By:
Daryl Sprehn & Jackie Dion
Presented at Alliance Occupational Medicine November 6, 2013 San Jose, CA
© 2013 On-site Safety & Ergonomics, LLC

Safety Specialist and Engineer
On-site Safety & Ergonomics, LLC Decades of experience in risk management
Specializing in Ergonomic Services for your home or office
Evaluations, demos and sales
408-828-9234
Thank you Alliance for all your good work and hosting this presentation
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• Introduction
• STF’s – why we care, a few statistics
• Common safety basics
• Slips, trips, falls
• Commonality – causes and prevention
• Wrap-up
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69 subcategories of “Falls,
Slips, Trips” in the CDC
Coding OIICS used also by
U.S. Bureau of Labor
Statistics
(http://wwwn.cdc.gov/wisards/oiics/)
This talk will not cover
“falls to a lower level”

Distribution of sprain, strain, and tear cases requiring days away from work 2011
.
U.S. Bureau of Labor Statistics

• STF’s are significant
• laborers, medical staff, janitors , truck drivers, freight handlers, delivery, & law enforcement - higher rates
• The older you are, the longer you’ll be away
(>65 is 4x <25)
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• Different emphasis for various industrial sectors
(wholesale, retail, manufacturing, office...)
• Same mitigation principles apply: research & planning, implementation & assessment
• $$$ Experience Modification (
XMOD ) factor $$$
• $ STF’s are largely preventable $
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Safety basics: Prevention with The Triangle
• H.W. Heinrich’s 300 / 29 / 1 ratio
( Industrial Accident Prevention, A Scientific Approach in 1931)
• For every 330 Incidents:
1 produces major, disabling injury
29 produce lost-time / minor injuries
300 result in first-aid / near-miss
• Most reporting gives you the 30, not 300
• Opportunities to improve are great
Whether 300 or 3000, most accidents have warning signs and are rehearsed many times
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1
29
300

1.
Unsafe Behavior
(HWH says 95%)
2.
Unsafe environment
3.
Lack of training
4.
Breach in policy or procedure
•
Most incidents are not single-cause
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Safety basics example: NYC triangle
Source: http://www.youtube.com/watch?v=ap-22FjgoE4

Safety basics example: NYC triangle
• Bottom of triangle has been well-rehearsed
• Cause – Step too high (0.125” out of tolerance)
• ~330,000 YouTube views - the stairs were blocked off and repaired
• Every organization likely has a “NYC subway staircase” that is unknown or unreported
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• There are Integrated Safety and Management
Systems, (add in the words Environmental or Health or ...) which all recognize the importance of feedback and improvement hence graphical representations are usually expressed as circles.
• We are going to make a simplified circle for the purposes of this talk...
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Research
Assess
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Implement
Plan

Research
Celebrate!
Plan
Assess
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Implement

Research analyze loss runs and assessments, consultations, don’t forget to look outside...
Plan – schools of fish and bottom fruit, address engineering aspects,
CODB, administrative aspects, policies, procedures, training, information flow, incident response, reporting, manpower...
Implement hardware and “software” (this is where the training, controls, investigations, modifications, inspections occur...boots on the ground)
Assess – audit, new hazards, unbeneficial outcomes, claims, metrics...
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Safety basics – triangles, circles, people
• People are our greatest asset – respect and empathy are our greatest tools, everyone can contribute
• Don’t underestimate the importance of culture, morale, and leadership – most people respond well to teamwork, fairness, and information flow
• Training, clear communication of expectations and resulting outcomes, clear policies and procedures
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Slip - not enough friction to keep your feet where they should be
4 main factors - floor, footwear, what’s on top of floor, gait
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Trip - occurs when something was in the way of your pedestrian motion (legs, feet) OR you stepped up or down in level...either way your motion was upset by your feet not initially placed as expected.
3 main factors – walking path, attention, gait
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Fall - happens when you
(or the system supporting you) aren’t above your feet (or firmly attached).
For the purpose of this talk a fall is to the same level, mostly by slip or trip
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SLIPS are all about friction
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• Friction: force resisting relative motion of your feet/footwear sliding against a walking surface.
• Coefficient of friction (COF): Common performance measurement of friction whereas higher numbers mean more friction.
– Certain circumstances such as ramps and wet flooring requires a higher COF
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Values needed for walking without falling...
•
COF of ~0.6 is considered standard
•
On ramps, a higher COF is needed
•
In wet environments a higher COF is needed
Measurement...
•
Almost impossible to measure in a practical sense and one has to depend on experience and manufacturers
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Coefficient of friction, (traction)
• It all comes down to how well your feet stick and don’t stick to the walking surface. Too little and you cannot move...too much and...ever tried walking with rubber shoes on a rubber mat? This is why the common COF is ~0.6 and not higher.
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Some contributions to COF
(besides shoes and flooring)
• Wet or Dry product, spills or other on walking surfaces
(water, flour, leaves and pine needles)
• External contamination (oil tracked in on shoes)
• Unsecured floor toppings (mats and loose rugs)
• Cleanliness in general
• Changes in COF (utility plate cover, sloped surface)
• Changes in center of gravity (getting in/out of vehicle)
• Loose &/or irregular surfaces (gravel, pavement domes)
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Friction and environment
• Footwear
• Flooring (or other surface)
• Floor toppings (mats, carpets, chemical treatments)
• Floor contamination (spills, housekeeping, entrances)
• Maintenance and inspection for the above
• Responding to temporary hazards
• Ability to see hazards (lighting, warnings)
• Demographics and gait
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Footwear: where the rubber meets the road
• DoL estimated in 2010 that inappropriate footwear may contribute up to
25% of the reported STF incidents
• Pretty tough to control your visitors, even more so your customers, but easier to control your employee’s footwear by: e.g. policies, footwear reimbursement, inspections, etc.
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Management should clearly define what footwear is appropriate for the workplace
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• Soles:
– Soft rubber soles for dry surfaces, not wet or greasy.
– Hard rubber soles for greasy, but not dry or wet surfaces.
– Synthetic soles for many conditions, but may not be recommended for oily surfaces
– Leather can be slippery when new on hard dry surface, but are less slippery on wet surfaces when broken in.
• Tread:
– Perp to travel, avoid trapped patterns, check for wear
• Flatter shoes give more surface area (heel issue)
• Shoes should be secure (flip-flops, sandals, fasteners)
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If installing new flooring the selection depends on many expert opinions and data
• Wide variety of options – concrete, stone, wood, synthetic, ceramic, rubber, metal...
• Budget and aesthetics
• Traffic – types of, controlled or uncontrolled
• Maintenance & housekeeping practicalities
• External conditions (weather, mud, oil...)
• Internal usage, systems, contamination sources
• Treatments and toppings
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Floor selection/topping continued...
• A shiny floor is often slippery, but a dull surface can also be slippery
• High COF values are less shiny in general terms and often harder to clean thoroughly
• Anti-slip toppings are available for almost any selection and generally require maintenance
• Some toppings can make a reasonable COF surface suddenly become unreasonable (what are your janitors doing to your nice floor?)
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Consult with experts to decide which is best
– Etching
– Paint or Epoxy compounds
– Texture finishing (such as concrete)
– Abrasive granules coating
– Carpet
– Chemical treatments
• Properly maintained/inspected
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Floor maintenance – inspect often!
– Cleaning for hard or resilient floor must be done but...
• Detergents with fragrance-can leave slippery residue
• Cleaner not diluted enough or too much
• Use the right cleaner type for the floor
– Repair damaged flooring immediately, or cordon off
– Buffing/burnishing
• Traction-enhanced polish and paint applied correctly can improve traction drastically, incorrectly can do the opposite
– Don’t cause an accident - Unattended items less 36” high, or power cords, or no signage during maintenance
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Don’t be dismayed, people have been building and walking on floors for thousands of years i.e. bad materials get pushed out of the market
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• 100% of employees and customers use them and tend to track in water, snow, debris, and oil on their shoes, coats, wet umbrellas or shopping carts
• Mats &/or special entrance transition regions are a real good idea
• Whatever you put on the floor, make sure it stays and doesn’t move when walked upon!
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Long mat at entrance, mats near wet areas and anti-slip flooring done well

• Clean, orderly and sanitary
• Particular attention to break rooms, bathrooms, entrances, storerooms, machinery and other sources of fluids or loose contamination
• Platforms, mats, or other dry standing places for wet processes
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Responding to Spills
– Written policy and procedure for all types of spills
• Warning signs –yellow caution cones or barricade tape (29
CFR 1910.144)
• MSDS
• Call emergency services and evacuate if necessary
• Spill kits - Hazardous materials, Bio Hazards & simple spills
• Equipment/supplies near jeopardy zones
• Wet mopping - what do you do with the bucket?
• Always dispose of hazardous waste properly
As with floor maintenance, don’t cause an accident!
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Lighting and slips (and trips)
• Poor lighting
– Various illumination requirements (OSHA, UBC...)
– Eliminate glare sources and shadows
– Replace burned out or flickering light bulbs
– Motion detection lighting in low use areas
– Emergency lighting especially on stairways
– Poor or malfunctioning outdoor lighting
– Transition lighting made gradual
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TRIPS
• Compared to slips, trips are much easier to address and spot because we don’t have the moving target of that pesky COF. Just ask yourself...
“What’s in the way of people’s feet and motion”?
and
“What behaviors require addressing”?
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What’s wrong here?

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?

• Uncovered hoses, cables, wires or extension cords across aisles or walkways
• Clutter, obstacles in aisles, walkway & work areas
• Open cabinet, file or desk drawers & doors
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• Irregularities in walking surfaces ( approved paths )
– Thresholds or gaps
– Curbs, driveways, speed bumps, tire bumpers, ramps...
– Stairs, platforms and other purposeful elevation changes
– Missing or uneven floor tiles & bricks
• Carpets & mats
– Design (e.g. no bevel or non-recessed when should be)
– Rumpled, rolled-up, curled edges, frayed, ripped
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Fatigue mats for medical, office, laboratory – ADA compliant, beveled edge anti-slip (Smart Step mats shown)

• Sufficient safe clearance maintained where mechanical handling equipment is used
• Aisles and passageways kept clear and in good repairs
• No obstruction across/in aisles that could be a hazard
• Permanent aisles and passageways should be appropriately marked
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– Maintain regular and emergency lighting
– Inspect stairs, lighting and handrails periodically
– Make sure stairs adhere to code
– Make sure any added slip resistant materials are in good condition
– Make sure handrails and risers are securely fastened
– Immediately coach and counsel employees that exhibit risky behavior
– Treat like your floor too – COF, maintenance, housekeeping
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• Walk around, examine, observe, ask
• Collect full data during incident reporting
• Good housekeeping, maintenance & inspection
• Fix what is wrong
• Train and explain (behaviors)
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Parking lot where trip occurred
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Parking lot nearby

Falls – to the same level (no slip/trip)
• unspecified and/or “loss of balance” medical (inner ear, fainting, prior injury...)
• against/on/through an object housekeeping, maintenance, engineering, behavioral
• while sitting faulty castors or chair, improper seating, uneven floor
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Falls – without Slip/Trip
Don’t fall off your chair!
improper use (standing on it), weight rating
& fit (body types), task (what you do in the chair), use (durability), fabric (environment, cleanliness, traction), correct castors (work surface), operation (complexity), aesthetics
& sustainability.
On-site Safety & Ergonomics : Dealer Rep & value-added ergonomic professionals of Office
Master products
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STF risks - Human Factors
• Visual perception, failing eyesight, sunglasses
• Fatigue, stress, illness, balance, other injury
• Medications, alcohol & drug effects
• Gait
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STF risks - Human Factors
• Moving cumbersome (or too many) objects
• Not paying attention to surroundings or distracted
• Taking unapproved shortcuts
• Being in a hurry and rushing
• Shoes / clothes of poor fit or inappropriate
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STF’s are common
Safety basics: + + people
Behavior, environment, training, p&p
COF, Eng/maint, housekeeping, train-explain
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