title: Investigating the fall-injury reducing effect of impact absorbing flooring among female nursing home residents: initial results.
abstract: BACKGROUND
  Fall-related injuries affect the lives of elderly to a substantial degree. This quasi-experimental study investigates the fall-injury reducing effect of impact absorbing flooring among female nursing home residents.
  
  
  METHODS
  The intervention site is a nursing home in Sweden where impact absorbing flooring was installed in parts of one of six wards (six out of 10 apartments (excluding bathrooms), the communal dining-room and parts of the corridor). The impact absorbing flooring is a 12 mm thick closed cell flexible polyurethane/polyurea composite tile (500×500 mm) with an exterior surface of polyurethane/polyurea. A generalised linear model (log-binomial) was used to calculate the RR of injury from falls on impact absorbing flooring compared to falls on regular flooring, adjusted for age, body mass index, visual and cognitive impairments.
  
  
  RESULTS
  During the study period (1 October 2011 to 31 March 2014), 254 falls occurred on regular flooring and 77 falls on impact absorbing flooring. The injury/fall rate was 30.3% for falls on regular flooring and 16.9% for falls on impact absorbing flooring. Adjusted for covariates, the impact absorbing flooring significantly reduced the RR of injury in the event of a fall by 59% (RR 0.41 (95% Cl 0.20 to 0.80)).
  
  
  CONCLUSIONS
  This is, to our knowledge, the first study evaluating the injury-reducing effect of impact absorbing flooring in a nursing home showing statistically significant effect. The results from this study are promising, indicating the considerable potential of impact absorbing flooring as a fall-related injury intervention among frail elderly.
authors.affiliation: Division of Risk Management, Department of Environmental and Life Sciences, Karlstad University, Karlstad, Sweden.
authors.forename: Johanna
authors.initials: J
authors.lastname: Gustavsson
authors.affiliation: Division of Risk Management, Department of Environmental and Life Sciences, Karlstad University, Karlstad, Sweden.
authors.forename: Carl
authors.initials: C
authors.lastname: Bonander
authors.affiliation: Division of Risk Management, Department of Environmental and Life Sciences, Karlstad University, Karlstad, Sweden.
authors.forename: Ragnar
authors.initials: R
authors.lastname: Andersson
authors.affiliation: Division of Risk Management, Department of Environmental and Life Sciences, Karlstad University, Karlstad, Sweden.
authors.forename: Finn
authors.initials: F
authors.lastname: Nilson
mesh_terms: D000058:Accidental Falls / Q000191:economics / Q000401:mortality; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D004779:Environment Design / Q000191:economics; D005260:Female; D005430:Floors and Floorcoverings / Q000191:economics; D016330:Frail Elderly; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000191:economics; D010865:Pilot Projects; D019057:Quality-Adjusted Life Years; D012307:Risk Factors; D017751:Safety Management; D013548:Sweden / Q000453:epidemiology; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000191:economics / Q000209:etiology* / Q000517:prevention & control*