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Falls on Stairs and Stair Safety

According to the National Safety Council reports nearly twelve thousand deaths per year with almost half of the deaths occurring in the home.  Incidents related to stairs are only second to automobile crashes as the major cause of unintended injuries in the United States.[1] 

“Stairs in the home can be one of the most dangerous places for anyone, in particular, for the elderly, handicapped and young children. They can create the opportunity not only for accidents, but also for potential liability. For this reason, stair safety should be a priority with any homeowner, whether you have at risk members of your home, or not.”[2] 

“Stair safety involves several other factors: 

  • Lighting: Make sure the stairway is well lit. A light switch at both the top and the bottom of the stairs ensures that someone about to use the stairs in either direction can make sure they’re lit. Especially if there are young children in the house and movement in the house at night, a night-light at both ends of the staircase can also increase stair safety.
  • Clear the space: Don’t let clutter accumulate on the stairs; while it can be convenient to place items that need to travel to another floor on the stairs, this should never be done in such a way that someone might trip.
  • No wax: Waxed floors look lovely, but they’re slippery—don’t ever wax the stairs. If they’re slippery in any case, try nonskid tape or stair treads.
  • Install two handrails: A handrail on either side of the stairs gives two people who are passing each other on the stairs something to hold onto.
  • Check the railings on landings: Railings in the area overlooking the staircase should have the same limit of 2 3/8” between spindles that you find for cribs. If the gap is wider, or if you have concerns about dropped toys or other items, you can install shatterproof clear plastic.
  • Tack down carpets: Stair carpeting should be well secured to avoid slips or a tripping hazard.”
  • Avoid throw rugs: Whether at the top or the bottom of the stairs, avoid throw rugs that might slip.[3]

According to Alvin & Lawrence Ubell the Top 21 Hazards in Stair and Ramp Installation[4] Problem Areas include

  • Handrail / Safety-Rail: not ergonomically designed, improper finger clearance, railing is missing, loose, broken, not strong enough, too large, too wide, too thin, not continuous from landing to landing, not smooth, too hot, too cold, splintery, not maintained, not sanitary looking, not of a contrasting color with background.
  • Riser: not equal height on all steps in the flight; missing; shifted out of stringer; open type with too much over-hang from the step above, too little over-hang.
  • Geometry: tread/riser relationship in flight not constant, does not conform ergonomically to known and accepted safety standards
  • Visual cue: missing, stair is camouflaged with merchandise or materials, not a contrasting color.
  • Single or Double Step Stair: three steps is the minimum considered optimum.
  • Balusters: when improperly spaced, a child can slip through or can get their head caught.
  • Platform or Landing: surface not slip resistant and has a sharp object, blunt wall or window in the possible fall direction.
  • Stringer, Carriage: broken, loose, twisted, extends above the top landing or platform, extends beyond the bottom step, top surface of the stringer extends into the stairwell three or more inches behind the handrail or the side without a handrail.
  • Tread: broken, loose, narrow, worn, highly abrasive, missing, shifted out of stringer, material not constant in the flight, not a slip resistant surface, surface slip resistance not consistent in the flight, loose carpet, torn carpet, debris, improper repair.
  • Nosing: missing, broken, worn, patched, loose, slippery, abrupt raised upper surface, sharp corners, not installed properly.
  • Ramp: steep, no handrail, slippery, too long.
  • Wash, Kilt: for exterior stairs: nonexistent for proper drainage, or too steep.
  • Circular or Helical Stair: tread at fulcrum too narrow, stair not ergonomically designed for safety.
  • Flight too long: too many steps causes fear of falling or fear of height.
  • Ergonomics: Conditions of stair not ergonomically designed or built.
  • Angle: stair or ramp too steep.
  • Lighting: below the accepted safety standards, too many shadows, a dark corridor and corners leading to a stair.
  • Sharp or Pointed Corners: on stair elements or hardware.
  • Construction: Abrupt wall or window at the bottom of a stair's landing or platform.
  • Low Headroom: 6′ feet - 8″ inches is standard, 7′ foot - 6″ inches is optimum in today's standards.
  • Abrasive: wall surfaces, stair elements or hardware.[5]

 

Free Stair Safety Checklist

At their website they provide for free to anyone an excellent checklist for everyone who is truly concerned with the stairway safety.

Common Reasons for falls

“Researchers have identified common elements in falls on stairs.

• Slipping is the primary cause of stair falls.

• Most stairway falls that cause injuries occur while people are walking down the stairs.

• Absence of handrails account for a large percentage of falls on stairs that result in injuries.

• Unexpected location of stairs leads to many falls. For example, stairs of just one or two steps in a hallway or doorway can be especially hazardous.”[6]

Stair Rails and Handrails

“Stair rails and handrails are needed for very different purposes. Stair rails or stair guardrails protect pedestrians from falling off the edge of the stairs or landings. Handrails serve to help pedestrians keep their balance and provide leverage when ascending/descending stairs.” [21]

Handrails

The Cornell University Stairway Safety Study discovered that the absence or partial absence of handrails were relatively common-28% and 22% respectively.  Their research also found that “[d]imensional uniformity in tread widths and riser heights is one of the most important safety factors in stair construction. In a study conducted by J. Templer[7] and published in by Massachusetts Institute of Technology Press (MIT is perhaps the leading research and scientific school in the United States) indicated the importance of having proper handrails to prevent falls:

“1) they help in preventing a loss of balance for users ascending or descending stairs;

2) they provide a means for users to quickly regain balance after a slip or stumble.”[8]

Many human factors have concluded that in order for handrails to be effective in preventing falls they must be capable of being securely grasped by human hands.  The safety and human factors evidence demonstrates that round shaped handrails are far preferable to those which are rectangular.  Round-shaped rails with a diameter of about 1.5 inches maximize grip forces for adults, while a diameter of between 1.125 and 1.25 inches maximizes grip forces for children. Rectangular shaped boards tipped on edge produce a nice decorative effect as a handrail and are often easier to attach than round shaped railings. This type handrail requires a pinch grip, the least effective grip for maximizing the gripping forces in the human hand.[9]  In 1985 the United States Department of Transportation, Federal Transportation Administration determined that “[m]ost stair accidents, and the more severe requiring first aid treatment or hospitalization, occur in descent. Unlike the ascending accident where steps above can help arrest a fall, only the handrail can help stop a descending fall in progress and prevent it from being extended further down the stair.”[10]  In 1982 the Division of Building Research, National Research Council of Canada, came too much the same conclusions regarding the use of handrails.[11]

Dimensional Uniformity – Even height and depth of stairs

A difference of just 1/4 inch between adjacent riser heights can cause an accident. Existing stairs that are not dimensionally uniform are significant hazards.  All Tread and riser dimensions shoulb e uniform throughout the entire stairway.[12]  Whenever possible, they should be replaced with correctly built stairs, especially if they are in a home or apartment with elderly users.”[13]  In 1985 the United States Department of Transportation, Federal Transportation Administration in its final report entitled “Pedestrian Falling Accidents in Transit Terminals” (UMTA-MA-06-0098-84-2 DOT-TSC-UMTA-84-36) concluded “In summary, dimensional regularity and designs consistent with common experience are emphasized as a very significant aspect of stair design, with even small variations in these factors increasing the probabilities of missteps.”[14]  The same report stated, “tread lengths beyond 14 in. (365 mm) can affect the stair pacing pattern and rhythm, potentially causing safety problems.”[15]  The report went on to state ““Expectancy can also become a factor in stair falls where there is a step riser lower or higher than others in the series. Apparently after negotiating the first few steps the stair pacing pattern becomes so ingrained that even relatively small variations in riser height can result in a misstep.”[16] The report concluded, “[u]niform dimensioning of stairs and risers is a critical design factor, with differences in step heights as little as 3/16 in. (5 mm) disrupting the pattern of movement and potentially causing falls. (2.3)”[17] In 1982 the Division of Building Research, National Research Council of Canada, came to much the same conclusions regarding the need for dimensional uniformity from landing to landing[18] as did the U.S. Department of Commerce, Technology Administration, National Institute of Standards and Technology.[19]

Visability

“Misreading the stair edge can translate to faulty foot placement and an accident.  This can be caused by poor visibility of both risers and treads.

Guidelines for stair visibility are as follows:

  • Provide visual contrast on tread nosings or at the leading edges of treads without nosings, so that the stair treads are more visible for people with low vision.  Surfaces colored Safety Yellow are the “most visually detectable” (U.S. Access Board Research).[20]
  • In low light areas an option is to highlight each step using step lighting.
  • Post signs calling attention to the stairway at waist height on the approaches from both directions. ”[21]

 

Conclusion

Although not all falls on stairs can be prevented and not all falls on stairs are due to the design defects or condition of the stairs many falls and deaths could easily be prevented by taking basic safety precautions regarding the condition and design of stairs so as to reduce the likelihood of injuries from falling on stairways.  Please be sure to take an inventory of the stairway safety where you live and work.  


[1] Watch Your Step And Hold On, Alvin & Lawrence Ubell, The Gotham City Inspector. http://www.accuratebuilding.com/services/legal/papers/WatchYourStepAndHoldOn.pdf

[2] Home Institute Stair Safety http://www.homeinstitute.com/stair-safety.htm

[3] Ibid.

[4] To download the technical paper http://www.accuratebuilding.com/services/legal/papers/WatchYourStepAndHoldOn.pdf

[5] http://www.accuratebuilding.com/services/legal/papers/stair_ramp_safety_hazards.html

[6] Stair Safety: Causes and Prevention of Residential Stair Injuries, Cornell Cooperative Extension Department of Design & Environmental Analysis Cornell University Ithaca, NY, http://www.human.cornell.edu/che/DEA/outreach/upload/Stair-Safety-2.pdf

[7] Templer, J. (1992). The Staircase: studies of hazards, falls, and safer design. Massachusetts: MIT Press.

[8] Stair Safety: Causes and Prevention supra.

[9] Ibid.

[10] Pedestrian Falling Accidents in Transit Terminals” (UMTA-MA-06-0098-84-2 DOT-TSC-UMTA-84-36) http://transit-safety.fta.dot.gov/publications/safety/pedestrian/dot-tsc-umta-84-36.pdf

[11] "Recommendations for Improving the Safety of Stairs" published by the Division of

Building Research, National Research Council of Canada, June 1982. http://www.nrc-cnrc.gc.ca/obj/irc/doc/pubs/bpn/35_e.pdf

[12] Liberty Mutual® Loss Prevention Reference Note “Controlling Falls on Stairways” (March 2007) http://www.jjnegley.com/workers_comp/lp5158.pdf

[13] Ibid.

[14] Pedestrian Falling Accidents in Transit Terminals” (UMTA-MA-06-0098-84-2 DOT-TSC-UMTA-84-36) http://transit-safety.fta.dot.gov/publications/safety/pedestrian/dot-tsc-umta-84-36.pdf

[15] Ibid.

[16] Ibid.

[17] Ibid.

[18] "Recommendations for Improving the Safety of Stairs" published by the Division of

Building Research, National Research Council of Canada, June 1982. http://www.nrc-cnrc.gc.ca/obj/irc/doc/pubs/bpn/35_e.pdf

[19] Chapter 7 of "Building and Fire Research at NBS/NIST 1975-2000" (December 2003) published by the U.S. Department of Commerce, Technology Administration, National Institute of Standards and Technology, page 98. http://www2.bfrl.nist.gov/info/bfrl_history/Chapters%201-15%20BFRL%20History/chp%207.pdf

[20] American National Standards Institute (ANSI) z535.1-2002, Safety Color Code. International Organization for Standardization (ISO) 3864-2004, Safety Colours and Safety Signs.

[21] Liberty Mutual® Loss Prevention Reference Note “Controlling Falls on Stairways” (March 2007) http://www.jjnegley.com/workers_comp/lp5158.pdf

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