Falls in a working-age population: The U.S. Army experience

Background: Fall prevention efforts often focus on children or elderly, but falls are also a leading cause of morbidity among working-age adults. This study describes the causes and risk factors associated with falls in a working-age population. Methods: Coded and narrative data on injured persons and circumstances associated with falls were obtained from U.S. Army accident reports dated September 1994-September 2002. Descriptive statistics are presented for injury outcomes and risk factors, with a focus on falls from elevation. Results: An average of 59 fall-related injuries per 100,000 person-years were reported from 1995-2001. Rates were higher among persons who were single, of white race, and 20-24 years of age. Falls from elevation resulted in more severe outcomes, longer hospitalizations, and more lost work time compared to falls from the same level. The majority of falls from elevation occurred on-duty (65%) and on an Army installation (73%), specifically in training areas (31%), individual housing (11%), and vehicle facilities (9%). Leading causes included routine activities (35%), physical training (12%), and sports (12%). Contributing factors included overconfidence (21%) and hurriedness (15%). Conclusions: Narrative data in safety reports provide cause information vital for planning and prioritizing fall prevention efforts. Results suggest that interventions to prevent falls from elevation should focus on reducing risks from routine activities such as walking or entering/exiting a vehicle, specifically in training and housing areas. With a high proportion of falls occurring on-duty and on an Army installation, workplace injury prevention programs would be likely to impact overall fall injury rates.