The epidemiology of emergency presentations for falls from height across Western Victoria, Australia

Abstract

Background

In order to implement intervention strategies to prevent falls from height, epidemiological data are needed. The aim of this study was to map emergency presentations for falls from height in residents aged ≥40 yr of the western region of Victoria, Australia.

Methods

Emergency presentations following a fall from height (≥1 m) were obtained from electronic medical records for 2014–2016 inclusive. For each Local Government Area, age-standardised incidence rates (per 10,000 population/year) were calculated.

Results

The age-standardised incidence rate was lowest in the Northern Grampians (3.4 95%CI 0.8–5.9), which has several main industries including health care, agriculture and manufacturing. The highest rates occurred in Corangamite (26.0 95%CI 19.9–32.0), Colac-Otway (23.7 95%CI 18.5–28.8) and Moyne (22.5 95%CI 16.8–28.3), which are sparsely populated (15,000–20,000 people each). Patterns were similar for men and women.

Most falls occurred during “leisure” (38.0%), followed by “other work” (15.4%). Men were more likely than women to experience a fall from height while undertaking work activities. Many falls occurred in the home (53.2%).

Conclusion

Future research should inform strategies to prevent falls from height in the region. This could include specific locations such as the home or farm, and during leisure activities or work.

Introduction

Falls from height (i.e. ≥1 m) can include falling from the roof of a building, a balcony, window, ladder, staircase or other high-level structure [1,2]. These types of falls are associated with significant injury, as well as substantial healthcare costs.

Falls from height are a major cause of injury in work environments; 11% of all work-related deaths in Australia are the result of a fall from height [3]. In Australia, construction, agriculture, manufacturing and transport and storage have higher rates of falls from height than other industries [4]. In Australia from July 2006 to July 2009, approximately 6900 workers were hospitalised due to a fall from height [4]. More recent data have shown that there were 132 fatal falls from height during 2012–2016 in Australia [5]. The mortality rate for falls from height in a work environment increases with increasing age. In Australia, 65% of fatal falls from height occurred in workers aged ≥45 yr [3].

Falls from height in a work environment can have a substantial burden for the employer and the employee. Data from Western Australia showed the average cost per year (2003–2007) for falls from height in workplaces was $AUD 91 million, and involved 276,984 days absent from work (average per year) [6]. This corresponded to 53 days absent from work, and a cost of $18,513 per person injured.

To our knowledge, no previous studies have specifically focused on falls from height in adults 40 years or older. This age group is important because the presence of chronic disease is high in adults aged ≥45 yr according to the Australian Institute of Health and Welfare; >60% of adults in this age group have one or more chronic diseases [7]. We also wanted to capture adults slightly younger than this, as risk factors for chronic diseases, such as overweight and obesity are increasing in prevalence for younger age groups [7]. Additionally, there are data available for falls from height in urban areas [[8], [9], [10], [11]], but less for semiurban [12] and rural areas [13,14].

The current study forms a part of the larger Ageing, Chronic Disease and Injury study, which aims to map chronic disease and injury throughout the western region of Victoria, Australia, in order to provide information that can be used to improve health service delivery through interventions, guidelines and policies. Further details regarding the study have been previously published [15].

The current study investigated the incidence of emergency presentations for falls from height (≥1 m) in men and women aged ≥40 yr, residing in western Victoria, Australia, as part of the Ageing, Chronic Disease and Injury study.