What is known about the topic?
Falls from height can include falls from ladders, windows, balconies and other high places. They occur at work or in the home and can
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.
Australia is divided into eight states and territories. The state of Victoria has the second largest population (Fig. 1) and is divided into 79 clearly-defined geographical regions called Local Government Areas (LGAs). The study region includes 21 of the 79 LGAs, which cover almost one-third of the state of Victoria by area. These 21 LGAs were selected because they form the region managed by the Western Victoria Primary Health Network [16]. This organisation has two main aims: “(1) Increasing
During 2014–2016, there were 1126 falls from height in the study region; 723 in men and 403 in women. The age-standardised incidence rates for men, women and men and women combined respectively, were 15.1 (95%CI 14.0–16.2), 7.7 (6.9–8.4) and 11.2 (10.6–11.9) per 10,000 population/year.
There was no specific pattern observed for age-standardised incidence rates across age groups in the whole study region (Fig. 2). However, rates for men were higher than that for women across almost all age
We report that the highest incidence rate for falls from height occurred in LGAs located in sparsely population areas to the southern part of the study region. Most patients arrived at the hospitals using either ambulance or private transport. Many falls occurred during leisure activities or work and in a home environment. Men were more likely to fall while undertaking work activities than women.
Falls from height can occur in a variety of circumstances, and one such example is falls from
Incidence rates for falls from height varied across the LGAs, and men had higher rates than women. Many men and women arrived at the hospitals primarily by private transport (including private car) or road ambulance, indicating that most individuals who experienced a fall from height were able to make their way to the ED with assistance from family or friends, or the ambulance service. The majority of falls from height occurred during leisure activities, and in a home environment. The data from
The study was funded by the Western Alliance Academic Health Science Centre, a partnership for research collaboration between Deakin University, Federation University and 13 health service providers operating across western Victoria. MAS is supported by a Centre for Innovation in Mental and Physical Health and Clinical Treatment Strategic Research Centre (Deakin University) stipend; SLB-O is supported by an National Health and Medical Research Council Career Development Fellowship (1107510).
JAP has received funding from the Western Alliance Academic Health Science Centre. KLH-K, TRB, MAS, MAK, PML, MK, SH, TLD, SB, RSP, AGS, SLB-O and LJW declare no conflicts of interest. No authors have had any financial relationships that could be perceived to influence, or that give the appearance of potentially influencing, what has been reported in this work. Falls from height can include falls from ladders, windows, balconies and other high places. They occur at work or in the home and canWhat is known about the topic?
The study was funded by the Western Alliance Academic Health Science Centre, a partnership for research collaboration between Deakin University, Federation University and 13 health service providers operating across western Victoria. Authors are supported by an Alfred Deakin Postdoctoral Research Fellowship; a stipend from the Centre for Innovation in Mental and Physical Health and Clinical Treatment Strategic Research Centre Deakin University and National Health and Medical Research Council
When spinal precautions were used, transport was the usual disposition (USA) [27,49]. Reported transport destinations included: ED [27–29,31,33,34,43,49,56,110,113,122,128], trauma unit (UK) [111], or a major trauma centre (UK) [111]. All transport destinations and methods had a majority of falls from “low levels”, although the majority of “high level” falls were transported directly to a major trauma centre, whereas low level falls were more commonly transported to hospital ED (Australia) [11,42], (England) [111].