Stop falling for it

Chris Dyer reports on research that aims to give companies practical tools to control the risks of falls from height - the commonest cause of UK workplace deaths.

In early October 2003, two companies were together fined £100,000 after a man fell 35 metres to his death at the Earls Court Exhibition Centre in London. He fell through fragile, false ceiling tiles while carrying out routine work.

The investigating HSE inspector said: "This was a foreseeable and avoidable incident; the dangers were well known to both companies. Simple, practicable steps could have been taken to prevent anyone falling through the tiles but these were ignored." A second man died six months before at the exhibition centre in similar circumstances.

Behind these headlines is the fact that falls from height is the single biggest cause of death in British workplaces, accounting for 69 deaths and 3,996 major injuries of workers in 2001/02. The gravity of the problem is similar throughout Europe and has led to a series of EU-wide inspection blitzes; the first took place in June 2003 and the second in September 2003.

Blitzes highlight gravity of problem

The results of the blitzes indicate that the HSE's Don't Fall For It initiative, which is part of the HSE's contribution to the EU campaign, has had little effect. The September blitz showed that one in 10 London workplaces (other than construction sites) were failing to prevent falls from height; HSE inspectors served 47 enforcement notices aimed at improving work at height practices at the 494 workplaces they visited, which included schools, bus garages, factories and public and private hospitals.

Much of the enforcement action was taken on industrial estates, requiring employers to undertake a risk assessment for work at height, improve problems such as edge protection on mezzanine floors or introduce safety checks and maintenance for ladders. Examples of poor practice included:

  • a gang of roofing contractors who were working on a fragile roof without any means of fall prevention, such as crawling boards, or fall arrest equipment, such as harnesses. This gang was immediately prohibited from working until appropriate measures had been taken; and

  • a wooden ladder in a garage that was so badly damaged that the inspector immediately prohibited its use.

    Nationwide, the September blitz found that over a third of construction sites were well below standard. HSE inspectors visited 1,429 sites, served 332 prohibition and 82 improvement notices and are considering 13 prosecutions. The results led Kevin Myers, the HSE's chief inspector for construction, to condemn the industry for its failure to raise the standards of work at height. Revealing that 17 construction workers have been killed in a fall from height since this April, he said: "Most falls from height accidents are preventable; there is no excuse for not ensuring that all work being carried out at height is done safely. What inspectors found . . . suggests that a large section of the industry is not improving itself, as it claims. Many in the industry are deliberately cutting corners, paying lip service to safety and risking the lives of their workers."

    Myers says that scaffolding and roofwork most often displayed the worst forms of bad practice and that it is not acceptable to work at height without first identifying the risks and putting into place measures to eliminate or control them. Inspectors found scaffolding propped up on a pile of loose bricks, workers working on a roof withoutedge protection, and workers balancing on scaffolding tubing without any fall arrest system. "These are all examples of work practices that could very quickly end in tragedy," said Myers.

    Cross-industry picture

    A recent study1 carried out for the HSE collated the views of stakeholders to identify: the underlying organisational and human factors influencing falls from height; risk control measures; and their potential effectiveness across UK industry. Although the research focused on specific industry sectors where falls from height were identified as a particular problem (see box 1), it is also able to draw conclusions and make recommendations for the whole of industry.

    The occupational group that appears to be particularly at risk across all sectors is vehicle drivers. On-site transfer, which relates to the movement (on site) of materials between processes by manual or mechanical means, and loading/unloading are work processes that are commonly associated with falls from vehicles. Goods drivers in extraction/utilities, manufacturing and services, agricultural machinery drivers and drivers in construction are the groups most at risk.

    Maintenance frequently appears as an activity related to falls, and this ties in with the finding that electric and maintenance fitters are groups involved in a considerable number of falls in all sectors except agriculture.

    Ladders are the most common agent in all major injury falls across industry and are implicated in a considerable proportion of deaths, although in construction and agriculture falling through fragile roofs appears to be the most prevalent agent. Vehicles also often emerge as the accident agent, especially in services industries, which follows from the finding that drivers are frequently involved in falls.

    In terms of low falls (less than two metres) and over three-day injuries, stairs are dominant, particularly in the manufacturing and services sectors, which are largely indoor-based industries.

    The researchers assume that the age profile of the workforce is normally distributed with the mean age somewhere in the 40-44 bracket; from their findings it appears that workers who are older than this may be at more risk. Workers in their 50s and 60s appear to account for a disproportionate number of accidents in agriculture, construction and services. Those in the 50-54 age group appear to have the most major injury low falls in manufacturing and services.

    Construction accounts for most high falls (more than two metres), but agriculture and construction have similar accident rates per 100,000 workers. In these sectors, on-site transfer is the most frequent activity leading to a fall, but the reported accidents imply that falls while carrying out roofing are most likely to kill. Ladders are the most common agent.

    There are few fatalities involving low falls. The dominant industry sector is construction - building and civil engineering work - but the goods driver is the dominant occupation because it is applicable to several sectors.

    The report contains specific recommendations for risk control selection in five areas of industry: agriculture; general construction; roofing; transport; and specialist access work.

    Causes of falls

    The research stresses that it is important to differentiate between the "where and how" and the "why" causes of falls from height:

  • the "where and how" concerns issues such as whether the fall was from a roof, a ladder or through a hole; and

  • the "why" causes relate to ergonomic and human factors and are not usually addressed in the available literature, including much of the guidance from enforcement bodies in various countries.

    The researchers used a technique known as "influence networks" to try to identify the "why" issues from workshops with stakeholders. An influence network envisages a hierarchy of influence levels: environmental level influences, such as the market or society, affects policy within organisations; policy level influences, such as labour relations and company profitability, affect how organisations are organised; organisational level influences, such as training, procedures and inspection and maintenance, affect workers directly; and direct level influences, such as competence, fatigue and compliance, affect the likelihood of a fall occurring.

    The analyses revealed many similarities across industry. Of the direct influences on falls from height, competence, situational awareness/risk perception, compliance and operational equipment are primary influences. Of the organisational level factors, process design, training, management/supervision and safety culture are significant. At the policy level, key factors are company culture and safety management. The regulator and the market are the primary environmental influences on falls.

    The researchers plotted the influences for fall accidents and identified improvements in four areas that could, they believe, reduce risks by around 30%.

    Improving compliance

    The research found that available guidance and equipment is sufficient; the difficulty is making people aware of the potential risks so that they use them. They recommend that plans are developed by HSE inspectors in industry sectors and stakeholders to see how stakeholders can be persuaded to adopt specific risk controls. Each sector requires tailored solutions that recognise the problems, cultures, structures and influence paths within it.

    Improving process design

    Designers are the only stakeholders who can eliminate the hazards or significantly reduce the risks, but the research concludes that they are failing to do so. The researchers believe that the HSE needs to exert its influence on designers and encourage clients to demand that designers consider safety in their work. Designers need to be given suitable information and training at all stages of their career so that they are aware of the options and the implications of their decisions.

    Low-level falls

    Low-level falls account for 60% of non-fatal accidents and injuries due to falls during the past five years. Work at high level has a pronounced profile, but low-level work is seen by many people as an everyday activity with little associated risk. The researchers think that industry sectors with significant numbers of low-level falls need to be targeted and understood, and awareness of the potential risks needs to be raised so that these sectors are encouraged to tackle the problems.

    Economic benefits

    The report highlights the need to change industry culture so that health and safety are high on the agenda. Cost is an integral part of the current culture in the UK and messages about health and safety must recognise this; the economic benefits of good health and safety need to be demonstrated to those who do not currently appreciate them. The report contains a methodology for costing accidents.

    The report also contains a risk control toolkit that provides a framework for selecting effective risk control measures, setting performance targets and monitoring improvement (see box 2).

    Revitalising targets

    The research is particularly relevant to four of the priority programmes in the government's Revitalising health and safety strategy (Employers face major health and safety at work shake-up): falls from height; agriculture; construction; and workplace transport. This recognises the high risks associated with work at height and the areas where falls from height are most prevalent.

    Over the past five years, nearly one-third of fatal injuries in UK industry occurred as a result of falls from height, as did one-fifth of major injuries. A 10% reduction in the number of falls from height in industry would lead to a reduction of around 3% in the overall number of fatal injuries and around 2% in major injuries. A major reduction in accidents and injuries resulting from falls from height would make a significant contribution to achieving the Revitalising targets.

    Chris Dyer is editor of HSB and a journalist specialising in health and safety matters.


    BOX 1: RISK OF FALLS IN INDUSTRY SECTORS

    Fatal injuries

  • Between 1996/97 and 2000/01, construction consistently accounts for 50%-60% of all falls from height that lead to fatalities (annual average of 45). The next highest number occurs in the service industries averaging about 20% of fatal falls (15).

  • The highest rates of fatal falls from height are found in construction (an average of 2.3 per 100,000 workers a year) and agriculture (2.1). Construction has the highest rate in more years but the rate in agriculture is a little higher in 1998/99 and 2000/01 (the number of accidents in agriculture is relatively low).

  • The rate of fatal falls from height in the service sector is very low and is consistently the lowest of all sectors (0.08).

  • In 2000/01 the rates in services, manufacturing and extraction/utilities are all extremely low and are at their lowest over the five-year period (there were no fatalities in extraction/utility supplies).

    Major injuries2

  • The service sector experiences the largest number of falls from height that lead to major injuries (an average of 2,431 each year), which accounts for about 45% of these injuries every year.

  • The percentage of major injury falls attributable to each sector remains fairly constant across the years. About 30% of major injury falls are in construction (1,690) followed by around 20% in manufacturing (1,206). But as with fatalities, construction presents the highest risk (a rate of 87.6 major injuries per 100,000 workers) and services the lowest (12.4). In construction, the rate is approaching one in every 1,000 construction workers having a reported major injury fall each year.

  • Agriculture has the second highest rate (32), despite only contributing about 3% of the total number of major injury falls.

    Over-three-day injuries2

  • Construction has the third highest number of falls leading to an over-three-day injury (an average of 3,088 each year), but it has by far the highest rate (an average of 160.1 per 100,000 workers each year).

  • The service sector has the highest number of falls leading to over-three-day injuries (7,208), but the lowest rate due to the large number of workers in the sector (36.8).

  • The manufacturing sector has a similar number of over-three-day injury falls to construction, but manufacturing has about half the injury rate. Agriculture has a similar rate to manufacturing.

    		•

     


    BOX 2: RISK CONTROL TOOLKIT

    The toolkit enables the selection of effective risk control measures, the setting of performance targets and the monitoring of improvement. The toolkit can be used by individual companies, industry trade associations for their member companies or sectors, or by the regulators for either industry sectors or industry as a whole. It is suitable for identifying and evaluating a broad range of risk control measures, from choice of equipment through to regulatory policy-setting.

    The toolkit methodology has 11 steps.

    1.Define the scope.

    2.Establish baseline data.

    3.Set improvement targets.

    4.Establish and quantify the baseline influence network.

    5.Identify potential risk controls.

    6.Evaluate the effectiveness of the identified risk controls.

    7.Undertake cost-benefit analyses of the potential risk controls.

    8.Select and implement the potentially most cost-effective risk controls.

    9.Monitor data.

    10.Monitor other indicators.

    11.Evaluate performance and determine future strategy.

    Readers interested in using the toolkit should look at the full report.

    1"Falls from height - prevention and risk control effectiveness", RR 116, BOMEL Ltd, HSE Books, ISBN 0 7176 2221 5, £50 or free at www.hse.gov.uk/research/rrhtm/index.htm.

    2As defined by the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR).