title: Environmental hazards and the risk of nonsyncopal falls in the homes of community-living older persons.
abstract: BACKGROUND
  Identifying and eliminating environmental hazards in the home has high face validity but little empirical support for fall prevention.
  
  
  OBJECTIVE
  The objective of this study was to determine whether environmental hazards increase the risk of nonsyncopal falls in the homes of community-living older persons.
  
  
  METHODS
  This was a prospective cohort study.
  
  
  METHODS
  The study included 1,088 men and women from a probability sample of 1,103 persons > or =72 years of age.
  
  
  METHODS
  A room-by-room assessment for 13 potential trip or slip hazards was completed at baseline and 1 year later by a trained research nurse using a standard instrument. Falls were ascertained monthly for 3 years using a fall calendar and follow-up phone calls.
  
  
  RESULTS
  The numbers of participants with a nonsyncopal fall (by room) were as follows: 88 (kitchen), 144 (living room), 41 (hallway), 136 (bedroom), and 59 (bathroom). The risk of a nonsyncopal fall was significantly elevated for only 1 of the 13 trip or slip hazards. For exposure to > or =1 hazards per room, the relative risks adjusted for age, gender, and housing type were 0.91 (95% CI, 0.58-1.43) for the kitchen, 1.30 (95% CI, 0.92-1.83) for the living room, 1.73 (95% CI, 0.93-3.22) for the hallway, 1.29 (95% CI, 0.90-1.84) for the bedroom, and 0.57 (95% CI, 0.32-1.00) for the bathroom. No consistent association was found between the 13 trip or slip hazards and nonsyncopal falls, even after participants were categorized by impairments in vision, balance/gait, and cognition.
  
  
  CONCLUSIONS
  Our findings do not support an association between environmental hazards and nonsyncopal falls.
authors.affiliation: Yale University School of Medicine, Department of Internal Medicine, New Haven, Connecticut 06504, USA. gill@ynhh.com
authors.forename: T M
authors.initials: TM
authors.lastname: Gill
authors.forename: C S
authors.initials: CS
authors.lastname: Williams
authors.forename: M E
authors.initials: ME
authors.lastname: Tinetti
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000061:Accidents, Home / Q000517:prevention & control / Q000706:statistics & numerical data*; D000368:Aged; D000375:Aging / Q000502:physiology; D015331:Cohort Studies; D003237:Connecticut / Q000453:epidemiology; D003625:Data Collection; D004779:Environment Design; D005260:Female; D006798:Housing; D006801:Humans; D007374:Interior Design and Furnishings; D008297:Male; D004856:Postural Balance; D018570:Risk Assessment; D017751:Safety Management / Q000379:methods*; D013575:Syncope / Q000503:physiopathology