A review of nonoccupational ladder-related injuries in Victoria: as easy as falling off a ladder.
BACKGROUND
The incidence of significant nonoccupational ladder injuries is rising. This is due to a culture that encourages a "do-it-yourself" attitude toward home renovation combined with a lack of formal training programs and regulations governing ladder use.


METHODS
A literature review of all English language reports related to ladder-related injuries since 1990 was performed and compared with data from Victorian injury databases between 1997 and 2002. A field visit was also undertaken to a selection of hardware stores in Melbourne (Australia) to assess levels of awareness and attention paid to ladder safety.


RESULTS
In the period 1997-2002, a series of 3,024 patients aged over 15 with self-reported nonoccupational falls from ladders were treated in Victorian hospitals. The mean age was 51 years and 80% were men. Seven hundred twenty-five (24%) required admission to hospital. The mean annual presentation rate was 25/100,000 inhabitants/year for men and 5.5/100,000 inhabitants/year for women. Twenty patients died as a result of their injuries. A significant rise in annual presentation rates with increasing age was noted for both men and women. Men over the age of 45 were found to be a particularly high-risk group.


CONCLUSIONS
The high risk group for nonoccupational ladder injuries is men over 45 years. They are most likely to sustain upper limb injuries and admission to hospital is not uncommon. The rate of injury might be significantly decreased if a simple algorithm of precautions was followed and there was generally a greater awareness of ladder safety.
Department of Orthopaedics, Monash University, Victoria, Australia. dgoldbloom@ozemail.com.au
Harvinder S
HS
Bedi
Daniel
D
Goldbloom
D000056:Accident Prevention; D000058:Accidental Falls / Q000706:statistics & numerical data*; D000061:Accidents, Home / Q000706:statistics & numerical data*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005160:Facility Design and Construction / Q000295:instrumentation*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011336:Probability; D018570:Risk Assessment; D017678:Sex Distribution; D014739:Victoria / Q000453:epidemiology; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology*