CHARACTARISTICS OF INDUSTRIAL FALL ACCIDENTS
IN ELDERLY WORKERS IN JAPANAkihiro Ohnishi1, Akiko Takahashi1 and Shoken Shimizu1
1

National Institute of Occupational Safety and Health, 1-4-6 Umezono, Kiyose,Tokyo 204-0024, Japan

In this study, to examine the necessity of reducing injury risks of fall, thecharacteristics of industrial fall accidents in the young to middle-aged group (20-49years) and elderly group (50-69 years), based on reports of more than 4 days ofabsence from work in 2006, were analyzed. The random sample data represented25.5% of all reports examined, from which human-induced accidents (n = 5,709)
were extracted. From the descriptions of each report, these data were classified into
slipping, tripping, and others. Because we found that the most frequent accidents
were falls caused by slipping (> 4 times), regardless of age, this study focused on
accidents caused by slipping. The prevalence of falls caused by slipping in theelderly group was estimated as being twofold of that in the young to middle-aged
group. Upper limb fractures occurred in 46% of all accidents caused by slipping in
the elderly group. In particular, it was found that wrist fracture was the most frequent
fracture in the elderly group, accounting for 60% of all upper limb fractures. To
prevent industrial fall accidents caused by slipping, the following two preventive
measures are suggested: the use of footwear with adequate slip resistance andexamination of protective equipment for wrists fracture in elderly workers.

Introduction
In recent years, the large number of falls in industrial accidents has become an issue. Falls werethe most common type of accident, accounting for 17.8% of all industrial accidents resulting inleave of four or more days in 2005 (Ministry of Health, Labour and Welfare, 2013). Thissituation has not improved in the eight years up to 2012, with the proportion actually rising to
21.7% (Ministry of Health, Labour and Welfare, 2013). Roughly 40% of all industrial accidents
occurred in tertiary industries, with retail and social welfare facilities reported as being the two
sectors in which the most falls occur, accounting for 31.3% and 29.1% of all falls respectively.
The percentage of elderly workers above 50 years is also known to be high. Whilecountermeasures are urgently required with the increase in falls, there are no statistics or reports
covering all types of industry and examining the relationship between situations that lead to falls,
types of injury, and sites of injury, which is basic information required to examine
countermeasures. Injury is likely to be particularly serious for elderly workers, who account fora large proportion of those injured. As returning to work may be hindered by aftereffects, it isimportant to understand the situations in which elderly workers fall and how they are injured
and to investigate possible countermeasures for such circumstances. Therefore, the purpose ofthis study was to divide falls into the main causes of “slipping” and “tripping” based on
descriptions of the accident reports, and to calculate frequency of falls according to cause. In
order to understand the details of accidents common in elderly workers, we also compared typeof injury, site of injury and number of absence days by age group, and investigated futurecountermeasures while analyzing the existence of characteristics of cases in which elderly
workers were affected.

- 79 -Methods
Data were sampled randomly 34,195 cases from the reports of more than 4 days of absencefrom work in 2006 by Ministry of Health, Labour and Welfare (25.5% of all cases). Of these,
we analyzed cases where the type of accident had been a fall. However, since this study targeted
human-induced falls, falling from heavy machinery such as cranes and falling from vehicles
while riding such as bicycles and motorcycles were excluded. Therefore, a total of 5,709 cases
were extracted for data analysis. Accidents were divided into “slipping,” “tripping” or “others”.
The categorized data was further divided into 20 to 49-year-olds (young to middle-aged group)and 50 to 69-year-olds (elderly group) and compared according to type of injury and injured site.

Results
The number of accidents of each type of fall by age group

Figure 1 shows falls divided into the three causes. There were 2,421 cases of slipping,accounting for 42.4% of falls in all ages, which was two times more frequent than tripping,which accounted for 1,090 cases (18.0%). Falls were more common in the elderly group in
regard to everything when subjects were looked at according to age group, and the proportion ofslips for the entire elderly group was 43.6%. This was slightly higher than all other ages. The
elderly group also scored slightly higher for tripping, at 19.5%. Therefore, the effect of age wassuggested for both slipping and tripping, but we decided to focus on and analyze “slipping”
when later comparing different age groups because slipping was an extremely common cause offalls in industrial accidents.

Others

Trip

335

Slip

646

1029

50-69 years
20-49 years

884
0All age

1000

1447

2421

2000

3000

Figure 1 The number of accidents of each cause of falls by age group

Type of injury in falls caused by slipping by age group

Figure 2 shows the number of cases by age group and the number of cases by type of injury offalls caused by slipping. When all falls caused by slipping were compared by age group, theelderly group comprised 1,447 cases and the young to middle-aged group comprised 884 cases,
with the number of cases for the former being more than 1.6 times higher. Fractures were themost common type of injury in both age groups. Fractures accounted for 72% of all injuries inthe elderly group and 54% in the young to middle-aged group (Figure 2).

Type of injury by age group in falls caused by slipping

As mentioned above, fractures were the most common injury in falls caused by slipping;
therefore, we aggregated injury sites by age group solely in regard to fractures. Results revealed
that in the young to middle-aged group, lower limb fractures were most common (40%),
followed by upper limb fractures (26%). In contrast, upper limb fractures were most common in
the elderly group (46%), accounting for nearly half of the total, followed by lower limb

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fractures (25%) (Figure 3). No differences were found for other sites.

Total

1447

884

Others

16
29

Wound

32
48

50-69 years

Bruise210
162

Sprain & Dislocate

145
169

Fracture

20-49 years

1044

476
0500

1000

1500

2000

Figure 2 The number of accidents of each type of injury by age groupin regard to falls caused by slipping
OthersLumbar & Pelvis
50-69 years

Trunk & Chest

20-49 years
Lower limb

191

Upper limb

261
481

122
0100

200

300

400

500

600

Figure 3 Accidents for each injury site by age group in regard to fracturesfrom falls caused by slipping

Upper limb fracture sites by age group in falls caused by slipping

Upper limb fractures were the most common in the elderly group in regard to fractures fromfalls caused by slipping, followed by lower limb fractures (which were most common in theyoung to middle-aged group); therefore, we aggregated detailed fracture sites by age group for
upper and lower limbs. Wrist fractures were most common in the upper limbs for both age
groups, and accounted for 60% in the elderly group, which was 20% higher than the young to
middle-aged group (Figure 4).
Unknown
Multiple
Upper arm
Forearm

50-69 years

FingerWrist
hand

20-49 years

29853

Elbow
Shoulder
0100

200

300

400

Figure 4 Upper limb fracture sites in falls caused by slipping- 81 -Discussion
Slipping caused over 40% of all falls regardless of age, making it the most commoncause. This suggested the importance of prioritizing the development of slipping
countermeasures. Specifically, these countermeasures included measures for improving
the facilities such as laying out anti-slip flooring, wearing slip-resistant shoes (e.g.
protective footwear), and educational and managerial measures such as always wiping
wet floors. However, measures for facilities incur significant costs, and educational andmanagerial measures as difficult as they require both time and understanding in order toestablish a system. In contrast, wearing slip-resistant shoes is relatively reasonable tointroduce in terms of both time and cost and fixed results can be obtained. The spread ofslip-resistant shoes is therefore preferable as a realistic countermeasure for slipprevention. Next, in regard to the characteristics of falls caused by slipping in theelderly group, this study found the number of cases to be approximately 1.6 times
higher than the young to middle-aged group, which was corroborated by the large
number of falls by elderly workers reported so far. However, the population ofemployee, which was the denominator of both groups, differed between groups; as aresult, it is difficult to compare directly. Therefore, when we compared the number ofemployees in 2006 (Ministry of International Affairs and Communications, 2013) as theclosest denominator of both groups despite not being entirely consistent because thisincluded the self-employed, there were 3,868 cases among 20 to 49-year-olds and 2,451
cases among those aged 50 years or over, with 1.58 times more cases in the elderlygroup. Based on these results, the number of accidents involving elderly workers may atthe very least be two times higher than that of young workers. The trend for all ages in
the case of slipping is a 50% chance of fractures. Therefore, the seriousness of slipping
must be recognized and it should be emphasized in particular to elderly workers due totheir even higher chance of injury.
Upper limb fractures were more common in the elderly group, particularly aroundthe wrist. Therefore, defensive motions and behavior when slipping may have been
influenced by age-related changes. More specifically, the stepping motion required toprotect against falls cannot be performed satisfactorily due to the decline in muscle
strength and agility (reduction in fast-twitch muscle fiber, decreased reaction time etc.)
and the individual is not fast in placing their hands on the floor. Furthermore, it may be
important to keep wrist fractures in mind in fall countermeasures for elderly workers,
since loss of bone density and decreased viscosity and elasticity of subcutaneous tissue
in elderly individuals are associated with the degree of severity. However, we could not
obtain information such what kind of situations hands were used to break falls in orwhether individuals were unable to use their hand to break a fall from the subject data
used in this study. Consequently, we were unable to investigate the effect of reducing
the risk of injury through the use of protective equipment for the distal end of theforearm bone in this study.
References
Ministry of Health, Labour and Welfare (2013). Statistics on Industrial accidents. Retrieved
July 20, 2013, from http://anzeninfo.mhlw.go.jp/user/anzen/tok/toukei_index.html. (inJapanese).
Statistics Bureau, Ministry of International Affairs and Communications (2013) Labour Force
Survey. Retrieved July 20, 2013, fromhttp://www.stat.go.jp/english/data/roudou/report/2006/ft/index.htm.

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