Staying a Step Ahead

Employees don't just slip and fall because they are careless. Hidden risks exist at all work sites.

SLIPS and falls are complex events. If you focus on just one part of the problem, such as a cracked tile or slippery floor, the risk will still exist. Instead, attack the whole problem with a systems approach that analyzes your organization and pinpoints areas needing attention.

Taking Control
Same-level slips and falls are the second-leading cause of disabling workplace injuries. They cost private industry more than $5 billion in direct costs alone each year. The indirect costs for hiring and training replacement workers, increased absenteeism, and decreased productivity are estimated to be three to five times higher. But slips and falls are not unavoidable "acts of God" due to employee carelessness or bad luck. You can control them. Here's how.

First, secure management buy-in. Employees don't just slip and fall because they are careless. Hidden risks exist at all work sites. You can demonstrate to managers the cost and the cause of slip-related injuries with photos of potential hazards, qualified worker observations, and slipperiness measurements from work sites. Managers often don't realize that a leading portion of their loss comes from preventable slips and falls; by illustrating the negative impact on the bottom line and the potential positive outcome from a system approach, you will get management buy-in.

Second, assess current slip-and-fall management conditions and practices. Look at your hazard assessment processes, physical controls, and organizational factors to identify areas for improvement. Use the 11 elements listed in the image above as your guide. Each part of the process must be strong--like the links in a chain, the control process for same-level slips and falls is only as good as its weakest link. For example, slip-resistant floors and shoes can be useless if floor cleaning protocols are not implemented. And even the best cleaning protocols will be ineffective without proper employee training or reinforcement of best practices.

Implementing Your Plan
Outlined here are the 11 elements of the slips and falls management process to help get your systems approach in place:

1. Management responsibility starts with proactive prevention. Managers and supervisors must be as responsible and accountable for implementing slip-and-fall controls as everyone else. There's no substitute for leading by example. Think of the impact it can make on employees to see, or even hear about, a CEO who personally cleaned up a spill. Management also should provide adequate funding for interventions such as proper flooring and floor treatments, lighting improvements, slip-resistant footwear, and appropriate matting. Start with this question: Do my managers take the lead and set an example for slip and fall prevention?

2. Educate and train employees on the seriousness of fall accidents. Implement "clean as you go" spill and housekeeping policies, footwear requirements, and incident reporting requirements. Use ongoing communication to reinforce your message. Teach managers about the causes of slips and falls and how to recognize, evaluate, and control hazards. Do this through technical instructions on types of floors, types of treatments or coatings, types of abrasive or grit material, chemistry of cleaning chemicals, design of slip-resistant footwear, and design of matting systems. Train maintenance employees to understand cleaning protocols, cleaning supply maintenance, and how to properly cordon off hazardous areas and place temporary warning signs as needed. Give supervisors information on hazard inspections, footwear programs, signage requirements, and incentives management and stress the importance of setting an example for "clean as you go" policies. Start with this question: Do all my employees understand the seriousness of slips and falls, as well as their role in the prevention process?

Even though you've armed management and employees with the proper protocol, procedures, and tools to get the job done right, you must remain vigilant.

3. Conduct frequent incident and injury surveillance. Collect, analyze, and interpret health and exposure information to stay informed and equipped to deal with accidents. Look at pre-loss incident data obtained through inspections, surveys, employee interviews, self reports, and post-loss data such as past accidents and injuries from insurance and other accident reports. Make sure employees report close-call incidents. A good guideline is the American Society for Testing and Materials ASTM F1694 Standard Guide for Composing Walkway Surface Evaluation and Incident Report Forms for Slips, Stumbles, Trips, and Falls. Start with this question: Do I know the full impact of slips trips and falls at my work site(s)?

4. Hazard surveillance is never-ending and requires employee feedback. Have employees complete job surveys such as facility audits, supervisor interviews with workers, and hazard assessment surveys. Start with this question: Where are my slip and fall hazards?

Of course, starting with the right floor surface makes housekeeping compliance easier for everyone.

5. Floor surface selection has many steps. If you are building a new facility, have a safety professional weigh in on slip-resistant properties, contaminants expected, and transition areas. Think about the contaminants present, the floor surface's overall slip resistance, and how the floor will hold up to pedestrian and equipment traffic. Most floor surfaces are "slip resistant" when dry but change dramatically when wet, greasy, or dirty. Focus on transitional areas, which often increase the likelihood of a slip and fall. For example, when someone walks from a carpeted floor to a glazed ceramic tile, the sudden change in slip resistance can result in a fall. Ease transition with similar slip-resistance properties between different types of flooring, especially when liquid contaminants may be present.

Remember, the slip resistance of today's new floor may not be there tomorrow if high traffic is expected and the floor offers little durability. Don't buy cheap materials. What seems inexpensive today may end up being more expensive in the long run if you have to replace the floor sooner than expected. Start with the question: Are your floor surfaces safe and durable?

6. The best scenario is an inherently slip-resistant floor used under the conditions for which it was designed. If you need to replace a floor but can't, there are many treatments available to improve floor surface slip resistance, such as abrasive floor coatings, chemical etches and cleaners, carpeting and mats, floor waxes, and slip-resistant floor treatments that can be applied daily. If a floor surface is too slippery or if a high number of slips and falls occurs in an area, investigate the best treatments available to increase surface slip resistance. With extremely slippery floors, however, replacement may be the best option. Determine whether you need to replace your floor by taking slip resistance measurements when the floors are dry and wet. Start with the question: Will proper treatments enhance my floor surface safety?

New floor or old, you still need to adhere to a good cleaning program.

7. Housekeeping and maintenance require comprehensive, written instructions. Your program should:

  • Identify contaminants and select effective cleaners/chemicals.
  • Establish contaminant removal protocol.
  • Provide proper floor cleaning tools for specific areas to avoid cross-contamination.
  • Implement a floor cleaning schedule that lists specific employees and cleaning times.
  • Establish an inspection, maintenance and cleaning training program. Include definitions of cleaning requirements, cleaning procedures, safe handling and disposal of chemicals and solutions, emergency conditions and operations, and recordkeeping.
  • Inspect often all floor surfaces for wear, damage, debris, and contaminants and report needed repairs to maintenance.
  • Focus inspections on the most common tripping hazards: floor condition, boxes, pallets, and hoses. Floor condition tripping hazards include loose carpet, broken tiles, and other incongruities larger than ¼ inch.
  • Test floor surfaces to monitor slip resistance levels and determine effectiveness of the floor cleaning protocol.

Start with the question: Where is my written program for housekeeping and floor maintenance?

It is equally important to use job-appropriate footwear and mats. Not doing so may wash away your best cleaning efforts.

8. Slip-resistant footwear and policy implementation take thought. Ensure that the footwear accommodates the working environment--indoors or outdoors, types of contaminants, etc.--and the program includes a written policy for selection, purchase, reimbursement, and replacement. Before implementing a slip-resistant footwear program, have legal counsel review the policy for potential exposures. Start with the question: Is my footwear program right for my environment?

9. Dirty, worn, old mats offer little slip protection. Don't choose your mats based on cost alone. Mats should be slip-resistant, able to adequately absorb liquids and scrape solids from shoes, long enough for the area, and have beveled edges or other features to prevent a tripping hazard. Replace mats often. For entry mats, it usually takes 10 to 12 steps (30+ feet!) of mat to absorb contaminants in snowy weather, 8 to 10 steps in rainy weather, and 6 to 8 steps in dry weather. Start with the question: Do I have quality entrance and back-of-house mats that meet the needs of the environment?

To keep your program operating smoothly, occasionally measure your floors' slipperiness.

10. Floor "slipperiness" assessment helps identify solutions to potential hazards. Slipmeters measure floor slipperiness by determining the slip index or coefficient of friction between the shoe sole and the floor surface. Select the slipmeter you use based on the surface tested. You can use the Horizontal Pull Slipmeter (HPS) on vinyl composition tile before and after applying wax or polish. But don't use the HPS on wet floors because it can make a floor appear more slip resistant than it is. Instead, use the Brungraber Mark II or English XL or other approved slipmeters on wet floors--especially in restaurant kitchens to determine the effectiveness of a floor cleaning protocol or the differences between various floor surface materials. Start with the question: Where is my slipmeter, and is it the right one for the job?

11. Warning signs and instructions are no guarantee for averting risky behavior, but it remains critical to use them consistently. When used properly, signs still will help some people. Better yet, if there is a full barricade around a spill, few people will climb over it. Not using warning signs and training opens you up to liability and could be considered negligence. Start with the question: Do I use warning signs or barricades to indicate the presence of hazards?

Organizational inattention, not bad luck, causes same-level slip-and-fall accidents. Implement a broad systems approach to identify, and address, your slip-and-fall hazards to really make a difference.

This article appeared in the October 2006 issue of Occupational Health & Safety.

This article originally appeared in the October 2006 issue of Occupational Health & Safety.

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