1. Medical and Other Risks Associated with Falls

Falls from heights remain the biggest cause of occupational fatalities in the construction industry. According to a report by the fatality assessment and control evaluation program, 54% of workers killed had no access to a personal fall arrest system; and 20% of fatalities occurred in the victims’ first two months on the job.

Injuries caused by falls are more likely to be life-threatening than most other types of injuries. While other common causes for accidents, such as falling objects, overexertion, or vehicle or machine accidents—are more likely to injure only a part of the body, injuries from falls can easily affect the whole body and vital organs.

The chances of surviving a fall from more than 9m are low, but even 1.8m can prove deadly when landing on the wrong body part or surface. Spinal, head, or neck injuries are a common result of falls, regardless of the height, and can leave the worker severely disabled or lead to death.

Although it seems to be the leading cause of death in the workplace, falls are actually not the most common cause of injury. Instead, overexertion and bodily reaction led to days away from work. Similarly, nonfatal injuries from contact with objects or equipment showed a similar incidence rate to falls, slips, or trips.

In other words, falls from height are not the most common type of accident, but when they happen, they are much more likely to be deadly than other occupational accidents. More so than the quantity of fall-related incidents, it is the severity that we need to focus on to decrease the number of fatalities.

Effective fall protection depends on an informed choice of equipment and knowledge on how to safeguard one and others from potential hazards. Workplace safety is, therefore, a two-step process, which involves, first, technical support from tools and machinery that can shield and protect in dangerous situations, and second, human support in the shape of comprehensive training, instructions and guidance.

Neglecting either of the two will most likely cause the safety system to have “holes” that will lead to breaches and dangerous working conditions for everyone at the site.

Safety equipment has become vastly effective and affordable in recent years, making it easy to choose the right solution to each individual task. Instead of going with one-size-fits-all solutions, well-tailored and modifiable equipment can potentially make every site completely hazard-free. A combination of fall arrest systems, edge protection, scaffolds and safety equipment (like lighting, ladders, protective gear, etc.) should be able to prevent injuries - if used correctly.

Even the newest and most expensive equipment won’t keep a worker safe from accidents if the worker does not know how to use it. Therefore, safety training should be a top priority for any company, regardless of the size or the industry. Safety training at regular intervals will educate staff on how to use tools, how to spot a potential hazard, and how to maintain a health and safety culture in the workplace that will spark awareness and interest in safety procedures among workers.

A good safety plan not only saves workers’ lives, it also profits a company’s revenue immensely. According to the National Safety Council, every R1 000.00 invested in injury prevention can return between R2 000.00 to R6 000.00 as productivity increases, contentment with work and the workplace among employees rises, and higher retention creates a more sustainable and successful working environment.

The responsibility for creating urgency when it comes to safety culture lies with the employer. Fall protection stands or falls with every individual on-site and cannot be considered solely as a structural or corporate issue.

Instead, the future of fall protection will be decided in close cooperation with those directly affected by it - the employees. Companies that take safety as a task that can be handled on the executive level are taking the wrong approach. An understanding of safety culture will only reach the worker if they are involved in the discussion, and only then can all work together to reduce fatalities.

The financial costs from fall-related injuries are substantial. Evidence suggests the implementation of effective prevention strategies with a subsequent 20% reduction in the incidence of falls could create substantial savings each year.

Across all age groups, both genders are at risk of falls. It has been noted that males are more likely to die from a fall, while females suffer more non-fatal falls. Males consistently sustain higher death rates and DALYs lost. Possible explanations of the greater burden seen among males may include higher levels of risk-taking behaviours and hazards within occupations.

Risk Factors Include:

• Occupations at elevated heights or other hazardous working conditions
• Alcohol or substance use
• Underlying medical conditions, such as neurological, cardiac or other disabling conditions
• Side effects of medication, physical inactivity and loss of balance
• Unsafe environments

Prevention:

• Enforcement of more stringent workplace safety regulations in high-risk occupations such as the construction industry
• Fall-risk assessments to address identified risks
• Fence off, or otherwise, restrict access to dangerous areas
• Functioning occupational health and safety systems
• Harnesses, restraint systems, fall arrest systems and safe scaffolding for those working at heights

Fall protection is required for anyone who is at risk of falling for more than 2m. That's the height at which falls become noticeably more dangerous. However, construction research data shows falls from a shorter elevation can still be fatal.

Chest injuries are more common in high falls, the commonest specific injuries being rib fractures, lung contusion, and the presence of air or gas in the membrane around the lung cavity, causing pain and difficulty in breathing. This can occur spontaneously because of accidental rupture or perforation of the membrane, in very high falls cardiac and aortic ruptures are common.

Decelerating rapidly - which is what happens if the human body falls and then makes a sudden impact - can cause cells to rupture. Like cells, blood vessels can also break open, preventing the circulation of oxygen throughout the body. Without oxygen, our organs, including the brain, cease to function.

Falls can have a variety of outcomes ranging from no injury or minor injury to serious injury or death.

Physical Injuries Can Include:

• Pain
• Bruising
• Scratches and other superficial wounds
• Haematomas
• Lacerations
• Fractures
• Intracranial (into the skull) bleeding.