We have all been there, just one more rung and the job is done. The problem is that rung is the top of the ladder. It’s ok, I will only do it this one time.

Trowel Trades has seen the shift, no more A-Frame ladders on the job unless it is a podium ladder. Being a scaffold company we feel that everything can be done with scaffold just as quick and MUCH safer, but there will always be a need for a ladder.

So should they be banned from job sites? Is the “Ladders Last” campaign picking up steam? That is the question raised in a recent IPAF magazine article. See page 10 here.

Who is at risk for ladder falls?
Anyone who uses a ladder can fall. However, workers who are male, Hispanic, older, self-employed, and work for smaller companies are at greater risk. Also, construction, maintenance, and repair workers experience higher rates of ladder fall injuries and deaths.

What are the major causes of ladder falls?
Incorrect extension ladder setup angle
Inappropriate ladder selection for the job or project
Insufficient ladder inspection
Improper ladder use
Lack of access to ladder safety tools and information

In a 2011 Morbidity and Mortality Weekly Report (MMWR) the CDC reports the following:

“Falls remain a leading cause of unintentional injury mortality nationwide, and 43% of fatal falls in the last decade have involved a ladder (1). Among workers, approximately 20% of fall injuries involve ladders (2–4). Among construction workers, an estimated 81% of fall injuries treated in U.S. emergency departments (EDs) involve a ladder (5). To fully characterize fatal and nonfatal injuries associated with ladder falls among workers in the United States, CDC’s National Institute for Occupational Safety and Health (NIOSH) analyzed data across multiple surveillance systems: 1) the Census of Fatal Occupational Injuries (CFOI), 2) the Survey of Occupational Injuries and Illnesses (SOII), and 3) the National Electronic Injury Surveillance System–occupational supplement (NEISS-Work). In 2011, work-related ladder fall injuries (LFIs) resulted in 113 fatalities (0.09 per 100,000 full-time equivalent* [FTE] workers), an estimated 15,460 nonfatal injuries reported by employers that involved ≥1 days away from work (DAFW), and an estimated 34,000 nonfatal injuries treated in EDs. Rates for nonfatal, work-related, ED-treated LFIs were higher (2.6 per 10,000 FTE) than those for such injuries reported by employers (1.2 per 10,000 FTE). LFIs represent a substantial public health burden of preventable injuries for workers. Because falls are the leading cause of work-related injuries and deaths in construction, NIOSH, the Occupational Safety and Health Administration, and the Center for Construction Research and Training are promoting a national campaign to prevent workplace falls (2). NIOSH is also developing innovative technologies to complement safe ladder use (6)………

…..Falls, particularly falls from ladders, contribute substantially to injuries in the workplace. To gain a comprehensive picture of the injury burden caused by ladder falls at work, cases from three different occupational surveillance systems were examined. Each system offers a different perspective on injuries. Current literature on LFIs indicates a higher burden of injuries to men, older workers, and construction workers (4,5). Although this analysis found similar results, it also indicated that Hispanics, self-employed workers, and workers in smaller establishments had disproportionately higher LFI rates. Higher rates of LFIs were identified in installation, maintenance, and repair occupations, in addition to construction and extraction workers. This report adds to the literature on occupational fall injuries by providing a comprehensive, multisystem view of LFIs across all occupational groups using the most recent surveillance data available in the United States. This analysis provides a baseline to the multiagency falls prevention campaign that started in 2012 (2).

The findings of this report are subject to at least four limitations. First, inclusion of cases is dependent on identifying the relationship between injury and work, which is not always clear, particularly for nonfatal injuries. Second, it is well recognized that nonfatal injury surveillance systems are subject to reporting and recording biases, which might result in underestimations of injury counts and rates (7). For example, not all demographic characteristics are pertinent to medical treatment, and therefore might be underreported during ED treatment. Such biases were minimal for CFOI because it is a census, rather than a sampled survey. Third, in this analysis, all workers were included in the denominator to calculate rates, which might underestimate the injury burden. A preferable denominator to understand LFI risk would be workers who used ladders in 2011, which might be available in future studies (8). Finally, this study is unable to evaluate adherence to safety recommendations.

Injuries from ladder falls can be severe but are preventable. Medical professionals might recommend safe ladder practices to their patients, such as those published by the American Academy of Orthopedic Surgeons as part of the Prevent Injuries Campaign (9). To prevent ladder falls, employers should consider the following steps: 1) plan the work to reduce or eliminate the need for using ladders by applying safety-in-design and constructability principles to finish as much of the work as possible on the ground; 2) provide alternative, safer equipment for extended work at elevation, such as aerial lifts, supported scaffolds, or mast climbing work platforms; 3) provide properly selected and thoroughly inspected ladders, that are well-matched to employee weight, task, and location; 4) when applicable, provide proper accessories to supplement safe ladder use; and 5) provide adequate ladder safety information and training for employees (6,9). Familiarity and compliance with the provisions of safety regulations, such as recognizing ladder types and conditions, and using ladder positioning and other safe ladder practices, are crucial to reducing injuries from ladder falls (2).

NIOSH safety research in this area focuses on innovative technologies to improve safe ladder use (6). For example, NIOSH recently developed and released a smartphone application (app) “Ladder Safety” (available at http://www.cdc.gov/niosh/topics/falls), which provides graphic-oriented, interactive, and easy-to-use reference materials, safety guidelines, and checklists for extension ladder selection, inspection, and use. The app is a convenient ladder safety performance and training tool and is available as a free download for Apple and Android mobile devices in English and Spanish (10).”

Here are some great guidlines to follow when using a ladder:

1. Read and follow all labels/markings on the ladder.
2. Avoid electrical hazards! – Look for overhead power lines before handling a ladder. Avoid using a metal ladder near power lines or exposed energized electrical equipment.
3. Always inspect the ladder prior to using it. If the ladder is damaged, it must be removed from service and tagged until repaired or discarded.
4. Always maintain a 3-point (two hands and a foot, or two feet and a hand) contact on the ladder when climbing. Keep your body near the middle of the step and always face the ladder while climbing (see diagram).
5. Only use ladders and appropriate accessories (ladder levelers, jacks or hooks) for their designed purposes.
6. Ladders must be free of any slippery material on the rungs, steps or feet.
7. Do not use a self-supporting ladder (e.g., step ladder) as a single ladder or in a partially closed position.
8. Do not use the top step/rung of a ladder as a step/rung unless it was designed for that purpose.
9. Use a ladder only on a stable and level surface, unless it has been secured (top or bottom) to prevent displacement.
10. Do not place a ladder on boxes, barrels or other unstable bases to obtain additional height.
11. Do not move or shift a ladder while a person or equipment is on the ladder.
12. An extension or straight ladder used to access an elevated surface must extend at least 3 feet above the point of support (see diagram). Do not stand on the three top rungs of a straight, single or extension ladder.
13. The proper angle for setting up a ladder is to place its base a quarter of the working length of the ladder from the wall or other vertical surface (see diagram).
14. A ladder placed in any location where it can be displaced by other work activities must be secured to prevent displacement or a barricade must be erected to keep traffic away from the ladder.
15. Be sure that all locks on an extension ladder are properly engaged.
16. Do not exceed the maximum load rating of a ladder. Be aware of the ladder’s load rating and of the weight it is supporting, including the weight of any tools or equipment.

Should ladders be banned? We don’t know. Will ladders be the goto for a quick fix? Yes. Your guess is as good as mine but at the end of the day, just think about ladder safety as it may save your life.