title: Ladders revisited.
abstract: OBJECTIVE
  To describe the epidemiology of falls from ladders in a state-wide population.
  
  
  METHODS
  Retrospective review of data from the the Victorian State Trauma Registry and the Victorian Emergency Minimum Dataset on patients presenting to public hospital emergency departments (EDs) with injuries due to a fall while climbing a ladder, from 1 July 2001 to 30 June 2005.
  
  
  METHODS
  Overall trends in the incidence of ladder-related ED presentations, and in cases of major trauma, trends according to age, and trends according to activity at the time of the fall.
  
  
  RESULTS
  4553 patients presented to EDs after falls from ladders in Victoria during the study period; 160 patients had injuries classified as major trauma. There has been a significant rise in the number of presentations to EDs following falls from ladders in Victoria, with a marked increase in the number of cases involving patients aged over 50 years and those climbing ladders outside of paid working conditions. Deaths occurred predominantly in the elderly after falls from heights above 1 metre.
  
  
  CONCLUSIONS
  Despite knowledge of the dangers of falls from ladders, there has been a significant increase in the number of patients presenting to hospitals after ladder falls. Middle-aged to elderly patients undertaking unpaid work account for this increase. A targeted public health initiative is required to curb this trend.
authors.affiliation: Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia. b.mitra@alfred.org.au
authors.forename: Biswadev
authors.initials: B
authors.lastname: Mitra
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cameron
authors.forename: Belinda J
authors.initials: BJ
authors.lastname: Gabbe
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution; D014739:Victoria / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology*