“We see ladder climbing as quite a benign thing to do,” says Dr Helen Ackland, a researcher at the National Trauma Research Institute. “When someone dies in a car accident we hear about it on the news, when someone dies from a ladder, it’s not on the news.”
However, that perception does not match up to reality. In 2018, 22 people died in ladder-related falls in Australia – and for every death, there are dozens of people who suffer from debilitating injuries.
A new study from Queensland University of Technology and Queensland Health, published in the journal Plos One, has found that, even six months after falling from a ladder, 49% of patients experienced a clinically significant deterioration in their quality of life, including depression, anxiety, trouble sleeping and pain.
The study looked at 255 Queensland hospital admissions due to ladder falls, then followed up with 134 patients six months later, conducting qualitative interviews.
Most of these injuries did not occur on worksites, where strict occupational health and safety codes are in place, but in the home. The largest cohort of patients were men over the age of 50, “people who like myself, would know better than climbing up and down ladders”, says Dr Rob Eley, a researcher at University of Queensland’s faculty of medicine, who worked on the study.
Over the course of the study, “we had a couple of people who died as a result of ladder falls”; “we had several more people who were permanently disabled”; and “then large numbers of people with abrasions and fractures”.
“But,” Eley says, “there’s a lot of psychological aspects to it as well, because as you get older and don’t heal quite as quickly … people end up off work, there’s a financial aspect, and it’s just very, very difficult. There are a lot of consequences that you don’t normally think of as being the result of just a visit to the hospital.”
Eley found that almost all of the injuries that occurred could have been avoided. Often, they were the result of inattention – people climbing back up a ladder to fix one last thing or grab a tool; or reaching too far, then falling.
Ackland, who also researches trauma as a result of ladder falls, sees a similar pattern. She says often these injuries are “completely preventable, plus in many ways the severity of the injury can be preventable with a little bit of extra care.”
Ackland found the Plos One study “very good”, and says “in our current research project we followed up at 12 months and we’ve found a similar picture.”
As Australia’s population ages, and more men enter into retirement age, these types of home improvement injuries are on the rise, says Ackland. “We’ve had 80- and 90-year-olds up ladders, just to give an example ... they’re used to doing things at home themselves, so they continue doing it past the age where they probably should be delegating to someone else.”
Eley is well aware of the temptation to climb a ladder without thinking about it – he experienced a ladder fall himself, while attempting to cut some bananas down from a tree. Fortunately, he was unharmed by this incident (he fell into bushes; while most of the worst injuries both he and Ackland have seen were the result of falling onto hard surfaces such as piles of bricks, or fences) – but, he says “I have been banned” from using ladders alone.
Now, Eley and his wife “do it together – you know somebody holds the bottom and the other person climbs”. He recommends having a ladder buddy as a basic safety precaution for all home ladder use. He has also set himself a height limit for climbs, because “it’s just not a sensible thing to do when you get older”.
Ackland points to a lack of legislation around ladder usage in the home as a driver of injury, but also says “we’ve found that people who are working in jobs where they climb ladders all the time, and are guided by [occupational] health and safety, when they’re at home they don’t use the occ health and safety regulations.” She says that while there’s some evidence to suggest that wearing helmets while using ladders in the home will help mitigate brain injuries in the case of a fall, prevention is better. “How about not falling to begin with?”
Eley notes that alcohol has been a factor in some injuries. “The message that I say to people is be very careful when you’re using a ladder, even more careful of using a ladder with a power tool, and certainly don’t use power tools on a ladder after you’ve been drinking.”
Ackland meanwhile suggests to those who ask, “give your dad a bike helmet and a list of guidelines for Christmas.”