|Falling is a normal experience for young children, but falling from a significant height or onto a hard surface can be dangerous.|
|Classification and external resources|
|ICD-10||W00-W19, X80, X81|
Falling is the second leading cause of accidental death worldwide and is a major cause of personal injury, especially for the elderly. Falls in older adults are an important class of preventable injuries. Builders, electricians, miners, and painters are occupations with high rates of fall injuries.
The most common cause of falls in healthy adults is accidents. It may be by slipping or tripping from stable surfaces or stairs, improper footwear, dark surroundings, uneven ground, or lack of exercise. Studies suggest that women are more prone to falling than men in all age groups.
Older people and particularly older people with dementia are at greater risk than young people to injuries due to falling. Older people are at risk due to accidents, gait disturbances, balance disorders, changed reflexes due to visual, sensory, motor and cognitive impairment, medications and alcohol consumption, infections, and deyhdration.
People who have experienced stroke are at risk for falls due to gait disturbances, reduced muscle tone and weakness, side effects of drugs to treat MS, low blood sugar, low blood pressure, and loss of vision.
People with Parkinson's disease are at risk of falling due to gait disturbances, loss of motion control including freezing and jerking, autonomic system disorders such as orthostatic hypotension, fainting, and postural orthostatic tachycardia syndrome; neurological and sensory disturbances including muscle weakness of lower limbs, deep sensibility impairment, epileptic seizure, cognitive impairment, visual impairment, balance impairment, and side effects of drugs to treat PD.
People with multiple sclerosis are at risk of falling due to gait disturbances, drop foot, ataxia, reduced proprioception, improper or reduced use of assistive devices, reduced vision, cognitive changes, and medications to treat MS.
In the occupational setting, falling incidents are commonly referred to as slips, trips, and falls (STFs). Falls from elevation hazards are present at almost every jobsite, and many workers are exposed to these hazards daily. As such, falls are an important topic for occupational safety and health services. Any walking/working surface could be a potential fall hazard. An unprotected side or edge which is 6 feet (1.8 m) or more above a lower level should be protected from falling by the use of a guard rail system, safety net system, or personal fall arrest system. These hazardous exposures exist in many forms, and can be as seemingly innocuous as changing a light bulb from a step ladder to something as high-risk as installing bolts on high steel at 200 feet (61 m) in the air. In 2000, 717 workers died of injuries caused by falls from ladders, scaffolds, buildings, or other elevations. More recent data in 2011, found that STFs contributed to 14% of all workplace fatalities in the United States that year.
Companies must make sure that they follow the applicable safety legislation (e.g., the Occupational Safety and Health Act in the United States) to keep their work environments safe.
The National Institute for Occupational Safety and Health has compiled certain known risk factors that have been found responsible for STFs in the workplace setting. While falling can occur at any time and by any means in the workplace, these factors have been known to cause same-level falls, which are less likely to occur than falls to a lower level.
Workplace factors: spills on walking surfaces, ice, precipitation (snow/sleet/rain), loose mats or rugs, boxes/containers, poor lighting, uneven walking surfaces
Work organization factors: fast work pace, work tasks involving liquids or greases
Individual factors: age; employee fatigue; failing eyesight / use of bifocals; inappropriate, loose, or poor-fitting footwear
Preventive measures: warning signs
Intentionally caused falls
Height and severity
The severity of injury increases with the height of the fall but also depends on body and surface features and the manner of the body's impacts against the surface. The chance of surviving increases if landing on a highly deformable surface (a surface that is easily bent, compressed, or displaced) such as snow or water.
Injuries caused by falls from buildings vary depending on the building's height and the age of the person. Falls from a building's second floor/story (American English) or first floor/storey (British English and equivalent idioms in continental European languages) usually cause injuries but are not fatal. Overall, the height at which 50% of children die from a fall is between four and five storey heights (around 12 to 15 metres or 40 to 50 feet) above the ground.
Rates of falls in hospital can be reduced with a number of interventions together by 0.72 from baseline in the elderly. In nursing homes fall prevention problems that involve a number of interventions prevent recurrent falls.
In 2013 unintentional falls resulted in 556,000 deaths up from 341,000 deaths in 1990. They are the second most common cause of death from unintentional injuries after motor vehicle collisions. They were the most common cause of injury seen in emergency departments in the United States. One study found that there were nearly 7.9 million emergency department visits involving falls, nearly 35.7% of all encounters.
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- Falls Among Older Adults: Brochures and Posters (in English, Spanish, and Chinese) US Centers for Disease Control and Prevention
- Falls Among Older Adults: An Overview US Centers for Disease Control and Prevention
- Costs of Falls Among Older Adults US Centers for Disease Control and Prevention
- Hip Fractures Among Older Adults US Centers for Disease Control and Prevention
- Falls in Nursing Homes US Centers for Disease Control and Prevention
- CDC Fall Prevention Activities US Centers for Disease Control and Prevention
- Preventing Falls: What Works―A CDC Compendium of Effective Community-based Interventions from Around the World US Centers for Disease Control and Prevention (PDF)
- Preventing Falls: How to Develop Community-based Fall Prevention Programs for Older Adults US Centers for Disease Control and Prevention
- Public Health Grand Rounds: Help Older Adults Live Better, Longer: Prevent Falls and Traumatic Brain Injuries US Centers for Disease Control and Prevention
- CDC's Division of Unintentional Injury – Podcasts US Centers for Disease Control and Prevention