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Ladder fall injury (all ages)
July 2008
There were at least 2,073 emergency department presentations related to ladder falls in Victoria over the two-year period January 2005 to December 2006. During this same time period there were a further 2,477 cases that required admission to a hospital ward.
This indicates an average of 2,275 cases of hospital treatment for injuries related to ladder falls a year, comprising 1,036 emergency department presentations and 1,238 hospital admissions.
Age: Ladder fall injury was more prevalent among older persons than younger age groups. Half of all presentations and three-quarters of admissions were of people aged 45 years or older. The mean age for emergency department presentations was 46.4 years, while for admissions it was 56.2 years. Ladder fall injuries were most common in the 45-59 age bracket and least common among children aged 14 years or younger. |
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Source: VAED & VEMD Jan ‘05 – Dec ‘06
Figure 1: Ladder fall hospital admissions and emergency dept. presentations by age group
Gender: Males were more frequently involved than females. Four-fifths of both emergency presentations (80%) and hospital admissions (82%) were male, no doubt reflecting higher ladder usage by males.
Body region: For presentations to emergency departments, injury to the upper extremity (33%) and lower extremity (31%) were most common, followed by injury to the trunk (16%) and the head, face or neck (11%). For hospitalisations, the proportion of injuries to the lower extremity (30%), upper extremity (29%) and trunk (26%) were all similar. Injury to the head, face or neck was less frequent, but still fairly common (14%).
Injury type: The most frequent injury type among persons presenting to emergency departments was ‘dislocation, sprain and strain' (29%), followed by ‘fracture' (25%), ‘open wound' (13%) and ‘bruise or abrasion' (11%). Injury to muscle or tendon (6%) and intracranial injury (1%) were less common. The pattern was different for hospitalisations with almost two-thirds of hospital admissions were due to fractures (64%). Open wounds (7%), intracranial injury (5%), dislocation/sprain/strain (4%) and bruises and abrasions (4%) were relatively uncommon.
Activity: Among emergency presentations the most commonly recorded activity undertaken when injured was ‘leisure', accounting for 35% of cases. Working for an income accounted for 18%, unpaid work for 13%, while other or unspecified activities comprised the remainder. However, it should be noted that the ‘leisure' code is used in some hospital emergency department systems as a default code to describe any activity other than paid work. It is likely that a large proportion of the 35% of cases coded as leisure should have been coded as ‘unpaid work', as this is the classification that covers home maintenance and gardening. Among admissions, 52% were sustained while undertaking unpaid work. A further 28% were due to working for an income, while less than 1% were coded to leisure activities.
Location: Ladder fall injuries occurred primarily in the home for both emergency department presentations (65%) and hospital admissions (84%). Trade or service areas (such as retail outlets or workshops) were the injury location for 9% of presentations and 3% of admissions, while industrial and construction areas accounted for 6% of emergency department cases and 7% of hospitalisations. Only 1% of presentations or admissions were due to injuries occurring in a school or other public building. |
Source: VAED Jan ‘05 – Dec ‘06
Figure 2: Place of occurrence of ladder fall hospital admissions |
Length of stay: Of the 2,477 ladder fall injury admissions, 47% were treated and discharged home in less than two days. A stay of two to seven days was required in 35% of cases, while a further 16% were in hospital for eight to thirty days. Less than 2% required a hospital stay of more than thirty days.
Injury prevention: Ladders should be place at an angle of 1:4, so that the horizontal distance between the foot of the ladder and the point it is resting against should be one quarter of its overall length. Have someone stand at the base of the ladder, to both brace the ladder and observe the climber. Secure the ladder by tying the ends to structures. Avoid overreaching, carrying excessive loads or moving the ladder during ascent.
Further information: ‘Hazard' edition 63 outlines ladder related injury data and prevention. It can be accessed at: www.monash.edu.au/muarc/VISU/hazard/haz63.pdf
Data source: Victorian Emergency Minimum Dataset (VEMD) and Victorian Admitted Episodes Dataset (VAED) January 2005 to December 2006 (2 years)
Search Strategy: [Presentations]: A search was conducted for the text ‘ladder' in the 250 character ‘Description of Injury Event' field of the VEMD. Narratives were manually checked and irrelevant cases excluded. Cases subsequently admitted to hospital were excluded as they are covered by data extracted from the VAED.
[Admissions]: Cases in the VAED were selected if the cause code was ‘W11: Fall on and from ladder'. |
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