Rushing, Distraction, Walking on Contaminated Floors and Risk of Slipping in Limited-service Restaurants – a Case-Crossover Study

Purpose: This nested case-crossover study in limited-service restaurant workers examined the association between rushing, distraction and walking on a contaminated floor and the rate of slipping. We also examined whether the effects were different according to weekly work hours, job tenure, and slip-resistant shoe use. Methods: 210 workers from 36 limited-service restaurants were recruited in a 12-week cohort study of workplace slipping. At baseline, participants reported work hours, and average duration of exposure to each transient risk factor per week. Slip-resistant shoe use was determined by examining participants' shoes and noting the presence of a “slip-resistant” marking on the sole. During the following 12 weeks, participants reported their slip experience and exposures to the three transient exposures at the time of the slip weekly. The Mantel-Haenszel estimator for person-time data were use to estimate rate ratios. Results: The rate of slipping was 2.9 times higher when rushing as compared to working at a normal pace (95% CI 2.5, 3.3). The rate of slipping was also significantly increased by distraction (RR = 1.7, 95% CI 1.5, 2.0) and walking on a contaminated floor (RR =14.6, 95% CI 12.6, 17.0). Use of slip-resistant shoes decreased the effects of rushing and walking on a contaminated floor. Rate ratios for all three transient factors decreased monotonically as job tenure increased. Conclusion: The results suggest the importance of these transient risk factors, particularly floor contamination, on rate of slipping in limited-service restaurant workers. Stable characteristics, such as slip-resistant shoes, reduced the effects of transient exposures.