Fall Prevention and Protection

Principles, Guidelines, and Practices

Hongwei Hsiao, PhD, Hongwei Hsiao, PhD

• Publisher: CRC Press
• Year: 2016
• ISBN:
  9781315356266
• Edition: 1
• Topic: Medicina
• Subtopic: Sanità, amministrazione e assistenza pubblica

This book covers a wealth of knowledge from experts and informed stakeholders on the best ways to understand, prevent, and control fall-related risk exposures. Featured are subjects on: (1) a public health view of fall problems and strategic goals; (2) the sciences behind human falls and injury risk; (3) research on slips, trips and falls; (4) practical applications of prevention and protection tools and methods in industrial sectors and home/communities; (5) fall incident investigation and reconstruction; and (6) knowledge gaps, emerging issues, and recommendations for fall protection research and fall mitigation.

Section III

Research on Slips, Trips, and Falls

11

Hazard Concept and Falls

Sylvie Leclercq

CONTENTS

11.1 Introduction

11.2 Hazard Concept within the Scope of Accident Prevention

11.2.1 Multiple Definitions

11.2.2 Hazard Concept Usage

11.2.3 Hazard Concept and Slip, Trip, and Fall

11.3 Hazard and Injury Mechanism in Accidents Triggered by Movement Disturbance

11.3.1 Hazard and Injury Mechanism in Falls

11.3.2 Composite Hazard Involved in the Injury Mechanism

11.3.3 Variety of Hazards Involved in Injury Mechanism

11.3.4 Representation of Injury Mechanism

11.4 Impact on Prevention Strategies and Risk Assessment

11.4.1 Haddon’s Strategies for Accidents Triggered by Movement Disturbance

11.4.2 Risk Assessment for Accidents Triggered by Movement Disturbance

11.5 Discussion and Conclusion

Acknowledgments

References

ABSTRACT

Many injuries and fatalities are the result of accidental falls and, more broadly, the result of movement disturbances. The accident process ends with an injury mechanism, which embodies the hazard concept involved in risk assessment and prevention strategies. If hazard taxonomy exists, it would seem that no category describes it precisely enough to represent the injury mechanism resulting from movement disturbance or loss of balance in particular. This chapter focuses on the injury mechanism and discusses the notion of “circumstantial hazard,” which causes an injury, when combined with the energy of the victim’s disturbed movement. The part played by the kinetic energy of the victim’s movement in causing injury would imply that walking or moving is a hazard. Describing the injury mechanism in any accident triggered by movement disturbance enables us to highlight the difficulties or impossibilities of assessing the related risk and of setting up the most effective protective barriers against the injury. Widening the scope of analysis from falls to any accident triggered by movement disturbance is meaningful, and it increases the visibility of many accidents that are not specifically considered.

KEY WORDS:

hazard, fall, movement disturbance, energy.

11.1 Introduction

Many injuries and fatalities are the result of accidental falls and, more broadly, the result of movement disturbances (e.g., colliding with an element in the environment, with an object when walking, or with a machine because a wrench slips when tightening a bolt). Such accidents are referred to in the literature by the acronym STFs (slips, trips, and falls) without being explicitly defined, and they represent a major issue. Among occupational accidents in particular, they represent a 25%–65% proportion of statistical database data depending on the injuries considered, based on data provided by the Communautés Européennes (CE [European communities]) (2008), the Caisse Nationale d’Assurance Maladie des Travailleurs Salariés (CNAMTS [the French national health insurance fund for salaried workers]) (2009), the Health and Safety Executive (HSE) (2011), and the Bureau of Labor Statistics (BLS) (2012). However, no in-depth study of the injury mechanism has been conducted in so-called STF cases, although accident prevention relies notably on this mechanism. The injury mechanism is not the entire sequence of events leading to injury but only its very final stage. It describes the process by which injury occurs, and it involves some form of energy (International Classification of External Causes of Injuries [ICECI], 2004). This mechanism develops when the contact/proximity between the victim and a form of energy is such that energy absorption by human tissue becomes injury-causing. The injury mechanism embodies the hazard concept usually involved in risk assessment and prevention strategies. Hazard is related to an exposed target and to the associated risk. There is no agreed definition of risk (Aven and Renn, 2009). In this chapter, the risk is the probability of an adverse outcome (Graham and Wiener, 1995) and, more precisely, the probability that a target will encounter a hazard. Hazard and target embrace different realities, depending on whether the accident is occupational or “major,” yet all accidents are represented by the same general and theoretical models using these concepts (cf. e.g., Kjellen, 2000).

The term hazard takes on different meanings in the literature. Definitions are not systematically given: reference is therefore implicitly made to common sense or a general dictionary definition. However, professionals in the prevention field often give a meaning to the term hazard that is different to common meaning. ““Hazard concept” can also be specific to models used by researchers or experts who are either working on regulations or normative texts or performing company risk assessment. These general models do not take into account the specific characteristics of so-called STFs. To our knowledge, only Leclercq et al. (2009, 2010) have detailed the hazard involved when modeling STFs. In this chapter, we will therefore first discuss how the hazard concept is defined and used in the literature on accident prevention in general and on so-called STF prevention thereafter. The injury mechanism resulting from a loss of balance (leading to a fall), which is also relevant to any injury following a movement disturbance, will then be described by focusing on the hazard concept and its specific characteristics in any accident triggered by movement disturbance. Throughout the chapter, the diversity of these accidents and their associated hazards will be illustrated based on real occupational accident accounts taken from the Études de Prévention par l’Informatisation des Comptes rendus d’Enquêtes d’Accidents (EPICEA) database (Ho et al., 1986; EPICEA, 2011) or directly from companies. EPICEA is a French anonymous database consolidating more than 18,000 occupational accident cases that have occurred since 1990 at companies operating within the French general social security system. EPICEA lists nearly all fatal occupational accidents and some accidents that were serious or significant for prevention. Finally, the consequences of the specific characteristics of the injury mechanism in accidents triggered by movement disturbance will be discussed with reference to the field of protection and prevention.

11.2 Hazard Concept within the Scope of Accident Prevention

11.2.1 Multiple Definitions

Accident-related literature and regulations often focus on so-called major accidents (spills, toxic clouds, fires, or explosions). These are related to work within a process that is liable to suddenly release considerable energy (chemical, nuclear, etc.), thereby causing serious damage to people and the environment. The definition of a hazard is therefore specifically oriented toward this kind of process. The October 2005 glossary of technological risks defines a hazard as “an intrinsic property of a substance (butane, chlorine, etc.), a technical system (pressurizing gas, etc.), a provision (elevation of a load), a body (microbes), etc., likely to cause damage to a ‘vulnerable target’.” In the same year, the International Risk Governance Council (IRGC, 2005) stated that “Hazards describe the potential for harm or other consequences of interest. They characterize the inherent properties of the risk agent and related processes.” Kjellen (2000) adopts the following definition of hazard: “a source of possible injury to personnel or damage to the environment or material assets.” This definition is close to the general one given in Webster (2002): “a thing that has potential to cause harm, or a source of danger.” On the other hand, Rasmussen and Svedung (2000) refer to the “hazard sources” found in a system and suggest a pragmatic classification of sources as “physical phenomena that may lead to damage, if not adequately controlled.”

Hazard is therefore frequently characterized by an intrinsic property of an element/agent likely to cause damage to a vulnerable target, which can be a human being and/or the environment. In most cases, these definitions refer, explicitly (see, e.g., the International Classification of External Causes of Injury [ICECI, 2004]) or not, to a hazard that is external to the target and recognizable as harmful when assessing a priori the risk. For example, when mapping hazards, Koehler and Volckens (2011) project the intensity or concentration of a chemical agent onto a two-dimensional floor plan or workplace layout. In this case, the hazard is a chemical agent (a chemical energy carrier) that is external to the target and identified a priori as a clear possible cause of damage if exposure occurs. The latter hazard characteristic is highlighted by Monteau (2010) in relation to occupational accidents, stating that hazards are “incompatible with human presence”; in other words, elements with which any contact would cause injury.

Other definitions of hazard are adopted in the specific context of occupational accidents, in which the target and the negative outcome are a human being and an injury, respectively. Unlike the previous definitions, these refer to the fact that hazards can originate from humans or objects, which are both energy carriers (kinetic, potential, thermal, chemical, or radiant) that can be harmful to humans (Hoyos, 1980). The kinetic energy involved in the injury mechanism associated with falling from a height, for example, is carried by humans. The expression physical ergonomic hazard is also used to qualify work activities and/or workplace conditions that create biomechanical stress for the workers (Tak and Calvert, 2011). This type of stress, applied when sitting in specific conditions, is therefore considered a hazard (Corlett, 2008). These wider definitions of a hazard blur the boundary between risk factors (each situation element which increases the risk of injury, even if it is not a direct cause of injury) and hazard regarded as the direct cause(s) of injury.

In this section, the injury mechanism involving direct causes of injury, that is, involving the hazard, will be described for accidents triggered by movement disturbance. In keeping with Gibson (1961), who deals with injuries in general, we will consider that injury to a human being resulting from a fall or a movement disturbance is caused...