title: How well are we controlling falls from height in construction? Experiences of union carpenters in Washington State, 1989-2008.
abstract: BACKGROUND
  Falls from height (FFH) continue to cause significant morbidity and mortality across the construction industry.
  
  
  METHODS
  By linking data on work hours with workers' compensation records, rates of work-related injuries resulting from FFH and associated days away from work were evaluated among a large cohort (n = 24,830) of union carpenters in Washington State from 1989 to 2008. Using Poisson regression we assessed rates of FFH over the 20-year period while adjusting for temporal trend in other work-related injuries. Patterns of paid lost days (PLDs) were assessed with negative binomial regression.
  
  
  RESULTS
  Crude rates of FFH decreased 82% over the 20-year period. Reductions were more modest and without demonstrable change since 1996 when adjusting for the temporal reduction in other injuries. Younger workers had higher injury rates; older workers lost more days following falls. Rates of PLDs associated with falls decreased over time, but there was not a consistent decline in mean lost days per fall.
  
  
  CONCLUSIONS
  These patterns are consistent with decreased FFH for several years surrounding state (1991) and then federal (1994) fall standards; the decline during this time period exceeded those seen in injury rates overall in this cohort. While crude rates of FFH have continued to decline, the decline is not as substantial as that seen for other types of injuries. This could reflect a variety of things including more global efforts designed to control risk (site planning, safety accountability) and changes in reporting practices.
authors.affiliation: Division of Occupational Medicine, Duke University Medical Center, Durham, North Carolina.
authors.forename: Hester J
authors.initials: HJ
authors.lastname: Lipscomb
authors.forename: Ashley L
authors.initials: AL
authors.lastname: Schoenfisch
authors.forename: Wilfrid
authors.initials: W
authors.lastname: Cameron
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Kucera
authors.forename: Darrin
authors.initials: D
authors.lastname: Adams
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Silverstein
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000062:Accidents, Occupational / Q000517:prevention & control / Q000639:trends*; D000328:Adult; D000367:Age Factors; D060389:Construction Industry / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007750:Labor Unions; D008297:Male; D008875:Middle Aged; D060051:Occupational Injuries / Q000453:epidemiology*; D018582:Sick Leave / Q000639:trends; D014861:Washington / Q000453:epidemiology; D014942:Workers' Compensation / Q000706:statistics & numerical data
keywords: cohort study; construction work; falls from height; injury surveillance; occupational injury