 ). Courtney et al. ( 2001b ) suggested that one workers’ compensation provider claimed that the cost ratio for ruptured discs due to same level falls was highest (13.3) among many injury claims ( cost ratio is the ratio of the average cost of the particular injury to the average cost of all injuries for that particular class of falls). Unexpected gait perturbations can be dangerous to the lumbar spine because of the rapid corrective movements needed to regain balance (Liu, Lockhart, and Kim 2014 ). Trunk acceleration can increase significantly during unexpected perturbation, such as slipping, compared with that during normal gait (Hirvonen et al. 1994 ; Ehsan et al. 2013 ).

4.  Biomechanics

This section describes some individual and task factors that may influence fall occurrence and severity. The knowledge generated based on biomechanics could complement that from existing injury surveillance systems. Understanding these factors contributes towards the development of fall prevention strategies. The examination also reveals where gaps in knowledge exist and further research is required.

Human bipedal locomotion (walking) is a challenging function for the central nervous system (CNS). During the single support period, which accounts for 80% of a gait cycle, the body is in a continuous state of instability since the whole body’s centre-of-mass is outside of the base of support (i.e. foot edge) (Perry 1992 ). The dynamic stability is recovered after the swing limb establishes firm contact with the ground. As such, dynamic stability is lost and regained in every gait cycle during normal walking. This recovery requires a complex interplay of neural and motor control mechanisms. Motor control is directly linked to the CNS’s processing of sensory inputs (visual, vestibular and proprioceptive). The sensory systems send input to an instantaneous controller to make an adjustment in real time. Additionally, an internal model is used to predict and adapt into the next step. It is clear that ‘expectancy’ is valuable for safe walking (Sicre et al. 2008 ). There can be a motion perturbation such as a slip, trip or a loss of balance if expectation and reality do not match. If not controlled, this perturbation could develop to become a fall.

4.1. Slips when walking

Falls initiated by slips are the most prevalent STFL (Courtney et al. 2001b ) and have received concerted research attention. A slip occurs at the shoe and floor interface when the friction required (required coefficient of friction, RCOF) to support walking exceeds the friction available (available coefficient of friction, ACOF) at the shoe and floor interface (Hanson, Redfern, and Mazumdar 1999 ). The RCOF for straight walking has been investigated extensively (Hanson, Redfern, and Mazumdar 1999 ; Cham and Redfern 2002a ; Kim, Lockhart, and Yoon 2005 ; Chang, Matz, and Chang 2012 ; Anderson, Franck, and Madigan 2014 ; Beringer, Nussbaum, and Madigan 2014 ; Fino and Lockhart 2014 ; Fino, Lockhart, and Fino 2015 ). The transverse component of the ground reaction force obtained with a force plate has been ignored in most of the RCOF calculations, but a study conducted by Chang, Chang, and Matz ( 2011 ) demonstrated that the transverse shear force could significantly increase RCOF and result in a much earlier occurrence of RCOF in the gait cycle. Recent studies showed that the RCOF for turning could be as high as 0.36, while that for straight walking was of the order of 0.2 (Burnfield, Tsai, and Powers 2005 ; Yamaguchi et al. 2013 ; Fino, Lockhart, and Fino 2015 ). The RCOF for carrying out different tasks under different situations, such as walking on different floor surfaces with different footwear, needs to be investigated further.

Much of the literature on biomechanical aspects of slips is concerned with human responses to unexpected contamination on floor surfaces (Lockhart 1997 ; Cham, Beschorner, and Redfern 2007 ; Lockhart, Woldstad, and Smith 2003 ; Lockhart, Smith, and Woldstad 2005 ; Lockhart 2008 ). Some of the research focus has been on the kinematic measurements at heel contact immediately before a slip incident and the body responses to a slip event. Parameters measured included heel displacements and velocities, joint angles and body part positions. For the kinematics immediately before a slip event, research has focused on identifying parameters associated with RCOF measurement or slip outcomes and anticipated reactions to potentially slippery floor surfaces (Kim, Lockhart, and Yoon 2005 ; Moyer et al. 2006 ; Hu and Qu 2013 ). Elsewhere, velocities, accelerations and joint moments calculated from the kinematic measurements were shown to be promising parameters in predicting slip severity and assessing the mechanisms (Liu and Lockhart 2006 ; Beschorner and Cham 2008 ; Hu and Qu 2013 ). Whole body and upper body responses to a slip incident were summarised by Liu, Lockhart, and Kim ( 2014 ) and Cham, Beschorner, and Redfern ( 2007 ).

4.2. Balance and stability

Nonlinear dynamics has also been used to investigate walking dynamic stability measured with accelerometers on a treadmill or a normal walking path (Stergiou 2004 ; Dingwell and Kang 2007 ; Lockhart and Liu 2008 ; Bruijn et al. 2013 ; van Schooten et al. 2013 ) . Instead of treating each step as an independent event, body movements for several consecutive steps were analysed to quantify variations in the temporal domain. The maximum Lyapunov exponent was identified as a measurement of stability (Dingwell et al. 2001 ; Stergiou 2004 ; Lockhart and Liu 2008 ). Further research is needed to assess the effects of working tasks and environmental conditions on dynamic stability, and to validate the relationship between dynamic stability and fall accidents.

4.3. Trips when walking

Stochastic distributions of the minimum foot clearance during mid swing of repeated walking of the same participant on a treadmill were investigated by Begg, Best, and Taylor ( 2007 ) and the probability of a trip event at different obstacle heights were calculated from these stochastic distributions. Walking on a treadmill could be very different from walking on an actual walkway. Therefore, it might be worthwhile to repeat the experiments by Begg, Best, and Taylor ( 2007 ) to measure the stochastic distributions of the minimum foot clearance in mid swing on an actual walkway.

For trips that occurred in early swing and late swing phases, common responses were an elevating strategy of the swing limb to overtake the obstacle and a lowering strategy to shorten the step length, respectively (Eng, Winter, and Patla 1994 ; Schulz 2011 ). The results from Grabiner et al. ( 1993 ) and Owings, Pavol, and Grabiner ( 2001 ) indicated that a recovery from a trip depended on factors such as the lower extremity muscular power, ability to restore control of the flexing trunk, reaction time, step length and walking speed. The results reported by Pijnappels, Bobbert, and van Dieën ( 2005a , 2005b , 2005c ), showed that lower limb strength could be a critical factor in trip recovery observed in laboratory situations, thus strength training might help reduce fall risk. The heights of the obstacles used in these experiments were 5 to 15 cm. In practice, interventions, such as a ramp, are needed when the change in height of the walking surface is higher than 0.63 cm (Di Pilla 2003 ). Therefore, the obstacles used in these experiments could be too high to reflect what might actually be encountered in workplace settings. There is a need to systematically investigate human responses to obstacles of various heights likely to be encountered in actual workplaces.

4.4. Work pace (walking speed)

Typical industrial tasks require workers to perform at a greater work pace than normal walking pace. Under these circumstances, one must override the natural frequency and consciously force cadence to a faster rate to increase the walking speed. An increase in walking velocity usually increases the friction demand and risk of slip initiation (Chang, Matz, and Chang 2012 ). Dingwell et al. ( 2001 ) also observed that increased walking speed reduces dynamic walking stability. Neuromuscular response must be faster at greater walking velocities to accommodate the quicker time sequences of fast walking. A perturbation or error at high velocity has greater momentum than at low velocity, and requires a larger neuromuscular response to correct and stabilise the system. Therefore, faster work pace or walking speed during rushed industrial activities may adversely affect STFL initiation and balance recovery processes.

4.5. Load carrying

Occupational load carrying tasks are considered as one of the major factors contributing to slip and fall injuries and a causal factor leading to more than 30% (54,792 cases in 2001) of all non-fatal occupational slip and fall injuries resulting in one or more days away from work (Courtney and Webster 2001 ). In normal walking, corrective postural movements are made by the upper body, arms and shoulders. Arm swing is used to offset the rhythmical acceleration and deceleration of the trunk by the leg movements, and also to damp-out the rotational forces of the trunk (Haywood 1986 ). However, these dampening effects are modified during load carrying (Davis 1983b ) and may influence risk of slip initiation (Liu, Lockhart, and Kim 2014 ).

4.6. Footwear

The human foot is the only source of direct contact with the floor during normal ambulation and plays an important role in maintaining dynamic stability (Chiou, Bhattacharya, and Succop 1996 ). As such, footwear may influence progression of the body during ambulation and may influence dynamic stability. For example, work shoes (e.g. stiff boots) can influence normal kinematics and kinetics at the ankle and may influence walking stability and even require more friction and increase the slip severity (Cikajlo and Matjačić 2007 ). Although softer footwear may allow for a better range of motion and push-off power generation, further research is needed to determine the effects of various work boots (metatarsal boots, safety-toe boots, etc.) on walking stability and comfort.

4.7. Ageing workforce

In order to develop effective engineering interventions and/or human support through training, the older age population segment needs to be included in the work system design. In general, isometric muscle strength peaks in the mid-twenties and then decreases slowly until after 50 years of age when there is an accelerated decline (Astrand and Rodahl 1986 ). Studies suggest that age-related changes in muscle strength have an important effect on recovery from a slip (Lockhart, Smith, and Woldstad 2005 ). This effect can be further aggravated by fatigue, and increase the risk of falls among older workers (Zhang, Lockhart, and Soangra 2015 ). Gait instability, sensory degradation and diminished rapid torque development capacities of the older workers imply that age must be considered as a factor in the identification of risk of occupational falls.

4.8. Conclusion

In conclusion, slip/trip-induced fall accidents have been investigated by various researchers utilising normal walking conditions and slip-perturbation methods. These investigators have collectively identified that the risk of slip-induced fall accidents is associated with friction demand characteristics during walking. Friction demand characteristics are affected by task factors (e.g. working-pace, turning, load carrying, etc.) as well as footwear dynamics. As such, further investigations are warranted to assess the effects of footwear properties (e.g. ankle support, personal protective equipment, shoe-sole materials, etc.) on friction demand and various industrial activities. Although initiating circumstances are important to modulate fall risks, given a perturbation (i.e. slip/trip), most investigators agree that reactive recovery characteristics are directly linked to fall severity. In other words, although slip initiating risks are directly linked to friction demand characteristics, overall fall risk is directly linked to how we maintain dynamic stability given a perturbation. Thus, concerted efforts are needed to control initiating circumstances as well as improving reactive recovery scenarios – e.g. since maintaining dynamic balance requires the upper body as well as the lower body, tasks such as carrying a load may further increase the risk of slips and falls.

5.  Slipperiness perception

In addition to the biomechanics of STFL, researchers have considered the psychological processes involved. This has been predominately with respect to slipping. The perception of slipperiness may be psychophysical in nature (Strandberg, 1985 ). The role of these processes was underlined by Courtney et al. ( 2013 ), who showed that perception of slipperiness and the subsequent rate of slipping were strongly associated. Their results suggest that safety professionals could utilise aggregated worker perceptions of slipperiness to identify slipping hazards and to assess possible intervention effectiveness.

5.1. Proprioceptive feedback

During walking, one is often not fully aware of the fact that sliding or creep between the footwear and the floor occurs in the very beginning of the heel contact phase on contaminated surfaces and even on dry non-slippery surfaces (Perkins 1978 , Strandberg and Lanshammar 1981 , Perkins and Wilson 1983 ). The results from Leamon and Li ( 1990 ) indicated that any slip distance less than 3 cm would be detected by humans in only 50% of the occasions, and that a slip distance more than 3 cm would be perceived as a slippery condition.

When potentially hazardous conditions are perceived through visual and proprioceptive sensation, or expected to exist in the walking person’s perceptual field, walking gait is adjusted accordingly (Ekkebus and Killey 1973 , Swensen, Purswell, and Schlegel 1992 , Cham and Redfern 2002b , Chambers, Perera, and Cham 2013 ). Increases in stance and stride times and step width, as well as decreases in stride length, walking speed, heel horizontal velocity, heel horizontal and vertical accelerations, foot and floor angle and utilised coefficient of friction (UCOF) are used to avoid a slip on slippery surfaces (Swensen, Purswell, and Schlegel 1992 , Bunterngchit et al. 2000 , Fong, Hong, Li 2005 , Lockhart, Spaulding, and Park 2007 , Menant et al. 2009 , Cappellini et al. 2010 , Chang et al. 2015 ). The results from Chang et al. ( 2015 ) show that the participants in their experiment appeared to rely on the potential for foot slip, i.e. the difference between UCOF and ACOF, to form their perception of slipperiness rating under wet conditions. In addition, some kinematic variables also became major predictors of the perception of slipperiness rating under glycerol conditions. It would be beneficial to identify additional factors contributing to the perception of slipperiness and how the perception of slipperiness contributes to human responses such as kinematics and UCOF when walking on slippery surfaces.

5.2. Tactile sensation

In contrast to the proprioceptive feedback outlined in the previous section, tactile sensation covers the aspects of special movements performed by participants in assessing slipperiness which might not occur in daily lives. Human subjects seem to be capable of differentiating the slipperiness of floors (Yoshioka et al. 1978 , 1979 , Swensen, Purswell, and Schlegel 1992 , Myung, Smith, and Leamon 1993 , Chiou, Bhattacharya, and Succop 1996 ) and footwear (Strandberg 1985 , Tisserand 1985 , Nagata 1989 , Grönqvist, Hirvonen, and Tuusa 1993 ) in dry, wet, or contaminated conditions. Yet Cohen and Cohen ( 1994b ) reported significant disagreements between the measured ACOF values of tiles and subjective responses obtained by sliding bare feet across 22 test tiles under dry conditions in comparison with a standard tile with a ACOF of 0.5. According to the results from Cohen and Cohen ( 1994a ), touch by running a bare foot across the tiles was the best sensing mechanism among touch, vision and hearing by dragging fingernails across the tiles, compared with the measured ACOF values.

Chiou, Bhattacharya, and Succop ( 2000 ) reported findings of workers’ perceived sense of slip during a standing task performance (e.g. a lateral reach task) and further related their sensory slipperiness scale to subjects’ postural sway and instability. They found that workers who were cautious in assessing surface slipperiness had less postural instability during task performance. Li, Yu, and Zhang ( 2011 ) asked participants to touch and slide across five floors with their index fingers, palms and bare feet. They reported that both index finger and palm were more sensitive than the foot in the sensation of floor roughness, and the floor surface roughness parameter was a better predictor of perceived floor slipperiness than the ACOF of the floor.

Although most people generally do not use their bare feet to sense floor slipperiness, various tactile cues can be used by safety professionals to assess slipperiness when friction measurements are not possible. The most common tactile cues used are finger touching and shoe bottom rubbing. It would be useful to compare the consistency of the results based on these tactile cues with the measured ACOF.

5.3. Vision

The visual field is an important psychophysiological parameter involved in gait regulation and visual impairment can lead to gait disturbance and loss of balance. Studies of the human visual mechanism have indicated that the visual field of a walking person is dynamically changing and only a small part of the effective visual field is attended to (Reed-Jones, Reed-Jones, and Hollands 2014 ). Therefore, if a slippery condition is not detected within one’s effective visual field (usually 3 to 4.6 m ahead), the likelihood of fall incidents is significantly increased (Zohar 1978 ). The involvement of visual impairment in STFL was demonstrated by Bentley et al. ( 2005 ), where underfoot hazards were not detected immediately prior to the incident in 65% of cases they studied. The causes of not being able to detect these hazards were concurrent visual task (45%), obscured view of hazard by object being carried (13%), insufficient illumination and weather condition (2%) and inability to recognise hazard (5%).

Joh et al. ( 2006 ) reported that people rely on ‘shine’ information in forming judgements of slipperiness under dry conditions despite variations as a function of surface colour, viewing distance and lighting conditions. Lesch, Chang, and Chang ( 2008 ) asked participants to rate 38 different floor surfaces under dry conditions in terms of slipperiness, reflectiveness, light/dark, traction, texture and likelihood of slipping just by looking at them. They reported that reflectiveness had the strongest correlation with perceived slipperiness ( r  = 0.73, p  < 0.05), and slipperiness ratings correlated most strongly with the measured ACOF ( r  = −0.58, p  < 0.05). All these studies were carried out under dry conditions, but most slip incidents occur under slippery conditions (Courtney et al. 2001b ). It is important to extend these studies to more dangerous conditions under which slip incidents are more likely to occur.

Visual control of locomotion has been classified into both avoidance and accommodation strategies (Patla 1991 ). Avoidance strategies include, for instance, changing foot placement, increasing ground clearance, changing the direction of gait and controlling the velocity of the swing foot. Redfern and Schuman ( 1994 ) emphasised that temporal control is as critical as spatial control in placement of the foot to maintain balance during gait. Accommodation strategies involve longer term modifications, such as those outlined in section 5.1 on a slippery surface. The effects of visual cues on biomechanical strategies to manoeuvre across contaminated floor surfaces, and the effectiveness of these strategies on various surfaces, could be important in reducing STFL. Also, training as a strategy to improve the perception of slipperiness, in particular for older individuals, should be explored as suggested by Bentley and Haslam ( 2001a ). However, we emphasise that training should not be considered without also deploying other risk elimination and reduction approaches.

5.4. Other intrinsic and extrinsic influences on perception

Extrinsic and intrinsic factors that can contribute to fall-related injuries are outlined by Gauchard et al. ( 2001 ). These same factors could also contribute to the perception of slipperiness. It has been demonstrated extensively how contaminants affect the perception of slipperiness. It was summarised earlier that vision could play a role. In addition, occupational organisational factors such as activities, temporal constraint and urgency, and environmental factors such as ground conditions, footwear, lighting and cold temperatures could also affect the perception rating. Intrinsic factors such as ageing, chronic or acute pathologies, alcohol, drugs, perimenopausal period, experience (including previous experience of STFL), attention, physical status, weakness and fatigue could also affect the perception rating. The results from Courtney et al. ( 2006 ) showed that a recent workplace history of slip, as well as the presence of shoe contaminants and age, could affect the perception rating. As it appears that the perception rating is a complex issue, the effects of additional factors should be explored such as demographic factors, fall history and culture.

5.5. Perceived slipperiness and objective measurements

The relationship between perception rating and measured coefficient of friction has been widely explored. Under laboratory or controlled environments, the perception rating has been mostly correlated with dynamic coefficient of friction (Tisserand 1969 , Harris and Shaw 1988 , Swensen, Purswell, and Schlegel 1992 , Myung, Smith, and Leamon 1993 , Grönqvist, Hirvonen, and Tuusa 1993 ). Likewise, the same relationship also has been reported in results from field environments, including fast food restaurants (Chang et al. 2004c, 2006, 2008 ), college campuses (Li et al. 2004 ) and a fish market (Hsu and Li 2010 ). Grönqvist, Hirvonen, and Tuusa ( 1993 ) reported a significant correlation between the subjective scores of slipperiness and slip distance.

6.  Tribology

6.1. friction variation.

Friction has been shown to have a direct correlation with the perception of slipperiness as summarised in the previous section. Levels of ACOF are typically used to assess the potential risk of slip and fall incidents that are generally assumed more likely to occur on floors with a low ACOF. The potential for slip and fall incidents can be increased by local variations in friction due to unexpectedly encountering an abrupt reduction in friction across floor surfaces (Strandberg 1985 ; Pater 1985 ; Andres, O’Connor and Eng 1992 ; Grönqvist et al. 2001 ). Chang et al. ( 2008 ) conducted a field study in fast food restaurants and obtained various friction reduction variables that could be derived from friction measurements across each working area. They reported that two of the friction reduction variables that they evaluated could have a slightly better correlation with perception rating scores ( r  = 0.34 and 0.37) than the mean ACOF of each working area (0.33). These two variables were the absolute and relative reductions in ACOF over the whole working area where the change in ACOF was assessed in the same direction at the distance of 60 cm, approximately a step length. The role of a sudden friction change in the measurement of slipperiness, as well as the risk of slipping, should be more systematically studied with more definite results obtained in laboratory environments to provide stronger evidence for such a link.

6.2. Footwear tread pattern

Footwear plays a key role in slip and fall incidents as indicated in the biomechanics section. Tread patterns on shoe surfaces, in particular, affect friction, especially when surfaces are contaminated with solid particles or liquid. SATRA published guidelines for selecting proper tread patterns on shoe soles (Wilson, 1990 ). Li and Chen ( 2005 ) and Li, Wu, and Lin ( 2006 ) investigated the effects of tread pattern width, orientation and depth on friction measured with a portable slipmeter, the Brungraber Mark II. All of their results showed that the measured ACOF was significantly affected by the tread depth, width and orientation. The footwear pads with grooves perpendicular to the friction direction had a higher ACOF than those with parallel grooves under wet conditions (Li and Chen 2005 ; Li, Wu, and Lin 2006 ). Blanchette and Powers ( 2015 ) carried out a similar study with a whole shoe tester (SATRA STM 603) and reported that an oblique orientation with 3-mm width and 2-mm depth had the highest measured ACOF under wet conditions, while an orientation parallel to the direction of friction measurement with a 6-mm width and 6-mm depth had the lowest measured ACOF. The fundamental issues on the tread pattern selections are not well demonstrated in the published literature. The guidelines recommended by SATRA (Wilson 1990 ) were published without supporting scientific data. Li and Chen ( 2005 ), Li, Wu, and Lin ( 2006 ) and Blanchette and Powers ( 2015 ) evaluated simple tread patterns with single direction straight grooves, while the tread patterns of most of the footwear available in the market have more complicated geometries. Therefore, tread pattern evaluations should be expanded to include patterns with more complicated geometries such as those which are available in the market today. Singh and Beschorner ( 2014 ) reported that high fluid pressures were observed in the absence of tread and the presence of high viscosity fluids and fluid pressures were negligibly small when at least 1.5 mm of tread depth was present or when a low viscosity fluid was present. It would be desirable to conduct systematic footwear research for industries in which slip and fall injuries are significant, such as in construction and food service.

6.3. Wear of floor and footwear

Wear of floor and footwear is another issue that could affect friction and is important in determining the effectiveness of selections as well as potential interventions for floor and footwear to reduce slip and fall injuries. Kim ( 2015 ) investigated changes in shoe surface roughness and wear mechanisms during repeated sliding under dry conditions. They reported that progressive wear was initiated by ploughing of the floor asperities on shoe sole surfaces after only a few slidings, which was followed by simultaneous ploughing and abrasion. They also quantified wear of footwear surfaces during repeated slidings. One of the difficulties in investigating wear is that the time spans can be quite long for real-life observations. Accelerated wear methodologies that could resemble repeated actual shoe and floor interaction are needed to shorten the observation periods. In the investigations conducted by Kim ( 2015 ), shoes were rubbed against floors under dry conditions with sliding speeds that could happen only on slippery surfaces. Therefore, their results and wear mechanisms identified might not reflect what actually happens at the shoe and floor interface. Before such accelerated wear methods are established, traditional field observations to monitor shoe and floor wear, such as the studies carried out by Leclercq and Saulnier ( 2002 ) and Grönqvist ( 1995 ), should be used to develop basic understandings as a reference for the accelerated tests.

6.4. Surface texture of floor and footwear

Surface textures on nominally flat floor and shoe surfaces have been shown to influence friction at the shoe and floor interface under liquid contaminated conditions (Chang et al. 2001c ). Surface roughness parameters representing the surface void volume, surface slope and kernel roughness depth on floor surfaces in general had strong correlations with the measured ACOF with liquid contaminants (Chang et al. 2001c, 2004b ). Furthermore, Chang et al. ( 2004a ) extended the scope to include surface waviness and identified additional surface waviness parameters that had strong correlations with the measured friction. The microscopic features on floor surfaces identified by Chang et al. ( 2004a , 2004b ) that were related to the friction measured under liquid contaminated conditions should be studied when subjected to traffic in real-life situations. Durability of these preferred microscopic features on floor surfaces should be investigated in future research as a part of the effort to identify those features that will be able to maintain a higher friction over time.

Similar to the floor surfaces, friction increases as the roughness level on footwear is increased (Rowland, Jones, and Manning 1996 ; Manning and Jones 2001 ; Kim 2015 ; Mohan, Das, and Sundaresan 2015 ). Although Kim measured a surface parameter representing the surface void volume, most of the parameters measured revealed little about surface features such as the centre line average, maximum height, maximum depth and maximum roughness depth. Parameters that represent surface slope could be important indicators to reflect viscoelastic properties of footwear materials. A surface roughness measurement is typically carried out with a stylus profilometer. The footwear materials could deform during the measurements. It is important to investigate the effect of the stylus force on the measurements. As three-dimensional surface microscopes such as a laser scanning confocal microscope and atomic force microscope, have been used to measure footwear surfaces by Kim ( 2015 ) and Mohan, Das, and Sundaresan ( 2015 ), studies on surface parameters based on three-dimensional measurements could reveal more details about important surface features.

6.5. Friction measurement devices

Mechanical devices have been widely used to measure various types of friction at the shoe and floor interface (Chang et al. 2001a ). A friction measurement device is intended to simulate a slip when operated on surfaces with or without contaminants in order to measure the maximum coefficient of friction that exists at the shoe and floor interface. Although human movements during slip incidents have been reported in the literature (Perkins 1978 ; Lanshammar and Strandberg 1983 ; Cham and Redfern 2002b ), design and reproducibility issues for the construction of friction measurement devices necessitated some simplifications in shoe movements compared with the experimental observations. More drastic simplifications were made with portable slipmeters than with laboratory-based devices due to constraints of weight and portability, with the consequence of limited fidelity to the actual shoe and floor interface. These simplifications further resulted in significant differences in the results measured with various devices, including both laboratory-based and field-based devices (Chang et al. 2001a ). Moreover, there appear to be regional preferences around the world regarding which devices could best give meaningful and useful results, so debates about their validities continue. These problems further complicate efforts in the development of interventions evaluated with friction measurements. As pointed out by Chang et al. ( 2001a , 2001b ), the measurement conditions of these devices are still far from perfect as compared with the biomechanical data reported in the literature and are inconsistent across various devices. Bio-fidelity of these devices remains a critical issue. Does the movement of the test foot used in these devices resemble that of shoes at the critical instants of slip events? In addition to the bio-fidelity, tribo-fidelity could be more important for field-based devices. Are the tribological phenomena at the shoe and floor interface of slip events reflected at the measurement interface with these devices? Due to the requirement of portability, the contact force applied with the portable slipmeters would not be as high as that at the actual shoe and floor interface. In order to maintain the same contact pressure and lubrication conditions, the contact area and contact velocity need to be altered. Therefore, tribo-fidelity could be more important than bio-fidelity to properly reflect what actually happens at the shoe and floor interface under lubricated conditions when using these portable devices to measure friction. In the light of these limitations, further investigations are needed to identify critical instants during slip events and understand the tribological phenomena at the shoe and floor interface.

6.6. Solid contaminant

Scientific investigations on the operating protocols and performance of slipmeters have focused on surfaces with liquid contaminants. Solid contaminants, such as sand, sugar or flour particles, could be a slip hazard. Friction measurements on surfaces covered with sand particles was investigated by Li et al. ( 2007 ). Mills, Dwyer-Joyce, and Loo-Morrey ( 2009 ) measured friction with various particulate contaminants of different diameters (calcite and silicon) and shape factors and floors with different roughness values. They reported that the adhesive friction is significantly affected by particulate contaminants while the hysteretic component is not. They identified three lubrication mechanisms as sliding, shearing and rolling. Li, Meng, Zhang ( 2014 ) investigated the effect of different sizes of silica particles on friction under dry and wet conditions. They reported that silica particles either increased or decreased friction under dry conditions, depending on the footwear material and particle size. The silica always increased friction under wet conditions measured with Neolite and ethylene vinyl acetate (EVA). Similar investigations should be conducted on surfaces covered with other solid contaminants that are more commonly found in occupational settings.

6.7. Friction modelling

Friction modelling has been widely used in tribology, but is a new approach to investigating friction at the shoe and floor interface and can complement experimental approaches. Beschorner et al. ( 2009 ) developed a friction model for steady sliding between shoe and floor interface. This model was based on mixed-lubrication and included elements such as lubrication and asperity contact. Their prediction of the ACOF had good agreement with experimental measurements. Recently, a viscoelastic friction model under dry condition and steady state sliding was developed (Moghaddam, Redfern, and Beschorner 2015 ). However, one of the critical issues involved with friction modelling for a slip event is that the viscoelastic model should be combined with other friction mechanisms (e.g. adhesion) for the shoe sole materials. Additional issues are the non-stationary solid and liquid interface caused by the deformation of solid surfaces under boundary and hydrodynamic lubrication between liquid contaminant and shoe or floor, and transient motions involved in slip and fall incidents.

6.8. Slip prediction

When RCOF for an activity exceeds ACOF at the interface, a slip may happen (Redfern et al. 2001 ). Hanson, Redfern, and Mazumdar ( 1999 ) developed a logistic regression model to estimate slip probability in which actual fall incidents were compared with the differences between mean ACOF and mean RCOF. Both RCOF and ACOF have random variations, so the mean values used by Hanson, Redfern, and Mazumdar ( 1999 ) were inadequate for estimating the slip probability since the stochastic distributions were simply represented by their mean values. The statistical model of comparing the stochastic distributions of ACOF and RCOF introduced by Chang ( 2004 ) is a promising way to estimate the probability of slip incidents when unexpectedly encountering a low friction area. Chang et al. ( 2012 ) reported that the distribution of the RCOF appears to have a good match with the normal distribution for most of the conditions in their experiment (85.5%), but each foot had a different distribution from the other foot under the same conditions in 76% of cases. Chang, Matz, and Chang ( 2014 ) investigated the stochastic distributions of the ACOF of five floor surfaces under dry, water and glycerol conditions. They reported that the ACOF distributions had a slightly better match with the normal and log-normal distributions than with the Weibull in only three out of 15 cases evaluated. Since the ACOF was compared with the RCOF for the estimate of slip probability, the distribution of the ACOF in seven conditions out of 15 could be considered a constant for this purpose when the ACOF was much lower or higher than the RCOF. No representation could be found in three conditions out of 15. Further investigations could be conducted in the future on the effects of ageing, anthropometric distribution on the stochastic distribution of RCOF, as well as the stochastic distributions of ACOF of commonly used floor surfaces. Ultimately, the output of the statistical model should be validated by experiments and the results considered valid only when ACOF measured with adequate fidelity is compared with RCOF.

6.9. Floor cleaning

Floor cleaning has received very little attention despite the efforts by Underwood ( 1991 ) and Quirion, Poirier, and Lehane ( 2008 ). Underwood ( 1991 ) analysed soil on typical floor tiles on restaurant floors and then proposed a process to generate a worn and soiled tile in the laboratory. The worn tiles generated by the process used by Underwood ( 1991 ) were not compared with actual worn tiles in terms of surface roughness and material compositions. The chemical compositions and structures of the contaminants on the fouled tiles generated by their process were not compared with contaminants on actual worn tiles. On top of fouled tiles, fresh contaminants such as cooking oil were applied by Quirion, Poirier, and Lehane ( 2008 ). These fresh contaminants might not resemble those contaminants deposited on fouled tiles in field environments.

Quirion, Poirier, and Lehane ( 2008 ) used the techniques developed by Underwood and onsite cleaning procedures observed in field visits to investigate the effectiveness of floor cleaning and improve cleaning protocols for various floor types. They reported that the cleaning efficiency and friction could be improved by simple changes in floor cleaning procedures. In addition, proper executions of existing cleaning protocols could affect the outcome. Verma et al. ( 2010 ) reported that 62% of the participants who were responsible for cleaning floors used hot/warm water with widely used enzyme-based floor cleaners, thus violating the manufacturer’s cold water floor cleaning protocol. Quirion, Poirier, and Lehane ( 2008 ) used very limited cleaning methods with few cleaning chemicals in their experiment. Systematic studies are needed to identify optimal cleaning methods and chemicals used to achieve the best cleaning outcomes in a real-world setting.

7.  Organisational influences

It should be noted that caution is needed when translating findings of laboratory studies to activities in actual workplaces. Walking and movements performed at work and the injury risks arising from them are determined by working conditions (e.g. work-pace, load carriage), worker characteristics (e.g. obesity, age) and worker goals (e.g. stress, motivation). A comprehensive understanding of balance and movement control in occupational situations requires consideration of not only the biomechanics of movement, but also the cognitive, psychological and organisational aspects (Leclercq et al. 2015 ). Indeed, displacements and, more generally, the movements performed at work are subjected to continuous adjustment of the required task as well as individual, organisational and environmental constraints. Thus, time required and time imposed for the action (i.e. workload as well as work-pace), mistakes made (Chassaing 2005 , 2010 ), tiredness, pain (Gaudart 2000 ; Derosier et al. 2008 ), previous work experience, life outside work (Chassaing 2005 ; Derosier et al. 2008 ; Caban-Martinez et al. 2014 ) and past experiences (Daniellou et al. 2008 ) are a few factors influencing our movement/motor patterns relevant to occupational fall risks. Moreover, production-safety arbitrations, which relate particularly to organisational activities implemented by the company, should be considered. Organisational factors highlighted during STFL analysis reveal worker arbitration between production and safety in the work situation, in which he/she is exposed to a risk of displacement or movement disturbance (Leclercq 2014 ).

7.1. Developing a systems approach

Various authors have emphasised the role of organisational influences on worker exposure to STFL hazards and eliminating or controlling risks (Bentley and Haslam 2001b ; Leclercq and Thouy 2004 ; Derosier et al. 2008 ; Leclercq 2014 ; Leclercq et al. 2015 ), while others argued explicitly for a systems or macro-ergonomics approach to STFL prevention (Leclercq 2002 ; Gao and Abeysekera 2004 ; Maynard and Robertson 2007 ; Bentley 2009 ). The reasoning for a systems approach is that for any STFL incident, its genesis will lie within the context of a socio-technical system, i.e. the combination and interactions among humans, equipment, work activities, environments, organisational structures and processes all affecting workplace safety (Carayon et al. 2015 ). It follows that it is necessary to develop scientific rationales considering worker attributes, work tasks, interactions with the physical environments and organisational factors to explain the processes involved in STFL.

Immediate or proximal factors in STFL, such as slippery flooring, inadequate footwear, the presence of trip hazards and unsafe behaviour are themselves caused by other upstream or distal factors. These factors could include, for example, nature of the tasks undertaken, equipment selection and usage (Bentley and Haslam 2001a ; Kines 2003 ), work organisation (Leclercq and Thouy 2004 ), work system design (Derosier et al. 2008 ) and safety management (Bentley and Haslam 2001b ). For example, Bentley and Haslam ( 1998 ) showed that the ‘job and finish’ policy implemented in the United Kingdom’s mail distribution company, which at that time allowed workers to go home as soon as the last mail had been distributed, could have encouraged workers to take risks by hurrying or taking short-cuts. Each factor involved in an STFL incident, regardless of its position in the causal chain, represents an opportunity, theoretically at least, for its prevention.

In the case of distal factors, their presence and combination will be specific to an organisation, industrial sector or occupation. This is illustrated by STFL studies in the literature concerned with particular work activities or work situations including delivery driving (Nicholson and David 1985 ), painting (Hunting et al. 1991 ), postal delivery (Haslam and Bentley 1999 ), power distribution (Leclercq and Thouy 2004 ; Mattila et al. 2006 ), health care (Staal et al. 2004 ; Bell et al. 2008 ), dairy farming (Bentley et al. 2005 ), seafaring (Jensen et al. 2005 ), rail transport (Leclercq, Thouy, Rossignol 2007 ), metallurgy (Derosier et al. 2008 ), metallurgy and construction (Abdat et al., 2014 ) and helicopter manufacturing (Amandus et al. 2012 ). Such investigations reveal a particular socio-technical system context and pattern of causal factors related to this socio-technical system. Slip-induced falls are a particular problem in restaurant workplaces, for example. Flach et al. ( 2015 ) considered slips in a national chain of fast food restaurants from a socio-technical systems perspective, focusing on the influences on a single factor (floor cleanliness). Flach et al.’s analysis showed how floor cleaning and its effectiveness were affected by organisational practices and decision-making, such as choice of detergent by the head office, improper use of the chosen detergent locally and the role of line communication and supervision. Flach et al. also identified the challenge for the company in maintaining local knowledge and correct floor cleaning practices in an industry with high turnover of staff and low paid workers.

In their commentary on STFL prevention, Maynard and Robertson ( 2007 ) referred to macro-ergonomics as an implementation of socio-technical system approaches and then proceeded to describe a work-system continuum. Key elements in this work-system continuum included management leadership, education and training, hazard surveillance, floor slipperiness assessment, incident and injury reports, floor surface selection, floor surface treatments, mats, housekeeping and maintenance, warning signs and instructions, and slip-resistant footwear. Maynard and Robertson concluded that preventing STFL requires a multi-factorial approach and combined effort among all members of an organisation, with communication across the entire work system being critical.

7.2. Safety climate and STFL

When considering organisational influences on STFL, another relevant concept is safety climate. Safety climate is defined as workers’ shared perceptions of safety policies, procedures and practices, as well as the overall importance and priority given to safety at work by their organisation and in their workplace (Zohar 2003 ). It has also been suggested that safety climate could be related to workers’ perceptions of injury risk (Mearns and Flin 1996 ). Safety climate, a multi-factorial construct, has been shown to be a robust predictor of safety outcomes, such as incidents and injuries, across industries and countries (Huang et al. 2007 ; Zohar 2010 ). There has, however, been only limited attention given to the relationship between safety climate and STFL.

Bentley and Haslam ( 2001a ) examined safety climate indirectly in their comparison of safety practices of managers of high and low accident rate postal delivery offices. They found that delivery office managers from low accident rate offices, drawn equally from matched high and low accident rate offices, appeared to have improved performance in quality of safety communication, dealing with hazards reported on delivery walks, and accident investigation and remedial action.

Swedler et al. ( 2015 ) reported a prospective study examining the relationship between safety climate and workplace slips involving 349 workers at 30 fast food restaurants in the US. At baseline, participants were questioned about safety training and management commitment to safety at their restaurant, with responses used to generate safety climate scores. Workers’ shoes were also assessed for slip resistance, with this rating included as a safety performance metric. The study found that safety climate influenced prospective slipping in restaurants, mediated by employees wearing slip-resistant shoes. Swedler et al. concluded that it should be possible to improve safety climate by improving training and managerial commitment to safety and in so doing reduce the prevalence of workplace slips. Further research is needed to confirm the role of other safety climate factors in STFL such as communication, management commitment and competing demands. Additional research issues could include the potential of safety climate measures being more widely used as a tool for evaluating STFL risk in organisations, and the possibilities for improving safety climate as a means of STFL prevention.

8.  Injury prevention and practices

As is apparent from earlier sections of this paper, the causes of STFL have been the focus of substantial research effort. Research with regard to STFL prevention, however, is another matter. There has been attention in the falls literature to specific hazards and to controlling the associated risks. From various research studies, for example, it is known that proper selection of footwear and flooring, considering the nature of any floor surface contamination that may occur, can increase the friction at the foot-floor interface thus reducing slips (e.g. Aschan et al. 2009 ; Verma et al. 2011 ). Based on their prospective cohort study conducted in fast food restaurants, Verma et al. ( 2011 ) showed that the use of slip-resistant shoes was associated with a 54% reduction in the reported rate of slipping. They also showed that the rate of slipping decreased as the mean kitchen coefficient of friction increased. A note of caution with footwear-based interventions is that, in occupations with variable underfoot conditions and task requirements, specifying appropriate footwear for the range of conditions that may be encountered presents challenges (e.g. Manning and Jones 2001 ; Aschan et al. 2005 ).

There remain notable gaps in our knowledge on STFL prevention. For example, knowledge of how floor cleaning protocols can reduce floor slipperiness is underdeveloped. The level and character of lighting that is needed in order to move around and negotiate the environment safely from a falls perspective is only crudely understood. There have been limited studies of the effectiveness of training, education and awareness raising as an approach to STFL reduction. These studies covered a slip-simulator to facilitate kinetic learning (Lockhart 2010 ; Rich 2012 ), and a virtual reality platform (Liu et al. 2015 ; Parijat, Lockhart, and Liu 2015a, 2015b ).

It is significant from an ergonomics perspective that there has been only limited research adopting an ergonomics systems approach, addressing the ‘… important latent failures or the upstream organisational and cultural contexts within which workplace STF occur’ (Bentley, 2009 ). Noting the lack of progress with STFL prevention, Leclercq et al. ( 2015 ) noticed the similarity between work-related musculoskeletal disorders (WMSD) and slips, trips and falls, resulting from movements made by workers. Leclercq et al. ( 2015 ) argued that STFL prevention could benefit from the extensive research effort directed at WMSD, at least from a methodological and theoretical point of view. From this, they identified the benefits in developing STFL prevention approaches based on a local, participatory search for solutions that take into account mental representations of the risk shared by all stakeholders.

Another surprising aspect is the paucity of prospective studies and evaluated occupational STFL prevention intervention programmes. This lack can be contrasted with the major effort addressing falls among older people. Gillespie ( 2013 ), a longstanding author of the Cochrane reviews on interventions for prevention of falls among older people, reported that as of 2012, there had been over 200 randomised controlled trials, involving almost 140,000 participants, addressing falls prevention among this group. An aspect with this is that prevention of falls among older people has often been focused on the mitigation of causal factors linked to individuals having greater susceptibility to falling. With causal patterns being different and more diverse for occupational STFL, prevention strategies are probably more difficult to define and to implement.

In the area of STFL, however, the only evaluated, multi-factorial intervention is the important study by Bell et al. ( 2008 ). Their research involved three hospitals in the US, applying a comprehensive package of intervention measures, phased in over 3 years and then monitored during a 3-year post-evaluation period. The intervention measures, which were based on analysis of the hospitals’ historical accident reporting data and on-site risk assessment, were developed around 11 main components (Table ​ (Table1 1 ).

The results from the Bell et al. ( 2008 ) intervention measures showed that the overall workers compensation STFL injury claims rate for the hospitals declined significantly (over 50%) during the post-intervention time period. A major success of the intervention showed that a comprehensive and sustained intervention can have a major effect in reducing STFL and related injuries. What the study was unable to reveal, however, was the relative effect or interdependency of the intervention components.

Drawing on the current knowledge that is available in the literature, a structured risk management approach to STFL reduction and injury prevention is appropriate. This approach was the starting point for the tailored strategy of Bell et al. ( 2008 ) for their hospital intervention. Similarly, Haslam and Stubbs ( 2006 ) described a generic approach with three overarching components: (i) primary prevention, (ii) residual risk reduction and (iii) measures to maximise individual capability, as outlined in Table ​ Table2 2 and expanded upon in the following sections.

8.1. Primary prevention

The purpose of primary prevention is to eliminate STFL hazards at source through the design of the work environment and work/activity systems. Flooring should be selected with appropriate slip resistance for the different conditions to which it will be subjected. Walkways and walking areas should be designed and constructed to avoid trip hazards. In addition, primary prevention involves attention to the equipment used (e.g. to avoid spillages and other walkway contamination), the manner in which equipment is arranged, the tasks workers need to perform, and the extent to which each of these elements might affect the risk of falling. Provision of sufficient, accessible storage is a measure aimed at reducing the need for objects and materials to be placed in the walking path, which may then present a trip hazard. The provision of sufficient lighting is important to aid visibility of the walking surface. The design and installation of walking surfaces and pathways should make allowances for their cleaning and maintenance. In addition, to avoid introducing hazards by wear and tear, installations should be appropriately durable and resistant to damage. Pedestrian walkways can be protected from vehicle intrusion or damage, for example, by ensuring there is physical separation between the two (e.g. through installation of bollards).

8.2. Risk reduction

Even with concerted attention to primary fall prevention, it is inevitable that STFL hazards will continue to be present in the environment. Risk reduction aims to reduce the likelihood of STFL and injuries arising from these hazards. An important starting point is to raise awareness of the problem and, through education, promote understanding of risk factors for falling and how they can be mitigated. Accompanying this is a need for proactive risk assessment and management.

Where STFL hazards may arise in an area used by pedestrians, it is important that adequate procedures are implemented to detect these hazards and to remedy the situation. Indoor flooring will usually need to be cleaned periodically for the sake of hygiene and appearances. Care should be taken during the cleaning process to make sure STFL hazards are not introduced, for example, the risk of slipping with wet vinyl or tiled floor surfaces while these surfaces are drying. For maintenance, routine inspection programmes should be arranged for walking areas and pathways. In all cases, housekeeping procedures should be designed to be sustainable so that initial good practices do not deteriorate to the point of becoming ineffective, as can readily occur over time.

Where STFL hazards are present and cannot be removed immediately, an obvious action is to warn of their existence. This can be done through use of signage warning of a risk of slipping. Lighting may be adequate, but is only effective if turned on at appropriate times. Carrying items and hurrying are additional behavioural factors contributing to STFL and should be discouraged in circumstances where other STFL risk factors are present. These behavioural factors often reveal more upstream organisational and cultural factors (Leclercq 2014 ).

There are certain conditions in which risk of STFL is increased. Poor weather, resulting in outdoor areas becoming covered with ice or snow, is frequently accompanied by increased prevalence of slip-induced falls, unless appropriate precautions have been taken. It should be possible to plan ahead for such occasions and facility managers ought to be ready and prepared to implement measures to reduce risk, either through clearing affected areas or by reducing exposure to the slippery conditions (e.g. by temporary changes to working practices which keep workers indoors).

8.3. Maximised capability

A third strand of the STFL prevention process is to maximise individual ability to negotiate the workplace environment. Use of footwear commensurate with underfoot conditions is a measure that can reduce slipping. This measure should include an employer advising on and, where appropriate, issuing suitable footwear for slippery outdoor conditions and shoes or boots with special soling for indoor occupational situations where floor contamination cannot be avoided. Protective clothing can restrict movement and cause sensory impairment, as may be the case with respirators and hearing protection, for example. Protective eyewear can distort vision. Thus, consideration is needed to STFL safety when specifying and managing the use of workplace apparel.

Risk of STFL is reduced if people can see what they are doing; thus, there may be benefit in promoting regular eyesight testing among workers, along with encouragement to use spectacles appropriately. Encouraging exercise to increase and maintain strength and coordination can help improve balance as well as having other benefits in promoting workability. Certain medications that may be prescribed for individual workers for a range of common health conditions can cause drowsiness, dizziness, unsteadiness and blurred vision, all undesirable from an STFL prevention perspective. Tiredness, as may arise among shift workers, can affect concentration and attention. The effects of alcohol on coordination and balance are well known, although this is not often a problem among a well-managed workforce. There is a particular need, however, to control STFL risk in workplace locations where alcohol is consumed regularly and drinks may be spilt or drink containers discarded onto the floor (e.g. by customers in bars and clubs).

While the risk management approach advocated by Haslam and Stubbs ( 2006 ) appears intuitive and based on sound reasoning, the ‘state of science’ for STFL prevention is such that evidence in support of its various elements and their prioritisation is sparse.

9.  Conclusions

This paper has reviewed the state of science concerning occupational STFL. The review has highlighted the continuing burden of STFL as a major source of workplace injury and subsequent cost to individuals, employers and wider society. Progress has been made in understanding the causal factors contributing to STFL, with slipping and the foot-floor interface, in particular, having received detailed attention. The contributing factors in trip-induced falls have also been examined, both experimentally and in workplace studies. Less attention has been given to same level falls arising from other loss of balance or movement disturbance events.

Although there is increasing recognition of the complexity of the interacting factors in STFL and the need for multi-disciplinary approaches, systems perspectives adopting a more holistic view of STFL causation are immature. Further work is needed, drawing on current developments in socio-technical systems thinking and safety. Greater attention is necessary to the factors upstream in the injury genesis forming the circumstances in which injuries occur. It is important to consider these upstream factors in STFL prevention.

The scale of STFL and the limited success in tackling the problem present a compelling case for further prevention trials to be undertaken in the field. Structured and evaluated studies will be essential in developing evidence-based approaches aimed at reducing the toll of STFL. Although important research has shown that intervention can be effective, resulting in reductions in the occurrence of injuries, confirmation is required regarding the effectiveness of different intervention components, both separately and combined. Given the multi-factorial nature of STFL, this improved understanding will allow intervention efforts to be better targeted and more feasible, taking into account cost effectiveness. Intervention research of this nature, with the cooperation needed by organisations and access needed to their workplaces and their workers, does present significant practical challenges. With coordinated, international research efforts, however, further progress should be possible.

In conclusion, the major messages from this state of science review are that STFL continue to be a major source of occupational injury. Progress has been made understanding the causes of STFL, with increasing recognition of the multi-factorial nature of the problem. Gaps in understanding still exist and have been flagged for further research. There is limited but encouraging evidence that STFL prevention activity can be beneficial in reducing injuries. Further research is needed to improve knowledge of the measures most beneficial for STFL prevention, how to deploy these and the cost-benefits of doing so. Finally, we underline that STFL occur in a socio-technical systems context. A systems approach will be essential to bring about real future progress in their prevention.

Disclosure statement

No potential conflict of interest was reported by the authors.

Acknowledgement

The authors would like to thank Debra Larnis and Margaret Rothwell for their assistance during the course of this study.

* A shortened version of this paper was presented at the International Conference on Fall Prevention and Protection 2013, National Institute of Occupational Safety and Health, Japan (JNIOSH), Tokyo. An earlier version of the commentary on injury prevention and practices appeared in Haslam and Stubbs (2006).

• Abdat F., Leclercq S., Cuny X., Tissot C. Extracting Recurrent Scenarios from Narrative Texts Using a Bayesian Network: Application to Serious Occupational Accidents with Movement Disturbance. Accident Analysis and Prevention . 2014; 70 :155–166. doi: 10.1016/j.aap.2014.04.004. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Alexander N. B., Shepard N., Gu M. J., Schultz A. Postural Control in Young and Elderly Adults When Stance is Perturbed: Kinematics. Journal of Gerontology . 1992; 47 (3):M79–M87. doi: 10.1093/geronj/47.3.M79. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Amandus H., Bell J., Tiesman H., Biddle E. The Epidemiology of Slips, Trips, and Falls in a Helicopter Manufacturing Plant. Human Factors: The Journal of the Human Factors and Ergonomics Society . 2012; 54 (3):387–395. doi: 10.1177/0018720811403140. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Anderson D. E., Franck C. T., Madigan M. L. Age Differences in the Required Coefficient of Friction during Level Walking Do Not Exist When Experimentally-controlling Speed and Step Length. Journal of Applied Biomechanics . 2014; 30 (4):542–546. doi: 10.1123/jab.2013-0275. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Andres R. O., O’Connor D., Eng T. A Practical Synthesis of Biomechanical Results to Prevent Slips and Falls in the Workplace. In: Kumar S., editor. Advances in industrial ergonomics and safety IV: Proceedings of the 23rd Annual International Industrial Ergonomics and Safety Conference; Denver, Colorado. 10–14 June; 1992. pp. 1001–1006. [ Google Scholar ]
• Aschan C., Hirvonen M., Rajamäki E., Mannelin T. Slip Resistance of Oil Resistant and Non-oil Resistant Footwear Outsoles in Winter Conditions. Safety Science . 2005; 43 (7):373–389. doi: 10.1016/j.ssci.2005.08.001. [ CrossRef ] [ Google Scholar ]
• Aschan C., Hirvonen M., Rajamäki E., Mannelin T., Ruotsalainen J., Ruuhela R. Performance of Slippery and Slip-resistant Footwear in Different Wintry Weather Conditions Measured in Situ. Safety Science . 2009; 47 (8):1195–1200. doi: 10.1016/j.ssci.2009.01.006. [ CrossRef ] [ Google Scholar ]
• Astrand P. O., Rodahl K. Textbook of Work Physiology . 3rd ed. New York: Mc-GrawHill; 1986. 1986. [ Google Scholar ]
• Begg R., Best R., Dell’Oro L., Taylor S. Minimum Foot Clearance during Walking: Strategies for the Minimisation of Trip-related Falls. Gait and Posture . 2007; 25 (2):191–198. doi: 10.1016/j.gaitpost.2006.03.008. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bell J. L., Collins J. W., Wolf L., Grönqvist R., Chiou S., Chang W. R., Sorock G. S., Courtney T. K., Lombardi D. A., Evanoff B. Evaluation of a Comprehensive Slip, Trip and Fall Prevention Programme for Hospital Employees. Ergonomics . 2008; 51 (12):1906–1925. doi: 10.1080/00140130802248092. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bentley T. A., Haslam R. A. Slip, Trip and Fall Accidents Occurring during the Delivery of Mail. Ergonomics . 1998; 41 (12):1859–1872. doi: 10.1080/001401398186027. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bentley T. A., Haslam R. A. Identification of Risk Factors and Countermeasures for Slip, Trip and Fall Accidents during the Delivery of Mail. Applied Ergonomics . 2001a; 32 (2):127–134. doi: 10.1016/S0003-6870(00)00048-X. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bentley T. A., Haslam R. A. A Comparison of Safety Practices Used by Managers of High and Low Accident Rate Postal Delivery Offices. Safety Science . 2001b; 37 (1):19–37. doi: 10.1016/S0925-7535(00)00042-4. [ CrossRef ] [ Google Scholar ]
• Bentley T. A., Tappin D., Moore D., Legg S., Ashby L., Parker R. Investigating Slips, Trips and Falls in the New Zealand Dairy Farming Sector. Ergonomics . 2005; 48 (8):1008–1019. doi: 10.1080/00140130500182072. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bentley T. The Role of Latent and Active Failures in Workplace Slips, Trips and Falls: An Information Processing Approach. Applied Ergonomics . 2009; 40 (2):175–180. doi: 10.1016/j.apergo.2008.04.009. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Beringer D. N., Nussbaum M. A., Madigan M. L. Temporal Changes in the Required Shoe-floor Friction When Walking following an Induced Slip. PLoS ONE . 2014; 9 (5):e96525. doi: 10.1371/journal.pone.0096525. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Beschorner K., Cham R. Impact of Joint Torques on Heel Acceleration at Heel Contact, a Contributor to Slips and Falls. Ergonomics . 2008; 51 (12):1799–1813. doi: 10.1080/00140130802136479. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Beschorner K., Lovell M., Higgs C. F., III, Redfern M. S. Modeling Mixed-Lubrication of a Shoe-floor Interface Applied to a Pin-on-Disk Apparatus. Tribology Transactions . 2009; 52 (4):560–568. doi: 10.1080/10402000902825705. [ CrossRef ] [ Google Scholar ]
• Blanchette M. G., Powers C. M. The Influence of Footwear Tread Groove Parameters on Available Friction. Applied Ergonomics . 2015; 50 :237–241. doi: 10.1016/j.apergo.2015.03.018. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bruijn S. M., Meijer O. G., Beek P. J., van Dieën J. H. Assessing the Stability of Human Locomotion: A Review of Current Measures. Journal of the Royal Society Interface . 2013; 10 :20120999. doi: 10.1098/rsif.2012.0999. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Buck P. C., Coleman V. P. Slipping, Tripping and Falling Accidents at Work: A National Picture. Ergonomics . 1985; 28 (7):949–958. doi: 10.1080/00140138508963217. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bureau of Labour Statistics Economic News Release: Table 5. Number, Incidence Rate, and Median Days Away from Work for Nonfatal Occupational Injuries and Illnesses Involving Days Away from Work by Injury or Illness Characteristics and Ownership, 2013. 2014 http://www.bls.gov/news.release/osh2.t05.htm
• Bunterngchit Y., Lockhart T., Woldstad J. C., Smith J. L. Age Related Effects of Transitional Floor Surfaces and Obstruction of View on Gait Characteristics Related to Slips and Falls. International Journal of Industrial Ergonomics . 2000; 25 (3):223–232. doi: 10.1016/S0169-8141(99)00012-8. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Burnfield J. M., Tsai Y. J., Powers C. M. Comparison of Utilized Coefficient of Friction during Different Walking Tasks in Persons with and without a Disability. Gait and Posture . 2005; 22 (1):82–88. doi: 10.1016/j.gaitpost.2004.07.004. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Caban-Martinez A. J., Courtney T. K., Chang W. R., Lombardi D. A., Huang Y. H., Brennan M. J., Perry M. J., Katz J. N., Verma S. K. Preventing Slips and Falls through Leisure-time Physical Activity: Findings from a Study of Limited-Service Restaurants. PLoS ONE . 2014; 9 (10):e110248. doi: 10.1371/journal.pone.0110248. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Cameron I. D., Gillespie L. D., Robertson M. C., Murray G. R., Hill K. D., Cumming R. G., Kerse N. Interventions for Preventing Falls in Older People in Care Facilities and Hospitals. Cochrane Database of Systematic Reviews . 2012; 12 doi: 10.1002/14651858.CD005465.pub3. Art. No.: CD005465. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Cappellini G., Ivanenko Y. P., Dominici N., Poppele R. E., Lacquaniti F. Motor Patterns during Walking on a Slippery Walkway. Journal of Neurophysiology . 2010; 103 (2):746–760. doi: 10.1152/jn.00499.2009. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Carayon P., Hancock P., Leveson N., Noy I., Sznelwar L., van Hootegem G. Advancing a Sociotechnical Systems Approach to Workplace Safety – Developing the Conceptual Framework. Ergonomics . 2015; 58 (4):548–564. doi: 10.1080/00140139.2015.1015623. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Cham R., Redfern M. S. Changes in Gait When Anticipating Slippery Floors. Gait and Posture . 2002a; 15 (2):159–171. doi: 10.1016/S0966-6362(01)00150-3. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Cham R., Redfern M. S. Heel Contact Dynamics during Slip Events on Level and Inclined Surfaces. Safety Science . 2002b; 40 (7–8):559–576. doi: 10.1016/S0925-7535(01)00059-5. [ CrossRef ] [ Google Scholar ]
• Cham R., Beschorner K., Redfern M. S. Whole Body Postural Responses to Slips. The Proceedings of the International Conference on Slips, Trips and Falls 2007 – From Research to Practice; Hopkinton, MA, USA: The IEA Press; 2007. pp. 30–34. [ Google Scholar ]
• Chambers A. J., Perera S., Cham R. Changes in Walking Characteristics of Young and Older Adults When Anticipating Slippery Floors. IIE Transactions on Occupational Ergonomics and Human Factors . 2013; 1 (3):166–175. doi: 10.1080/21577323.2013.815139. [ CrossRef ] [ Google Scholar ]
• Chang W. R. Preface. Ergonomics . 2008; 51 (12):1797–1798. doi: 10.1080/00140130802560686. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chang W. R., Grönqvist R., Leclercq S., Brungraber R., Mattke U., Strandberg L., Thorpe S., Myung R., Makkonen L., Courtney T. K. The Role of Friction in the Measurement of Slipperiness, Part 2: Survey of Friction Measurement Devices. Ergonomics . 2001a; 44 (13):1233–1261. doi: 10.1080/00140130110085583. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chang W. R., Grönqvist R., Leclercq S., Myung R., Makkonen L., Strandberg L., Brungraber R., Mattke U., Thorpe S. The Role of Friction in the Measurement of Slipperiness, Part 1: Friction Mechanisms and Definition of Test Conditions. Ergonomics . 2001b; 44 (13):1217–1232. doi: 10.1080/00140130110085574. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chang W. R., Kim I. J., Manning D., Bunterngchit Y. The Role of Surface Roughness in the Measurement of Slipperiness. Ergonomics . 2001c; 44 (13):1200–1216. doi: 10.1080/00140130110085565. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chang W. R. A Statistical Model to Estimate the Probability of Slip and Fall Incidents. Safety Science . 2004; 42 (9):779–789. doi: 10.1016/j.ssci.2004.02.001. [ CrossRef ] [ Google Scholar ]
• Chang W. R., Grönqvist R., Hirvonen M., Matz S. The Effect of Surface Waviness on Friction between Neolite and Quarry Tiles. Ergonomics . 2004a; 47 (8):890–906. doi: 10.1080/00140130410001670390. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chang W. R., Hirvonen M., Grönqvist R. The Effects of Cut-off Length on Surface Roughness Parameters and Their Correlation with Transition Friction. Safety Science . 2004; 42 (8):755–769. doi: 10.1016/j.ssci.2004.01.002. [ CrossRef ] [ Google Scholar ]
• Chang W. R., Li K. W., Huang Y. H., Filiaggi A., Courtney T. K. Assessing Floor Slipperiness in Fast-food Restaurants in Taiwan Using Objective and Subjective Measures. Applied Ergonomics . 2004; 35 (4):401–408. doi: 10.1016/j.apergo.2004.01.006. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chang W. R., Li K. W., Huang Y. H., Filiaggi A., Courtney T. K. Objective and Subjective Measurements of Slipperiness in Fast-Food Restaurants in the USA and Their Comparison with the Previous Results Obtained in Taiwan. Safety Science . 2006; 44 (10):891–903. doi: 10.1016/j.ssci.2006.06.001. [ CrossRef ] [ Google Scholar ]
• Chang W. R., Huang Y. H., Li K. W., Filiaggi A., Courtney T. K. Assessing Slipperiness in Fast-Food Restaurants in the USA Using Friction Variation, Friction Level and Perception Rating. Applied Ergonomics . 2008; 39 (3):359–367. doi: 10.1016/j.apergo.2007.08.004. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chang W. R., Chang C. C., Matz S. The Effect of Transverse Shear Force on the Required Coefficient of Friction for Level Walking. Human Factors: The Journal of the Human Factors and Ergonomics Society . 2011; 53 (5):461–473. doi: 10.1177/0018720811414885. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chang W. R., Matz S., Chang C. C. Stochastic Distribution of the Required Coefficient of Friction for Level Walking – An In-depth Study. Ergonomics . 2012; 55 (8):937–945. doi: 10.1080/00140139.2012.683880. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chang W. R., Matz S., Chang C. C. The Stochastic Distribution of Available Coefficient of Friction for Human Locomotion of Five Different Floor Surfaces. Applied Ergonomics . 2014; 45 (3):811–815. doi: 10.1016/j.apergo.2013.10.006. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chang W. R., Lesch M. F., Chang C. C., Matz S. Contribution of Gait Parameters and Available Coefficient of Friction to Perceptions of Slipperiness. Gait & Posture . 2015; 41 (1):288–290. doi: 10.1016/j.gaitpost.2014.08.010. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chassaing K. Stratégies D’expérience Et Organisation Du Travail Dans La Prévention Des Douleurs Articulaires. 1er congrès francophone sur les troubles musculosquelettiques; Nancy. 2005. [ Google Scholar ]
• Chassaing K. Les “Gestuelles” à L’épreuve De L’organisation Du Travail: Du Contexte De L’industrie Automobile à Celui Du Génie Civil. Le Travail Humain . 2010; 73 (2):163–192. doi: 10.3917/th.732.0163. Understanding Gesture and Work Organization: An Analysis in the Context of the Car Industry and Civil Engineering. [ CrossRef ] [ Google Scholar ]
• Chau N., Gauchard G. C., Siegfried C., Banamghar L., Dangelzer J. L., Francais M., Sourdot A., Perrin P. P., Mur J. M. Relationships of Job, Age, and Life Conditions with the Causes and Severity of Occupational Injuries in Construction Workers. International Archives of Occupational and Environmental Health . 2004; 77 (1):60–66. doi: 10.1007/s00420-003-0460-7. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chiou S. Y., Bhattacharya A., Succop P. A. Effect of Workers’ Shoe Wear on Objective and Subjective Assessment of Slipperiness. American Industrial Hygiene Association Journal . 1996; 57 (9):825–831. doi: 10.1080/15428119691014503. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chiou S. Y., Bhattacharya A., Succop P. A. Evaluation of Workers’ Perceived Sense of Slip and Effect of Prior Knowledge of Slipperiness during Task Performance on Slippery Surfaces. AIHAJ – American Industrial Hygiene Association . 2000; 61 (4):492–500. doi: 10.1080/15298660008984560. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Cikajlo I., Matjačić Z. The Influence of Boot Stiffness on Gait Kinematics and Kinetics during Stance Phase. Ergonomics . 2007; 50 (12):2171–2182. doi: 10.1080/00140130701582104. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• CNAMTS . Statistiques Nationales Des Accidents Du Travail, Des Accidents De Trajet Et Des Maladies Professionnelles . [National Statistics of Occupational Accidents, Commuting Accidents and Occupational Diseases]. Paris: CNAMTS; 1988. [ Google Scholar ]
• CNAMTS . Statistiques Nationales Des Accidents Du Travail, Des Accidents De Trajet Et Des Maladies Professionnelles . [National Statistics of Occupational Accidents, Commuting Accidents and Occupational Diseases]. Paris: CNAMTS; 2012. [ Google Scholar ]
• Cohen H. H., Cohen D. M. Psychophysical Assessment of the Perceived Slipperiness of Floor Tile Surfaces in a Laboratory Setting. Journal of Safety Research . 1994a; 25 (1):19–26. doi: 10.1016/0022-4375(94)90004-3. [ CrossRef ] [ Google Scholar ]
• Cohen H. H., Cohen D. M. Perceptions of Walking Surface Slipperiness under Realistic Conditions, Utilizing a Slipperiness Rating Scale. Journal of Safety Research . 1994b; 25 (1):27–31. doi: 10.1016/0022-4375(94)90005-1. [ CrossRef ] [ Google Scholar ]
• Courtney T. K., Chang W. R., Grönqvist R., Redfern M. S. The Measurement of Slipperiness – An International Symposium. Ergonomics . 2001a; 44 (13):1097–1101. doi: 10.1080/00140130110085510. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Courtney T. K., Huang Y. H., Verma S. K., Chang W. R., Li K. W., Filiaggi A. J. Factors Influencing Restaurant Worker Perception of Floor Slipperiness. Journal of Occupational and Environmental Hygiene . 2006; 3 (11):592–598. doi: 10.1080/15459620600934367. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Courtney T. K., Sorock G. S., Manning D. P., Collins J. W., Holbein-Jenny M. A. Occupational Slip, Trip, and Fall-related Injuries – Can the Contribution of Slipperiness Be Isolated? Ergonomics . 2001b; 44 (13):1118–1137. doi: 10.1080/00140130110085538. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Courtney T. K., Verma S. K., Chang W. R., Huang Y. H., Lombardi D. A., Brennan M. J., Perry M. J. Perception of Slipperiness and Prospective Risk of Slipping at Work. Occupational and Environmental Medicine . 2013; 70 (1):35–40. doi: 10.1136/oemed-2012-100831. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Courtney T. K., Webster B. S. Antecedent Factors and Disabling Occupational Morbidity Insights from the New BLS Data. AIHAJ – American Industrial Hygiene Association . 2001; 62 (5):622–632. doi: 10.1080/15298660108984662. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Daniellou F., Caroly S., Coutarel F., Escriva E., Roquelaure Y., Schweitzer J. M. “La Prévention Durable Des TMS Quels Freins? Quels Leviers D’action?” Recherche-action 2004–2007 . [Sustainable Prevention of WRMSD. What obstacles? What targets for the action?]. Paris: Direction générale du Travail; 2008. [ Google Scholar ]
• Davis P. R. Slipping, Tripping and Falling Accidents: An Introduction. Ergonomics . 1983a; 26 (1):1–2. doi: 10.1080/00140138308963307. [ CrossRef ] [ Google Scholar ]
• Davis P. R. Human Factors Contributing to Slips, Trips and Falls. Ergonomics . 1983b; 26 (1):51–59. doi: 10.1080/00140138308963312. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Derosier C., Leclercq S., Rabardel P., Langa P. Studying Work Practices: A Key Factor in Understanding Accidents on the Level Triggered by a Balance Disturbance. Ergonomics . 2008; 51 (12):1926–1943. doi: 10.1080/00140130802567061. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Di Pilla S. Slip and Fall Prevention . Boca Raton, FL: Lewis Publishers; 2003. ISBN 1-56670-659-9. [ CrossRef ] [ Google Scholar ]
• Dingwell J. B., Cusumano J. P., Cavanagh P. R., Sternad D. Local Dynamic Stability versus Kinematic Variability of Continuous Overground and Treadmill Walking. Journal of Biomechanical Engineering . 2001; 123 (1):27–32. doi: 10.1115/1.1336798. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Dingwell J. B., Kang H. G. Differences between Local and Orbital Dynamic Stability during Human Walking. Journal of Biomechanical Engineering-Transactions of the ASME . 2007; 129 (4):586–593. doi: 10.1115/1.2746383. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Ehsan R., Bochen J., Nussbaum M., Lockhart T.2013 Investigating the Effects of Slipping on Lumbar Muscle Activity, Dinematics, and Dinetics Proceedings of the International Annual Meeting of the Human Factors and Ergonomics Society Annual Meeting . Sept. 30–Oct. 4, 2013San Diego, CA, USASage; 1201–1205.ISBN 978-0-945289-43-2 [ Google Scholar ]
• Ekkebus C. E., Killey W. Soap/Cosmetics/Chemical Specialties . 1973. Measurement of Safe Walkway Surfaces; pp. 40–45. February 1973. [ Google Scholar ]
• Eng J. J., Winter D. A., Patla A. E. Strategies for Recovery from a Trip in Early and Late Swing during Human Walking. Experimental Brain Research . 1994; 102 (2):339–349. doi: 10.1007/BF00227520. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• European Agency for Safety and Health at Work (EU-OSHA) Preventing Accidents at Work . Luxembourg: Office for Official Publications of the European Communities; 2001. ISSN 1608-4144. [ Google Scholar ]
• European Commission . Causes and Circumstances of Accidents at Work in the EU . Luxembourg: Office for Official Publications of the European Communities; 2008. [ Google Scholar ]
• European Commission . European Statistics on Accidents at Work (ESAW) Luxembourg: Office for Official Publications of the European Communities; 2013. [ Google Scholar ]
• Fino P., Lockhart T. E. Required Coefficient of Friction during Turning at Self-selected Slow, Normal, and Fast Walking Speeds. Journal of Biomechanics . 2014; 47 (6):1395–1400. doi: 10.1016/j.jbiomech.2014.01.032. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Fino P. C., Lockhart T. E., Fino N. F. Corner Height Influences Center of Mass Kinematics and Path Trajectory during Turning. Journal of Biomechanics . 2015; 48 (1):104–112. doi: 10.1016/j.jbiomech.2014.10.034. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Flach J. M., Carroll J. S., Dainoff M. J., Hamilton W. I. Striving for Safety: Communicating and Deciding in Sociotechnical Systems. Ergonomics . 2015; 58 (4):615–634. doi: 10.1080/00140139.2015.1015621. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Fong D. T. P., Hong Y., Li J. X. Lower-extremity Gait Kinematics on Slippery Surfaces in Construction Worksites. Medicine & Science in Sports & Exercise . 2005; 37 (3):447–454. doi: 10.1249/01.MSS.0000155390.41572.DE. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Gao C., Abeysekera J. A Systems Perspective of Slip and Fall Accidents on Icy and Snowy Surfaces. Ergonomics . 2004; 47 (5):573–598. doi: 10.1080/00140130410081658718. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Gauchard G., Chau N., Mur J. M., Perrin P. Falls and Working Individuals: Role of Extrinsic and Intrinsic Factors. Ergonomics . 2001; 44 (14):1330–1339. doi: 10.1080/00140130110084791. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Gaudart C. Conditions for Maintaining Ageing Operators at Work – A Case Study Conducted at an Automobile Manufacturing Plant. Applied Ergonomics . 2000; 31 (5):453–462. doi: 10.1016/S0003-6870(00)00024-7. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Gaudez C., Leclercq S., Derosier C. National Statistics of Occupational Accidents on the Level in France. Proceedings of the 16th International Ergonomics Association Congress; 10–14 July; Maastricht, The Netherlands. 2006. [ Google Scholar ]
• Gillespie L. D. Preventing Falls in Older People: The Story of a Cochrane Review. Cochrane Database of Systematic Reviews . 2013; 2 doi: 10.1002/14651858.ED000053. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Grabiner M. D., Koh T. J., Lundin T. M., Jahnigen D. W. Kinematics of Recovery from a Stumble. Journal of Gerontology . 1993; 48 (3):M97–M102. doi: 10.1093/geronj/48.3.M97. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Grönqvist R. Mechanisms of Friction and Assessment of Slip Resistance of New and Used Footwear Soles on Contaminated Floors. Ergonomics . 1995; 38 (2):224–241. doi: 10.1080/00140139508925100. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Grönqvist R., Abeysekera J., Gard G., Hsiang S. M., Leamon T. B., Newman D. J., Gielo-Perczak K., Lockhart T. E., Pai C. Y. C. Human-centred Approaches in Slipperiness Measurement. Ergonomics . 2001; 44 (13):1167–1199. doi: 10.1080/00140130110085556. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Grönqvist R., Hirvonen M., Tuusa A. Slipperiness of the Shoe-floor Interface: Comparison of Objective and Subjective Assessments. Applied Ergonomics . 1993; 24 (4):258–262. doi: 10.1016/0003-6870(93)90460-Q. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Guo H. R., Tanaka S., Halperin W. E., Cameron L. L. Back Pain Prevalence in US Industry and Estimates of Lost Workdays. American Journal of Public Health . 1999; 89 (7):1029–1035. doi: 10.2105/AJPH.89.7.1029. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hämäläinen P., Takala J., Saarela K. L. Global Estimates of Occupational Accidents. Safety Science . 2006; 44 (2):137–156. doi: 10.1016/j.ssci.2005.08.017. [ CrossRef ] [ Google Scholar ]
• Hanson J. P., Redfern M. S., Mazumdar M. Predicting Slips and Falls Considering Required and Available Friction. Ergonomics . 1999; 42 (12):1619–1633. doi: 10.1080/001401399184712. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Harris G. W., Shaw S. R. Slip Resistance of Floors: Users’ Opinions, Tortus Instrument Readings and Roughness Measurement. Journal of Occupational Accidents . 1988; 9 (4):287–298. doi: 10.1016/0376-6349(88)90019-3. [ CrossRef ] [ Google Scholar ]
• Haslam R. A., Bentley T. A. Follow-up Investigations of Slip, Trip and Fall Accidents among Postal Delivery Workers. Safety Science . 1999; 32 (1):33–47. doi: 10.1016/S0925-7535(99)00009-0. [ CrossRef ] [ Google Scholar ]
• Haslam R., Stubbs D. Understanding and Preventing Falls . Boca Raton, FL: Taylor & Francis, CRC Press; 2006. ISBN: 0-203-64723-8. [ Google Scholar ]
• Haywood K. M. Life Span Motor Development . Champaign, IL: Human Kinetics; 1986. pp. 109–115. 0873220544. [ Google Scholar ]
• Health and Safety Executive . Health and Safety Executive . 2014. Slips and Trips and Falls from Height in Great Britain. http://www.hse.gov.uk/statistics Bootle, UK. [ Google Scholar ]
• Hirvonen M., Leskinen T., Grönqvist R., Saario J. Detection of near Accidents by Measurement of Horizontal Acceleration of the Trunk. International Journal of Industrial Ergonomics . 1994; 14 (4):307–314. doi: 10.1016/0169-8141(94)90019-1. [ CrossRef ] [ Google Scholar ]
• Hsu Y. W., Li K. W. A Field Assessment of Floor Slipperiness in a Fish Market in Taiwan. Safety Science . 2010; 48 (5):556–561. doi: 10.1016/j.ssci.2010.01.001. [ CrossRef ] [ Google Scholar ]
• Hu X., Qu X. Differentiating Slip-induced Falls from Normal Walking and Successful Recovery after Slips Using Kinematic Measures. Ergonomics . 2013; 56 (5):856–867. doi: 10.1080/00140139.2013.776705. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Huang Y. H., Chen J. C., DeArmond S., Cigularov K., Chen P. Y. Roles of Safety Climate and Shift Work on Perceived Injury Risk: A Multi-level Analysis. Accident Analysis and Prevention . 2007; 39 (6):1088–1096. doi: 10.1016/j.aap.2007.02.006. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hunting K. L., Matanoski G. M., Larson M., Wolford R. Solvent Exposure and the Risk of Slips, Trips, and Falls among Painters. American Journal of Industrial Medicine . 1991; 20 (3):353–370. doi: 10.1002/ajim.4700200308. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Jensen O. C., Sørensen J. F. L., Canals M. L., Hu Y., Nikolic N., Mozer A. A. Non-fatal Occupational Injuries Related to Slips, Trips and Falls in Seafaring. American Journal of Industrial Medicine . 2005; 47 (2):161–171. doi: 10.1002/ajim.20119. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Joh A. S., Adolph K. E., Campbell M. R., Eppler M. A. Why Walkers Slip: Shine is Not a Reliable Cue for Slippery Ground. Perception and Psychophysics . 2006; 68 (3):339–352. doi: 10.3758/BF03193681. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kemmlert K., Lundholm L. Slips, Trips and Falls in Different Work Groups with Reference to Age. Safety Science . 1998; 28 (1):59–75. doi: 10.1016/S0925-7535(97)00071-4. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kim I. J. Wear Observation of Shoe Surfaces: Application for Slip and Fall Safety Assessments. Tribology Transactions . 2015; 58 (3):407–417. doi: 10.1080/10402004.2014.980593. [ CrossRef ] [ Google Scholar ]
• Kim S., Lockhart T., Yoon H. Y. Relationship between Age-related Gait Adaptations and Required Coefficient of Friction. Safety Science . 2005; 43 (7):425–436. doi: 10.1016/j.ssci.2005.08.004. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kines P. Case Studies of Occupational Falls from Heights: Cognition and Behavior in Context. Journal of Safety Research . 2003; 34 (3):263–271. doi: 10.1016/S0022-4375(03)00023-9. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Koepp G. A., Snedden B. J., Levine J. A. Workplace Slip, Trip and Fall Injuries and Obesity. Ergonomics . 2015; 58 (5):674–679. doi: 10.1080/00140139.2014.985260. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kong P. W., Suyama J., Hostler D. A Review of Risk Factors of Accidental Slips, Trips, and Falls among Firefighters. Safety Science . 2013; 60 :203–209. doi: 10.1016/j.ssci.2013.07.016. [ CrossRef ] [ Google Scholar ]
• Lanshammar H., Strandberg L. Horizontal Floor Reaction Forces and Heel Movements during the Initial Stance Phase. In: Matsui H., Kobayashi K., editors. Biomechanics VIII . Baltimore, MD: University Park Press; 1983. pp. 1123–1128. [ Google Scholar ]
• Leamon T. B., Li K. W. Microslip Length and the Perception of Slipping; Proceedings of the 23rd International Advances in Industrial Congress on Occupational Health ; Montreal, Canada. Sept. 1990.1990. [ Google Scholar ]
• Leamon T. B., Murphy P. L. Occupational Slips and Falls: More than a Trivial Problem. Ergonomics . 1995; 38 (3):487–498. doi: 10.1080/00140139508925120. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Leclercq S. Prevention of Falls on the Level in Occupational Situations: A Major Issue, a Risk to Be Managed. International Journal of Occupational Safety and Ergonomics . 2002; 8 (3):377–385. doi: 10.1080/10803548.2002.11076537. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Leclercq S. Organisational Factors of Occupational Accidents with Movement Disturbance (OAMD) and Prevention. Industrial Health . 2014; 52 (5):393–398. doi: 10.2486/indhealth.2014-0076. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Leclercq S., Cuny-Guerrier A., Gaudez C., Aublet-Cuvelier A. Similarities between Work Related Musculoskeletal Disorders and Slips, Trips and Falls. Ergonomics . 2015; 58 (10):1624–1636. doi: 10.1080/00140139.2015.1031191. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Leclercq S., Monteau M., Cuny X. Avancée Dans La Prévention Des «Chutes De Plain-Pied» Au Travail. Proposition De Définition Opérationnelle D’une Nouvelle Classe: «Les Accidents Avec Perturbation Du Mouvement (APM) [Progress in the prevention of occupational ‘falls on the same level’. Proposed operational definition of a new category: ‘Accidents with movement disturbance’]. PISTES. 2010; 12 (3):14. [ Google Scholar ]
• Leclercq S., Saulnier H. Floor Slip Resistance Changes in Food Sector Workshops: Prevailing Role Played by “Fouling” Safety Science . 2002; 40 (7–8):659–673. doi: 10.1016/S0925-7535(01)00065-0. [ CrossRef ] [ Google Scholar ]
• Leclercq S., Saurel D., Cuny X., Monteau M. Research into Cases of Slips, Collisions and Other Movement Disturbances Occurring in Work Situations in a Hospital Environment. Safety Science . 2014; 68 :204–211. doi: 10.1016/j.ssci.2014.04.009. [ CrossRef ] [ Google Scholar ]
• Leclercq S., Thouy S. Systemic Analysis of So-called ‘Accidents on the Level’ in a Multi Trade Company. Ergonomics . 2004; 47 (12):1282–1300. doi: 10.1080/00140130410001712627. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Leclercq S., Thouy S., Rossignol E. Progress in Understanding Processes Underlying Occupational Accidents on the Level Based on Case Studies. Ergonomics . 2007; 50 (1):59–79. doi: 10.1080/00140130600980862. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lesch M. F., Chang W. R., Chang C. C. Visually Based Perceptions of Slipperiness: Underlying Cues, Consistency and Relationship to Coefficient of Friction. Ergonomics . 2008; 51 (12):1973–1983. doi: 10.1080/00140130802558979. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Li K. W., Chang W. R., Leamon T. B., Chen C. J. Floor Slipperiness Measurement: Friction Coefficient, Roughness of Floors, and Subjective Perception under Spillage Conditions. Safety Science . 2004; 42 (6):547–565. doi: 10.1016/j.ssci.2003.08.006. [ CrossRef ] [ Google Scholar ]
• Li K. Y., Chen C. J. Effects of Tread Groove Orientation and Width of the Footwear Pads on Measured Friction Coefficients. Safety Science . 2005; 43 (7):391–405. doi: 10.1016/j.ssci.2005.08.006. [ CrossRef ] [ Google Scholar ]
• Li K. W., Hsu Y. W., Chang W. R., Lin C. H. Friction Measurements on Three Commonly Used Floors on a College Campus under Dry, Wet, and Sand-covered Conditions. Safety Science . 2007; 45 (9):980–992. doi: 10.1016/j.ssci.2006.08.030. [ CrossRef ] [ Google Scholar ]
• Li K. W., Meng F., Zhang W. Friction between Footwear and Floor Covered with Solid Particles under Dry and Wet Conditions. International Journal of Occupational Safety and Ergonomics . 2014; 20 (1):43–53. doi: 10.1080/10803548.2014.11077027. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Li K. W., Wu H. H., Lin Y. C. The Effect of Shoe Sole Tread Groove Depth on the Friction Coefficient with Different Tread Groove Widths, Floors and Contaminants. Applied Ergonomics . 2006; 37 (6):743–748. doi: 10.1016/j.apergo.2004.06.010. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Li K. W., Yu R., Zhang W. Roughness and Slipperiness of Floor Surface: Tactile Sensation and Perception. Safety Science . 2011; 49 (3):508–512. doi: 10.1016/j.ssci.2010.11.010. [ CrossRef ] [ Google Scholar ]
• Liberty Mutual Research Institute for Safety . From Research to Reality . 3. Vol. 15. Hopkinton, MA: 2012. 2012 Workplace Safety Index. http://www.libertymutual.com/researchinstitute [ Google Scholar ]
• Liberty Mutual Research Institute for Safety 2014 Workplace Safety Index. From Research to Reality . 2014 http://www.libertymutual.com/researchinstitute
• Liu J., Lockhart T. E. Comparison of 3D Joint Moments Using Local and Global Inverse Dynamics Approaches among Three Different Age Groups. Gait & Posture . 2006; 23 (4):480–485. doi: 10.1016/j.gaitpost.2005.06.011. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Liu J., Lockhart T. E., Kim S. Reaction Moment at the L5/S1 Joint during Simulated Forward Slipping with a Handheld Load. International Journal of Occupational Safety and Ergonomics . 2014; 20 (3):429–436. doi: 10.1080/10803548.2014.11077067. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Liu J., Lockhart T. E., Parijat P., McIntosh J. D., Chiu Y. P. Comparison of Slip Training in VR Environment and on Movement Platform. Biomedical Sciences Instrumentation . 2015; 51 :189–197. [ PubMed ] [ Google Scholar ]
• Lockhart T. E. The Ability of Elderly People to Traverse Slippery Walking Surfaces. Proceedings of the Human Factors and Ergonomics Society 41st Annual Meeting; Albuquerque, NM. October 1997; 1997. pp. 125–129. [ CrossRef ] [ Google Scholar ]
• Lockhart T. E. An Integrated Approach towards Identifying Age-related Mechanisms of Slip Initiated Falls. Journal of Electromyography and Kinesiology . 2008; 18 (2):205–217. doi: 10.1016/j.jelekin.2007.06.006. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lockhart T. E. Kinetic Learning in Occupational Fall Prevention Training. The Proceedings of the 2010 International Conference on Fall Prevention and Protection; May 2010; Morgantown, WV, USA. 2010. DHHS (NIOSH) Publication No. 2012-103. [ Google Scholar ]
• Lockhart T. E., Liu J. Differentiating Fall-prone and Healthy Adults Using Local Dynamic Stability. Ergonomics . 2008; 51 (12):1860–1872. doi: 10.1080/00140130802567079. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lockhart T. E., Smith J. L., Woldstad J. C. Effects of Aging on the Biomechanics of Slips and Falls. Human Factors: The Journal of the Human Factors and Ergonomics Society . 2005; 47 (4):708–729. doi: 10.1518/001872005775571014. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lockhart T. E., Spaulding J., Park S. H. Age-related Slip Avoidance Strategy While Walking over a Known Slippery Floor Surface. Gait and Posture . 2007; 26 (1):142–149. doi: 10.1016/j.gaitpost.2006.08.009. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lockhart T. E., Woldstad J. C., Smith J. L. Effects of Age-related Gait Changes on the Biomechanics of Slips and Falls. Ergonomics . 2003; 46 (12):1136–1160. doi: 10.1080/0014013031000139491. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lortie M., Rizzo P. Reporting and Classification of Loss of Balance Accidents. Safety Science . 1999; 33 (1–2):69–85. doi: 10.1016/S0925-7535(99)00025-9. [ CrossRef ] [ Google Scholar ]
• Manning D. P., Jones C. The Effect of Roughness, Floor Polish, Water, Oil and Ice on Underfoot Friction:: Current Safety Footwear Solings are Less Slip Resistant than Microcellular Polyurethane. Applied Ergonomics . 2001; 32 (2):185–196. doi: 10.1016/S0003-6870(00)00055-7. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Manning D. P., Mitchell R. G., Blanchfield L P. Body Movements and Events Contributing to Accidental and Nonaccidental Back Injuries. Spine . 1984; 9 (7):734–739. doi: 10.1097/00007632-198410000-00014. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Manning D. P., Shannon H. S. Slipping Accidents Causing Low-Back Pain in a Gearbox Factory. Spine . 1981; 6 (1):70–72. doi: 10.1097/00007632-198101000-00015. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Mattila M. S., Grönqvist R. A., Lankinen T. T., Leskinen T. P. J., Plaketti P. J., Ikonen K. J., Suvensalmi J. A. K.2006 Safer Work for Electricians in Hazardous Conditions Proceedings of the 16th International Ergonomics Association Congress . 10–14 JulyMaastricht, The Netherlands [ Google Scholar ]
• Maynard W. S., Robertson M. M. Application of Tribology Research: Prevention of Slips, Trips and Falls. The Proceedings of the International Conference on Slips, Trips and Falls 2007: From Research to Practice; Hopkinton, MA: The IEA Press; 2007. pp. 103–107. [ Google Scholar ]
• Mearns K., Flin R. Risk Perceptions in Hazardous Industries. Psychologist . 1996; 9 (9):401–404. [ Google Scholar ]
• Menant J. C., Steele J. R., Menz H. B., Munro B. J., Lord S. R. Effects of Walking Surfaces and Footwear on Temporo-spatial Gait Parameters in Young and Older People. Gait and Posture . 2009; 29 (3):392–397. doi: 10.1016/j.gaitpost.2008.10.057. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Miller E. M., Matrangola S. L., Madigan M. L. Effects of Obesity on Balance Recovery from Small Postural Perturbations. Ergonomics . 2011; 54 (6):547–554. doi: 10.1080/00140139.2011.582959. [ CrossRef ] [ Google Scholar ]
• Mills R., Dwyer-Joyce R. S., Loo-Morrey M. The Mechanisms of Pedestrian Slip on Flooring Contaminated with Solid Particles. Tribology International . 2009; 42 (3):403–412. doi: 10.1016/j.triboint.2008.07.013. [ CrossRef ] [ Google Scholar ]
• Mohan R., Das B. N., Sundaresan R. Effect of Hardness and Surface Roughness on Slip Resistance of Rubber. Journal of Testing and Evaluation . 2015; 43 (6):1574–1586. doi: 10.1520/JTE20140249. [ CrossRef ] [ Google Scholar ]
• Moghaddam S. R. M., Redfern M. S., Beschorner K. E. A Microscopic Finite Element Model of Shoe-floor Hysteresis and Adhesion Friction. Tribology Letters . 2015; 59 (3):42. doi: 10.1007/s11249-015-0570-x. [ CrossRef ] [ Google Scholar ]
• Moyer B. E., Chambers A. J., Redfern M. S., Cham R. Gait Parameters as Predictors of Slip Severity in Younger and Older Adults. Ergonomics . 2006; 49 (4):329–343. doi: 10.1080/00140130500478553. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Myung R., Smith J. L., Leamon T. B. Subjective Assessment of Floor Slipperiness. International Journal of Industrial Ergonomics . 1993; 11 (4):313–319. doi: 10.1016/0169-8141(93)90081-N. [ CrossRef ] [ Google Scholar ]
• Nagata H. The Methodology of Insuring the Validity of a Slip-resistance Meter. Proceedings of the International Conference on Safety; August 1989; Tokyo, Japan. 1989. pp. 33–38. [ Google Scholar ]
• Nenonen N. Analysing Factors Related to Slipping, Stumbling, and Falling Accidents at Work: Application of Data Mining Methods to Finnish Occupational Accidents and Diseases Statistics Database. Applied Ergonomics . 2013; 44 (2):215–224. doi: 10.1016/j.apergo.2012.07.001. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Nicholson A. S., David G. C. Slipping, Tripping and Falling Accidents to Delivery Drivers. Ergonomics . 1985; 28 (7):977–991. doi: 10.1080/00140138508963220. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Owings T. M., Pavol M. J., Grabiner M. D. Mechanisms of Failed Recovery following Postural Perturbations on a Motorized Treadmill Mimic Those Associated with an Actual Forward Trip. Clinical Biomechanics . 2001; 16 (9):813–819. doi: 10.1016/S0268-0033(01)00077-8. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Parijat P., Lockhart T. E., Liu J. EMG and Kinematic Responses to Unexpected Slips after Slip Training in Virtual Reality. IEEE Transactions on Biomedical Engineering . 2015a; 62 (2):593–599. doi: 10.1109/TBME.2014.2361324. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Parijat P., Lockhart T. E., Liu J. Effects of Perturbation-based Slip Training Using a Virtual Reality Environment on Slip-induced Falls. Annals of Biomedical Engineering . 2015b; 43 (4):958–967. doi: 10.1007/s10439-014-1128-z. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Pater R. How to Reduce Falling Injuries. National Safety and Health News . 1985; 132 :87–91. [ Google Scholar ]
• Patla A. E. Visual Control of Human Locomotion. In: Patla A. E., editor. Adaptability of Human Gait: Implications for the Control of Locomotion . Amsterdam: Elsevier; 1991. pp. 55–97. ISBN: 9780080867328. [ Google Scholar ]
• Perkins P. J. Measurements of Slip between the Shoe and Ground during Walking. In: Anderson C., Senne J., editors. American Society of Testing and Materials: Special Technical Publication . Vol. 649. 1978. pp. 71–87. [ Google Scholar ]
• Perkins P. J., Wilson M. P. Slip Resistance Testing of Shoes – New Developments. Ergonomics . 1983; 26 (1):73–82. doi: 10.1080/00140138308963314. [ CrossRef ] [ Google Scholar ]
• Perrin P., Lestienne F. Mécanismes De L’Equilibration Humaine . Paris: Masson, 1994; 1994. [ Google Scholar ]
• Perry J. Gait Analysis: Normal and Pathological Function . Thorofare, NJ: SLACK Incorporated; 1992. 978-1-55642-192-1. [ Google Scholar ]
• Pijnappels M., Bobbert M. F., van Dieën J. H. How Early Reactions in the Support Limb Contribute to Balance Recovery after Tripping. Journal of Biomechanics . 2005a; 38 (3):627–634. doi: 10.1016/j.jbiomech.2004.03.029. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Pijnappels M., Bobbert M. F., van Dieën J. H. Control of Support Limb Muscles in Recovery after Tripping in Young and Older Subjects. Experimental Brain Research . 2005b; 160 (3):326–333. doi: 10.1007/s00221-004-2014-y. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Pijnappels M., Bobbert M. F., van Dieën J. H. Push-off Reactions in Recovery after Tripping Discriminate Young Subjects, Older Non-fallers and Older Fallers. Gait and Posture . 2005c; 21 (4):388–394. doi: 10.1016/j.gaitpost.2004.04.009. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Pyykkö I., Jantti P., Aalto H. Postural Control in Elderly Subjects. Age and Ageing . 1990; 19 (3):215–221. doi: 10.1093/ageing/19.3.215. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Quirion F., Poirier P., Lehane P. Improving the Cleaning Procedure to Make Kitchen Floors Less Slippery. Ergonomics . 2008; 51 (12):2013–2029. doi: 10.1080/00140130802277554. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Redfern M. S., Schumann T. A Model of Foot Placement during Gait. Journal of Biomechanics . 1994; 27 (11):1339–1346. doi: 10.1016/0021-9290(94)90043-4. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Redfern M. S., Cham R., Gielo-Perczak K., Grönqvist R., Hirvonen M., Lanshammar H., Marpet M., Pai C. Y. C., Powers C. Biomechanics of Slips. Ergonomics . 2001; 44 (13):1138–1166. doi: 10.1080/00140130110085547. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Reed-Jones J. G., Reed-Jones R. J., Hollands M. A. Is the Size of the Useful Field of View Affected by Postural Demands Associated with Standing and Stepping? Neuroscience Letters . 2014; 566 :27–31. doi: 10.1016/j.neulet.2014.02.031. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Rich B. M. Integrating Safety with Science, Technology and Innovation at Los Alamos National Laboratory. [9 September, 2015]; 2012 http://permalink.lanl.gov/object/tr?what=info:lanl-repo/lareport/LA-UR-12-20335 [ Google Scholar ]
• Riihimäki H. Back Pain and Heavy Physical Work: A Comparative Study of Concrete Reinforcement Workers and Maintenance House Painters. British Journal of Industrial Medicine . 1985; 42 (4):226–232. doi: 10.1136/oem.42.4.226. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Rohrlich J. T., Sadhu A., Sebastian A., Ahn N. Risk Factors for Nonorganic Low Back Pain in Patients with Worker's Compensation. The Spine Journal . 2014; 14 (7):1166–1170. doi: 10.1016/j.spinee.2013.09.017. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Rowland F. J., Jones C., Manning D. P. Surface Roughness of Footwear Soling Materials: Relevance to Slip-resistance. Journal of Testing and Evaluation . 1996; 24 (6):368–376. doi: 10.1520/JTE11459J. [ CrossRef ] [ Google Scholar ]
• van Schooten K. S., Rispens S. M., Pijnappels M., Daffertshofer A., van Dieen J. H. Assessing Gait Stability: The Influence of State Space Reconstruction on Inter- and Intra-day Reliability of Local Dynamic Stability during Over-ground Walking. Journal of Biomechanics . 2013; 46 (1):137–141. doi: 10.1016/j.jbiomech.2012.10.032. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Schulz B. W. Minimum Toe Clearance Adaptations to Floor Surface Irregularity and Gait Speed. Journal of Biomechanics . 2011; 44 (7):1277–1284. doi: 10.1016/j.jbiomech.2011.02.010. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Sicre A., Leclercq S., Gaudez C., Gauthier G., Vercher J., Bourdin C. Modelling Gait Processes as a Combination of Sensory-motor and Cognitive Controls in an Attempt to Describe Accidents on the Level in Occupational Situations. Industrial Health . 2008; 46 (1):3–14. doi: 10.2486/indhealth.46.3. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Singh G., Beschorner K. E. A Method for Measuring Fluid Pressures in the Shoe-Floor-Fluid Interface: Application to Shoe Tread Evaluation. IIE Transactions on Occupational Ergonomics and Human Factors . 2014; 2 (2):53–59. doi: 10.1080/21577323.2014.919367. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Staal C., White B., Brasser B., LeForge L., Dlouhy A., Gabier J. Reducing Employee Slips, Trips and Falls during Employee-assisted Patient Activities. Rehabilitation Nursing . 2004; 29 (6):211–214. 230. [ PubMed ] [ Google Scholar ]
• Stergiou N. Innovative Analyses of Human Movement . Champaign, IL: Human Kinetics; 2004. [ Google Scholar ]
• Strandberg L., Lanshammar H. The Dynamics of Slipping Accidents. Journal of Occupational Accidents . 1981; 3 (3):153–162. doi: 10.1016/0376-6349(81)90009-2. [ CrossRef ] [ Google Scholar ]
• Strandberg L. On Accident Analysis and Slip-resistance Measurement. Ergonomics . 1983; 26 (1):11–32. doi: 10.1080/00140138308963309. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Strandberg L. The Effect of Conditions Underfoot on Falling and Overexertion Accidents. Ergonomics . 1985; 28 (1):131–147. doi: 10.1080/00140138508963123. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Swedler D. I., Verma S. K., Huang Y.-H., Lombardi D. A., Chang W. R., Brennan M., Courtney T. K. A Structural Equation Modelling Approach Examining the Pathways between Safety Climate, Behaviour Performance and Workplace Slipping. Occupational and Environmental Medicine . 2015; 72 (7):476–481. doi: 10.1136/oemed-2014-102496. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Swensen E. E., Purswell J. L., Schlegel R. E. Coefficient of Friction and Subjective Assessment of Slippery Work Surfaces. Human Factors: The Journal of the Human Factors and Ergonomics Society . 1992; 34 (1):67–77. doi: 10.1177/001872089203400108. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Tisserand M. Institute de Recherche et de Securite; Nancy, France: 1969. Criteres D’adherences Des Semelles De Securite. Disseratation. [ Google Scholar ]
• Tisserand M. Progress in the Prevention of Falls Caused by Slipping. Ergonomics . 1985; 28 (7):1027–1042. doi: 10.1080/00140138508963225. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Underwood D. C. Effect of Floor Soil on Coefficient of Friction in Foodservice Operations. Ceramica Acta . 1991; 3 (6):21–26. [ Google Scholar ]
• Verma S. K., Chang W. R., Courtney T. K., Lombardi D. A., Huang Y. H., Brennan M. J., Mittleman M. A., Perry M. J. Workers’ Experience of Slipping in US Limited Service Restaurants. Journal of Occupational & Environmental Hygiene . 2010; 7 (9):491–500. doi: 10.1080/15459624.2010.486693. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Verma S. K., Chang W. R., Courtney T. K., Lombardi D. A., Huang Y. H., Brennan M. J., Mittleman M. A., Ware J. H., Perry M. J. A Prospective Study of Floor Surface, Shoes, Floor Cleaning and Slipping in US Limited-service Restaurant Workers. Occupational Environmental Medicine . 2011; 68 (4):279–285. doi: 10.1136/oem.2010.056218. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Videman T., Nurminen T., Tola S., Kuorinka I., Vanharanta H., Troup J. D. G. Low-back Pain in Nurses and Some Loading Factors of Work. Spine . 1984; 9 (4):400–404. doi: 10.1016/0268-0033(86)90092-6. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Wilson M. P. Development of SATRA Slip Test and Tread Pattern Design Guidelines. In: Gray B. E., editor. Slips, Stumbles, and Falls: Pedestrian Footwear and Surfaces . Philadelphia, PA: American Society for Testing and Materials; 1990. pp. 113–123. [ CrossRef ] [ Google Scholar ]
• Wu X., Lockhart T. E., Yeoh H. Effects of Obesity on Slip-induced Fall Risks among Young Male Adults. Journal of Biomechanics . 2012; 45 (6):1042–1047. doi: 10.1016/j.jbiomech.2011.12.021. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Yamaguchi T., Yano M., Onodera H., Hokkirigawa K. Kinematics of Center of Mass and Center of Pressure Predict Friction Requirement at Shoe–Floor Interface during Walking. Gait and Posture . 2013; 38 (2):209–214. doi: 10.1016/j.gaitpost.2012.11.007. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Yeoh H. T., Lockart T. E., Wu X. Non-fatal Occupational Falls on the Same Level. Ergonomics . 2013; 56 (2):153–165. doi: 10.1080/00140139.2012.746739. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Yoshioka M., Ono H., Kawamura S., Miyaki M.1978 On Slipperiness of Building Floors – Fundamental Investigation for Scaling of Slipperiness Report of the Research Laboratory of Engineering Materials, No. 3 . Tokyo: Tokyo Institute of Technology; 129–134. [ Google Scholar ]
• Yoshioka M., Ono H., Shinohara M., Kawamura S., Miyaki M., Kawata A. Report of the Research Laboratory of Engineering Materials, No. 4 . Tokyo: Tokyo Institute of Technology; 1979. Slipperiness of Building Floors; pp. 140–157. [ Google Scholar ]
• Zhang J., Lockhart T. E., Soangra R. Classifying Lower Extremity Muscle Fatigue during Walking Using Machine Learning and Inertial Sensors. Annals of Biomedical Engineering . 2015; 42 (3):600–612. doi: 10.1007/s10439-013-0917-0. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Zohar D. Why Do We Bump into Things While Walking? Human Factors: The Journal of the Human Factors and Ergonomics Society . 1978; 20 (6):671–679. doi: 10.1177/001872087802000605. [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Zohar D. Safety Climate: Conceptual and Measurement Issues. In: Quick J. C., Tetrick L. E., editors. Handbook of Occupational Health Psychology . Washington, DC: American Psychological Association; 2003. pp. 123–142. [ CrossRef ] [ Google Scholar ]
• Zohar D. Thirty Years of Safety Climate Research: Reflections and Future Directions. Accident Analysis and Prevention . 2010; 42 (5):1517–1522. doi: 10.1016/j.aap.2009.12.019. [ PubMed ] [ CrossRef ] [ Google Scholar ]

Election latest: Rishi Sunak heckled by GP at the end of 'torrid day'; Nigel Farage accused of 'bigotry' during debate

The latest updates from the general election campaign, as Rishi Sunak is heckled by a GP and Nigel Farage gets stuck in during a televised debate.

Saturday 8 June 2024 01:40, UK

• General Election 2024

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Election news

• New poll reveals what public think about PM leaving D-Day events early
• 'The country is not stupid': Sunak laughs as GP heckles him
• Farage accused of 'bigotry' in TV debate
• Sunak apologises for D-Day decision and admits it was a 'mistake'
• PM says 'it's important we don't politicise this'
• Starmer says PM will 'have to answer for his own actions'
• Unite did not endorse Labour's election manifesto
• Electoral Dysfunction: What could be in the party manifestos?
• Live reporting by Brad Young

Expert analysis

• Rob Powell: It beggars belief someone didn't sound the alarm about PM leaving D-Day events early
• Tamara Cohen: Labour can't believe their luck

Election essentials

• Battle For No 10: PM and Starmer taking part in Sky News special
• Have your say: Be in the audience for our election leaders event
• Campaign Heritage: Memorable moments from elections gone by
• Trackers: Who's leading polls? | Is PM keeping promises?
• Follow Sky's politics podcasts: Electoral Dysfunction | Politics At Jack And Sam's
• Read more: Who is standing down? | Key seats to watch | How to register to vote | What counts as voter ID? | Check if your constituency is changing | Your essential guide to election lingo | Sky's election night plans

Snap findings from a More in Common poll of more than 1,000 viewers of last night's BBC debate suggest Nigel Farage came out on top.

According to the poll results , the audience is most likely to think Reform UK's leader won, with 25% picking him.

Labour's deputy leader Angela Rayner comes in second with 19%.

Just 7% thought Tory Penny Mordaunt won, but 32% believe she'd be a better prime minister than Rishi Sunak - with 12% picking him.

Full Results

• Nigel Farage - 25%
• Angela Rayner - 19%
• None of the above - 14%
• Carla Denyer - 11%
• Stephen Flynn - 10%
• Penny Mordaunt - 7%
• Daisy Cooper - 5%
• Rhun ap Iowerth - 2%
• Don’t know - 8%

Almost half (47%) of 2019 Tory voters watching the debate thought that Mr Farage won the debate, while Ms Rayner leads among 2019 Labour and Lib Dem voters who tuned in.

The poll also shows viewers are most likely to think the SNP's Stephen Flynn (net +31), the Green Party's Carla Denyer (net +31) and the Lib Dem's Daisy Cooper (+30) did well in the debate.

Reform's original candidate for Clacton will stand as an independent against Nigel Farage in the upcoming general election.

Anthony Mack quit Reform after he was replaced by Mr Farage earlier this week to vie for the seat in Essex.

But that hasn't stopped him from trying to win there.

Mr Mack is expected to hold a press conference later today.

Olympic athletes, top musicians and an ex-soap actor are among those standing to become members of parliament at the general election.

The deadline for candidates to submit their nominations passed earlier today.

Notable names on the list include:

• Blur drummer Dave Rowntree, Labour, Mid Sussex
• Double Olympic gold medal rower James Cracknell, Conservative, Colchester
• Rock star Tom Gray from the band Gomez, Labour, Brighton Pavilion
• Former Coronation Street actor Marc Anwar, independent, Bury North
• Gogglebox's Josh Tapper, Labour, Hertfordshire
• Olympian Marc Jenkins, Conservative, Gower

Count Binface has announced he will stand against Rishi Sunak in his Richmond and Northallerton constituency.

Speaking on his podcast, Trash Talk, Binface said it would be like "Fury vs Usyk times a billion" in the July 4 election.

"That's right, I am here right now in Richmond and Northallerton and I can announce that I will be taking on Prime Minister Rishi Sunak in electoral combat on July 4.

"You shirked D-Day Rishi, you can't miss the B-Day.

"That's right. Binface vs Sunak is going to be Fury vs Usyk times a billion. Bring it on."

Binface recently came 11th in the London Mayoral Elections, where he earned 24,260 votes.

It was reported last weekend that allies of Penny Mordaunt claimed Downing Street was keeping her "in a box" during the election campaign because Rishi Sunak's team see her as a threat.

Well, after her barnstorming performance in a TV debate against politicians from six opposition parties, the Leader of the Commons is well and truly out of her box now. And she mustn't be put back in it.

Her opening words in this 90-minute showdown were explosive. The prime minister, she declared, had been "completely wrong" to leave the D-day ceremonies in Normandy early. No pulling of punches there.

She said the PM was wrong, not once, not twice, but three times. No wonder Number 10 see her as a threat. If this was an audition for a leadership bid after the election, her friends will claim she passed with flying colours.

But once she'd dug her black stilettos out of the PM's back with her opening remarks, after that she was relentlessly on message in hammering Labour on its policies on tax, immigration and crime.

She was at her most combative on the Tories' controversial allegation – first made by Rishi Sunak in his TV debate with Sir Keir Starmer on Tuesday – that Labour is planning a £2,000 tax grab if it wins the election.

This attack triggered the most heated clash of the whole debate, when Mordaunt traded blows with Labour's Angela Rayner on tax. It was a shouting match that went on long after presenter Mishal Husain attempted – but failed - to stop them.

It was all the more heated because the pair were standing next to each other at the end of the row of seven leading politicians, including Nigel Farage, the Lib Dems' Daisy Cooper and the SNP's Westminster leader Stephen Flynn.

For the rest of the debate, Rayner was slightly subdued, rather like Sir Keir had been against the PM on Tuesday. Rayner didn't even attack Sunak about D-day at the start. Nor did Daisy Cooper. Like Sir Keir, his deputy needs to raise her game.

Besides Mordaunt, on D-day Farage claimed Sunak had been unpatriotic and Flynn accused the PM of putting his own political career before public service and Normandy war veterans. Strong stuff.

Mordaunt also tore into Rayner over her previous voting record against renewing Trident. And the brightness of Rayner's red dress wasn't matched by a bright performance in the debate, although she improved as the debate went on. Mordaunt, incidentally, wore Thatcher blue. Remind you of anyone?

Throughout the debate, Farage was typically impish. His quips included claiming Starmer was "very dull" and "Blair without the flair". The PM, he joked, was "slippery Sunak". Yes, he's used those jibes before, but the audience enjoyed them.

Stephen Flynn had his good moments, most notably when he condemned Brexit, an attack on the Conservatives and Labour that the audience enjoyed.

But this debate was about Penny Mordaunt. It was her show, despite the large cast list. If she has been kept in a box by Number 10 up to now, the PM's allies will have been delighted on her attacks on Angela Rayner and Labour's policies.

But they won't have appreciated her blunt – and completely unprompted criticism – of the prime minister over the big story of the day, his D-day snub.

It was a story about a blunder of the PM's own making. It wasn't a gaffe, or an accident. It was sheer bad planning, terrible political judgment, embarrassing and highly damaging to Sunak and the Tory election campaign.

That, apparently was, Penny Mordaunt's view. And she said so. Number 10 won't be happy. A threat? You bet.

Foreign Secretary Lord David Cameron has been the victim of a hoax video call and messages from someone claiming to be the former president of Ukraine.

The government said it was making the incident public to stave off any attempts to manipulate footage of Lord Cameron.

The Foreign Office said a "number of text messages were exchanged followed by a brief video call between the foreign secretary and someone purporting to be Petro Poroshenko, former president of Ukraine".

Mr Poroshenko served as Ukrainian president between 2014 and 2019, and has remained a prominent figure in the country since leaving office.

"Whilst the video call clearly appeared to be with Mr Poroshenko, following the conversation the foreign secretary became suspicious," the Foreign Office said, adding contact details for other people were requested by the caller.

"Whilst regretting his mistake, the foreign secretary thinks it important to call out this behaviour and increase efforts to counter the use of misinformation."

Politicians have received repeated warnings in recent months about the growing threat of misinformation and disinformation, especially as artificial intelligence technology improves.

The prime minister is not the only one whose feet are being held to the fire over D-Day 80th anniversary commemorations.

Northern Ireland's first minister has been criticised for not attending, with only the deputy going instead.

DUP leader Gavin Robinson said it had been an opportunity for Michelle O'Neill to act as a first minister for all.

"With men from across the island being remembered, I am disappointed that the deputy first minister was alone in Normandy and the other half of the joint office was absent.

"When we consider how so many from this island have only been able to openly remember their grandparents' war efforts in recent years, this was a missed opportunity for leadership and reconciliation."

He continued: "The first minister should recognise it was a mistake."

Mr Robinson also accused Rishi Sunak of undermining "the authenticity of the speech" he made at the British Normandy Memorial by departing early.

A spokesperson for the Executive Office said: "The Executive Office [TEO] receives many invitations and endeavours to attend as many events as possible.

"TEO is represented by the first minister, deputy first minister and junior ministers.

"This week, TEO was represented at events including the D-Day commemorations; business awards and the Your Time to Shine female leaders celebration event."

Crime is the last theme of the BBC's debate, with one audience member raising the issue of knife crime.

The Green Party's Carla Denyer says not all crime can be tackled by being "tough", explaining a generation of young people have grown up with services like youth centres closing.

Nigel Farage says "stop and search" must be done "in a very tough way".

"We are seeing a societal decline of law and order in this country," he says.

The Liberal Democrats' Daisy Cooper says the model of policing must be changed, with more community policing engaging with families and faith groups.

She says stop and search can be useful, but "suspicion-less" deployment of it has been used to target people.

Penny Mordaunt, the Conservatives Commons leader, says knife crime in London is "top of the list", but the host points out the West Midlands has a higher rate.

"We need more police and we need police who are embedded in communities," she says.

Labour's Angela Rayner says education and reversing cuts to neighbourhood policing is needed.

Rhun ap Iorwerth, of Plaid Cymru, says decision-making should be made closer to communities, calling for more devolution.

Stephen Flynn, of the Scottish National Party, says tackling poverty as a driver of crime is required, and those in poverty have been failed by the government.

The final 30 second concluding statements are under way. Angela Rayner goes first. "If you want change, vote Labour," she says, though it's as though she's memorising a script rather than talking with passion.

Carla Denyer, of the Greens, says Labour are offering more of the same and Labour has changed into the Tories. She got better as the debate went on. Iorwerth is lively and will have done his party some good here.

Penny Mordaunt is polished. "For a more secure future, vote Conservative," she says. She's been class here and shows why for the Tories, she's an underused asset. Daisy Cooper mentions sewage in rivers for the first time this evening. Why so late?

The last word goes to Nigel Farage, who says that unlike the others he doesn't need an autocue. He's right about that. He's been impish throughout, clearly enjoying himself. We'll see a lot more of him in this campaign. That's why he became party leader, of course!

We're staying with the BBC's seven-way political debate between senior figures in the UK's political parties.

"What matters to you more: Economic growth or successful climate policy?" asks an audience member.

Mr Farage says climate policies like net zero are unrealistic and unaffordable. 

"Nigel is going to keep your fact-checkers busy for a little while. Farage has been misleading you... so much of what he said there is simply untrue," says the Greens' Carla Denyer.

She criticises Labour for dropping a £28bn green investment  pledge earlier this year.

Labour's Angela Rayner says there will be investment including insulating homes and creating green jobs, but oil and gas will be part of the future.

The SNP's Stephen Flynn says Westminster is betraying future generations and his party maintains its commitment to net zero.

"We are facing an ecological emergency", and economic growth can come with tackling it, says the Liberal Democrats, calling for a national insulation scheme.

"Nothing is more important than protecting the environment that you will be living in in future," says Plaid Cymru's Rhun ap Iorwerth.

The Conservatives' Penny Mordaunt says moving to green policies too quickly will "destroy supply chains".

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