title: Ladders: accidents waiting to happen.
abstract: OBJECTIVE
  To examine the nature, severity and outcomes of injuries sustained from ladder falls.
  
  
  METHODS
  Retrospective survey of medical records.
  
  
  METHODS
  Patients who presented after a fall from a ladder to the emergency department of a tertiary hospital in Melbourne, Victoria, between January 1994 and December 1997.
  
  
  METHODS
  Demographic characteristics; height and mechanism of fall; injury site and Injury Severity Score (ISS); rate of hospital admissions.
  
  
  RESULTS
  163 patients presented after ladder falls. They were aged 2.5 to 86 years (mean age, 48 years); 83% were male, and 78% were injured in non-occupational settings. Almost half the accidents (43%) were caused by ladder instability (ladder sliding from position or tilting sideways). Most patients had mild or moderate injuries (usually of the extremities), but 13% had an ISS > or = 16 (indicating severe trauma), usually with head, chest or spinal injuries; 42% were admitted to hospital. Multiple regression analyses showed that ISS increased signficantly with height of fall and age (P< 0.05 for both), although a substantial amount of variation was not attributable to these variables. Likelihood of hospital admission increased linearly with increasing ISS to an ISS of 8 and remained high thereafter.
  
  
  CONCLUSIONS
  Ladder falls resulted in significant morbidity, with men undertaking non-occupational activities comprising most of those injured. New strategies to encourage safe ladder use are needed.
authors: Emergency Department, Austin and Repatriation Medical Centre, Melbourne, VIC.
authors: S
authors: S
authors: Tsipouras
authors: J M
authors: JM
authors: Hendrie
authors: M J
authors: MJ
authors: Silvapulle
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000061:Accidents, Home / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D014739:Victoria / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology