The relationship between slips, trips and falls and the design and construction of buildings

Monash University Accident Research Centre - Report #281 [2008]

Authors: J. Ozanne-Smith, J. Guy, M. Kelly & A. Clapperton

Full report in .pdf format [950KB]

Abstract:

Aim

Monash University Accident Research Centre was commissioned by the Australian Building Codes Board (ABCB) to undertake a study of the incidence of slips, trips and falls and their relationship to the design and construction of buildings. The objective of this study was to review and analyse Australian fall injury and fatality data and the international scientific literature in order to ascertain whether the existing requirements of the BCA provide an acceptable minimum standard of safety relating to the incidence of slips, trips and falls in buildings for the community.

Methods

Slip, trip and fall injuries were examined across three levels of severity: emergency department presentations (without admission), hospital admissions, and deaths. Through a preliminary analysis of state, national and international data and as identified in similar studies conducted internationally, the most prevalent hazards and harms related to slips, trips and falls and the design and construction of buildings were identified. Accordingly, the literature review focused on the design and construction of stairs and steps, access to and falls from heights, other building features identified as particular hazards such as balconies, verandahs/porches and flooring surfaces, the particular vulnerability of the old and young to these hazards (with an emphasis on aged care and health service areas) and the resultant economic and societal costs of these falls.

An expert panel including the project researchers, ABCB and Federal Government representation, and representation of the building, architectural and design industries and aged care providers was convened and informed the final recommendations of the study.

Results

The major building structural and design components identified as being associated with fall injuries in this study were flooring surfaces, stairs, windows, balconies, verandahs and, indirectly, guttering and roofs in residential settings. As shown by the epidemiological data in this study, many of the victims of fall injuries in buildings are from vulnerable populations, particularly the elderly, the sick and children.

This report contains a review of all relevant literature available for the primary structural and design building components outlined above, a thorough analysis of Australian national injury and fatality data pertaining to falls in buildings, estimates of the economic costs of these hospitalisations and deaths and wide ranging recommendations for improvements to the Building Code of Australia.

The total average annual frequency of deaths and hospitalisations respectively, for falls in buildings in Australia were 343 and 105,968 for the period July 2002 – June 2005. The estimated annual cost for these deaths was $250 million, and $1.28 billion for hospital admissions, excluding indirect costs.

This compares with 110 deaths and 3,300 injuries in one year in Australia related to fires. As for falls, other factors (such as alcohol and cigarettes in the case of fires) may contribute to the chain of events resulting in fire related injury. Also, while property damage may add to the cost of fires, the research and development investment in fire related injury prevention may be disproportionate to that directed at fall injury prevention.

While changes to building design and construction could prevent many fall injuries, particularly the generic effects of inadequacies in protection against falls from heights and falling onto a hard surface, other factors also contribute to the chain of events that result in injuries falls.

Beyond a categorical analysis, it was beyond the scope of this study to analyse death and hospital data with regard to the details of non-building related trip hazards, for example, the removal of which might have prevented initiation of the fall. Co-morbidities and frailties associated with vulnerable populations probably contributed to a substantial proportion of the falls studied here, or the consequences of the falls. However, it can be argued that these community members are equally entitled to a safe environment as the more physically robust members of society. Accordingly they should be protected by the BCA and innovation in safe building design and construction.

Conclusion

Slips, trips and falls in buildings constitute a large and costly public health problem, which is expected to grow in coming years due to the ageing of the Australian population and the increase in housing density, with associated trends to multi-storey dwellings. Although falls and injuries in buildings may be caused by a combination of factors including the design and construction of buildings, many potential solutions lie with the building industry and its regulators. Others with responsibility include the residential and community aged care sectors, the health sector, Standards makers and those responsible for death and injury data systems and research funding. Given the enormous cost of the problem, investment in effective preventative solutions is imperative.

Sponsoring organisation - Australian Building Codes Board