273315 When Injury Evidence and Building Industry Policies plus Practices Clash: The case of home stairway design regulation to reduce number and severity of injurious falls

Wednesday, October 31, 2012 : 8:50 AM - 9:10 AM

Jake L. Pauls, BArch, CPE , Jake Pauls Consulting Services, Silver Spring, MD
Background: Beginning in the late 1990s, APHA has been formally represented on committees advising on policies and developing specific built environment design and construction requirements.

Methods: Collect, analyze and interpret epidemiological and etiological data of fall injuries associated with the built environment, especially with stairways. Relate these to the development, adoption and enforcement of built environment regulation. Provide international forums for discussion of these issues.

Results: Injuries resulting in post-ED, hospital admission, associated with stairways in homes, recently grew at a relatively high rate in the USA while such injuries in settings other than homes showed little or no growth. Rates, per 100,000, of hospital-admissions following home stair-related injuries, grew more rapidly for the under-65 age group, with highest rates seen in middle age adults. Overlapping the trends was growing divergence of design and construction requirements, plus their adoption and enforcement, in homes versus other buildings.

Discussion: We are paying a high price for policies and practices, dominated by the building industry, retarding development, adoption and enforcement of improved home stairway requirements shown to be effective in reducing missteps and injurious falls. Research has been much better applied to non-home settings where such benefits are most evident. Industry-dominated, traditional, lower standards for homes persist despite policies on equity by organizations like APHA. On the other hand, there is important progress, including an international conference in 2011, new centers for research, plus several workshops, directed to a wide range of disciplines, in the USA, Canada and overseas during 2012.

Learning Areas:
Other professions or practice related to public health
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
1. Assess effectiveness of environmental interventions in reducing the occurrence and severity of ambulation-related, injurious falls in the built environment in homes and other buildings, especially on stairways. 2. Identify three key factors contributing to, and retarding, achievement of such objectives.

Keywords: Injury Prevention, Environment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: For over a decade I have formally represented APHA, in a volunteer, unpaid capacity, on eight national committees responsible for policy and technical aspect of model building codes and safety standards in the USA. In Canada, I am active on several national committees (with memberships on two) working in close collaboration with, rather than as a formal representative of, the Canadian Public Health Association. Both roles build on work in, or collaboration with, research institutes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.