Falls in the Workplace: Publications

Construction: accessing and working on elevated work surfaces safely
Modern occupational diseases: diagnosis, epidemiology, management and prevention. Bang KM, ed. Singapore: Bentham Science Publishers: September 2022 / :255-285

Prevent Falls through Holes
NIOSH Publication No. 2022-145 (August 2022)

Prevent Falls: Guardrails
NIOSH Publication No. 2022-146 (August 2022)

Evaluation of the Fall Protection of Type I Industrial Helmets
Annals of Biomedical Engineering: Feb 2022 / :[Epub ahead of print]

2021 stand-down to prevent falls in construction: a snapshot based on OSHA’s certificate of participation database & CPWR’s online ordering form.
Silver Spring, MD: CPWR-The Center for Construction Research and Training, 2022 Jan; :1-2

The National Campaign to Prevent falls in Construction evaluation report: 2021 Safety Stand-Down based on OSHA certificate of participation data.
Silver Spring, MD: CPWR-The Center for Construction Research and Training, 2022 Jan; :1-17

Infographics for the National Campaign to Prevent Falls in Construction
NIOSH Infographics
Each year, NIOSH, CPWR, along with the NORA Construction Sector Council Falls Working Group work together to develop a new series of infographics in English and Spanish. View and download the infographics as PDFs or JPEGs for use in social media, presentations, and print materials.

Infographic: Fall Protection: As Easy as A-B-C
NIOSH Infographic (2020)
This infographic on fall protection helps mine workers identify three essential components of a fall arrest system: anchor, body harness, and connecting device.

Infographic: Fall Protection: As Easy as 1-2-3
NIOSH Infographic (2020)
This infographic on fall protection helps mine workers identify three essential steps to take when using a personal fall arrest system: select and inspect, put on, and tie off.

Prevent Construction Falls from Roofs, Ladders, and Scaffolds
NIOSH Publication No. 2019-128 (2019)
This fact sheet gives recommendations, reports, and resources to help employers, safety professionals, and workers prevent fall injuries and deaths from roofs, ladders, and scaffolds.

Fatal work-related falls in the United States, 2003-2014
American Journal of Industrial Medicine: March 2018 / 61(3)204-215

Construction Chart Book
Silver Spring, MD: CPWR-The Center for Construction Research and Trainings, February 2018 / :1-74
The sixth edition of The Construction Chart Book – The U.S. Construction Industry and Its Workers continues to present the most complete data available on all facets of the U.S. construction industry: economic, demographic, employment/income, education/training, and safety and health issues, plus much more all in one place. This edition not only offers on-demand access to the charts and data, but also includes interactive features that enhance the user’s experience. Users can click on terms to access definitions instantly, and easily enlarge charts and tables within each page. References, citations, and databases are also hyperlinked to enable users to further explore these sources.

NIOSH National campaign to prevent falls in construction – United States, 2017
Morbidity and Mortality Weekly Report (MMWR): April 2017 / 66(16):427

Evaluation of a “walk-through” ladder top design during ladder-roof transitioning tasks
Applied Ergonomics: March, 2017 / 59(Pt A):460-469

Finite Element Simulations of the Head-Brain Responses to the Top Impacts of a Construction Helmet: Effects of the Neck and Body Mass
Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine: Jan 2017 / 231(1):58-68

Fall prevention and protection: a public health matter
Fall Prevention and Protection: Principles, Guidelines and Practices
CRC Press: October 2016 / :3-18 chapter 1

Influence of personal protective equipment use on fall risk
Fall Prevention and Protection: Principles, Guidelines and Practices
CRC Press: October 2016 / :77-100 chapter 6

Suspension trauma and fall-arrest harness design
Fall Prevention and Protection: Principles, Guidelines and Practices
CRC Press: October 2016 / :109-118 chapter 8

Fall risk associated with restricted and elevated support surfaces
Fall Prevention and Protection: Principles, Guidelines and Practices
CRC Press: October 2016 / :119-140 chapter 9

Ladder safety: research, control, and practice
Fall Prevention and Protection: Principles, Guidelines and Practices
CRC Press: October 2016 / :241-270 chapter 15

Aerial lift hazard recognition simulator
NIOSH Publication No. 2017-103 (November 2016)

NIOSH guardrail system – from research to field evaluation to production
Safety 2015: Proceedings of the 2015 ASSE Professional Development Conference, June 7-10, 2015, Dallas, Texas. Des Plaines, IL: American Society of Safety Engineers, ASSE-15-703, 2015 Jun; :1-18

Preventing falls from heights through the design of embedded safety features
NIOSH Publication No. 2014-124 (May 2014)

Occupational ladder fall injuries – United States, 2011
Morbidity and Mortality Weekly Report: April 2014 / 63(16):341-346

Falls as a work place hazard
Chicago, IL: University of Illinois Chicago, School of Public Health, Environmental and Occupational Health Sciences Division, 2013 Jun; :1

NIOSH Ladder Safety App User’s Manual [Android (En español), iOS (En español)] Updated 2016
The Ladder Safety application provides easy access to graphic aids, safety checklists, and reference information, to assist ladder users in making safe choices. The application can also be used with the phone as a tool to assist users in properly positioning a ladder at an optimal angle.

Preface to the special section on occupational fall prevention and protection
Human Factors: June 2012 / 54(3):301-302

Factors affecting extension ladder angular positioning
Human Factors: June 2012 / 54(3):334-345

Impact of harness fit on suspension tolerance
Human Factors: June 2012 / 54(3):346-357

Assessment of fall-arrest systems for scissor lift operators: computer modeling and manikin drop testing
Human Factors: June 2012 / 54(3):358-372

Worker Health Chartbooks
NIOSH webpage
Using worker health information gathered by NIOSH and the Bureau of Labor Statistics, here you can create your own charts to assess current rates, distribution, and trends in workplace injuries, illnesses and deaths.

Postural stability effects of random vibration at the feet of construction workers in simulated elevation
Applied Ergonomics: July 2011 / 42(5):672-681

Non-fatal construction industry fall-related injuries treated in US emergency departments, 1998-2005
American Journal of Industrial Medicine: February 2011 / 54(2):128-135

Changes in fall prevention training for apprentice carpenters based on a comprehensive needs assessment
Journal of Safety Research: June 2010 / 41(3):221-227

Evaluation of guardrail systems for preventing falls through roof and floor holes
Journal of Safety Research: June 2010 / 41(3):203-211

Fall prevention among apprentice carpenters
Scandinavian Journal of Work, Environment & Health: May 2010 / 36(3):258-265

Occupational Injuries & Fatalities Due To Falls
NIOSH Publication No. 2010-143 (May 2010)
An estimated 15.9 million people worked in the Manufacturing Sector in 2008, which accounted for approximately 10.9% of the employed U.S. workforce. In 2008, 411 manufacturing sector workers died from occupational injuries. The leading causes of death were contact with objects and equipment (116), transportation incidents (104), and falls (58).

Fatal falls among Hispanic construction workers
Acciddent Analysis & Prevention: September 2009 / 41(5):1047-1052

Development of sizing structure for fall arrest harness design
Ergonomics: September 2009 / 52(9):1128-1143

Harness sizing and strap length configurations
Human Factors: August 2009 / 51(4):497-518

Don&apost become another statistic: work safely at heights
Occupational Health & Safety: July 2009 / 78(7):36,38,40,42-43

Fall hazard control observed on residential construction sites 
American Journal of Industrial Medicine: June 2009 / 52(6):491-499

Effectiveness of vertical visual reference for reducing postural instability on inclined and compliant surfaces at elevation
Applied Ergonomics: May 2009 / 40(3):353-361

Scissor lift safety – an initiative to model static stability
Professional Safety: April 2009 / 54(4):43-48

Footwear effects on walking balance at elevation
Ergonomics: Dec 2008 / 51(12):1885-1905

Extension-ladder safety: solutions and knowledge gaps
International Journal of Industrial Ergonomics: November-December 2008 / 38(11-12):959-965

Take Pride in Your Job: Fall Protection
NIOSH Publication No. 2009-108D (DVD) (November 2008)
This video encourages oil and gas extraction workers to use fall protection and never be “un-clipped” and thus vulnerable when at height. The video features oil and gas extraction workers talking about their use of fall protection and sharing their personal stories about why fall protection should always be worn when working at height. The purpose of the video is to raise awareness of fall injuries in this industry and to provide information about the use, proper fit, and inspection of fall protection. This video is designed to be used in pre-shift or weekly safety meetings.

Development of the St. Louis audit of fall risks at residential construction sites
International Journal of Occupational and Environmental Health: October-December 2008 / 14(4):243-249

Development of a unique fall-prevention guardrail system for the construction industry
2008 National Occupational Injury Research Symposium, October 21-23, 2008, Pittsburgh, Pennsylvania. Morgantown, WV: National Institute for Occupational Safety and Health: October 2008 / :69

Development of improved harness sizing system
2008 National Occupational Injury Research Symposium, October 21-23, 2008, Pittsburgh, Pennsylvania. Morgantown, WV: National Institute for Occupational Safety and Health: October 2008 / :78-79

Effect of scaffold end frame carrying strategies on worker stepping response, postural stability, and perceived task difficulty
Human Factors: February 2008 / 50(1):27–36

Worker Health Chartbook, 2004
NIOSH Publication No. 2004-146 (September 2004)
This publication is a descriptive epidemiologic reference on occupational morbidity and mortality in the United States. A resource for agencies, organizations, employers, researchers, workers, and others who need to know about occupational injuries and illnesses, the Chartbook includes more than 400 figures and tables describing the magnitude, distribution, and trends of the Nation’s occupational injuries, illnesses, and fatalities.

Alert: Preventing Falls of Workers through Skylights and Roof and Floor Openings
NIOSH Publication No. 2004-156 (August 2004)
This Alert describes five deaths resulting from falls through skylights and roof and floor openings. Recommendations are provided to help prevent similar deaths in the future.

Alert: Preventing Injuries and Deaths of Workers Who Operate or Work Near Forklifts
NIOSH Publication No. 2001-109 (June 2001)
The National Institute for Occupational Safety and Health (NIOSH) requests assistance in preventing injuries and deaths of workers who operate or work near forklifts. Most fatalities occur when a worker is crushed by a forklift that has overturned or fallen from a loading dock.

NIOSH Update: Strategic Precautions Against Fatal Falls on the Job are Recommended by NIOSH (January 2, 2001)
Once the third leading cause of work-related death across all industries, falls have surpassed workplace homicide to become the second leading cause after motor vehicle crashes. Last year alone, some 717 workers died of injuries caused by falls from ladders, scaffolds, buildings, or other elevations. That equaled almost two deaths per day on average.

In the construction industry, falls lead all other causes of occupational death, but the risk is present in virtually every kind of workplace. It may occur in many forms, from standing on a ladder to change a light bulb, to connecting bolts on steel girders hundreds of feet above the ground.

Worker Deaths by Falls: A Summary of Surveillance Findings and Investigative Case Reports
NIOSH Publication No. 2000-116 (November 2000)
This monograph summarizes surveillance data and investigative reports of fatal work-related falls from elevations. It reviews what is known about occupational fatalities due to falls from elevations, identifies common risk factors and exposures, and recommends general approaches to preventing these fatal events.

NIOSH Update: Fatal Falls of Contractor, Teen Workers Highlight Safety Concerns in Telecommunication Tower Work (April 27, 2000)
The deaths of a contractor, his 16-year-old stepson, and a 19-year-old employee highlight the serious risk of fatal falls for workers who construct and maintain telecommunication towers in the rapidly growing cellular and wireless communications industry, a report from the National Institute for Occupational Safety and Health (NIOSH) finds.

Available data suggest that workers in those tasks sustain fatal occupational injuries, mostly from falls, at a substantially greater rate than employees in all U.S. industry. Because the industry has grown rapidly to meet increasing demand for additional towers, many new employers, supervisors, and workers may be unaware of the injury risk and unfamiliar with safety requirements.

Update: NIOSH Issues Nationwide Alert on Dangers of Working from Scaffolds

• On September 5, 1992, a 45-year-old masonry worker fell 50 feet to his death from a scaffold in New York.
• On September 8, 1992, a 34-year-old painter plunged 364 feet from a bridge in Pennsylvania when a scaffolding cable broke. He was killed instantly.
• On October 2, 1992, two bricklayers, age 35 years and 50 years, fell 47 feet to their deaths when the plywood on their scaffold gave way at a construction site in Missouri.
• On October 27, 1992, a construction worker fell 13 feet when a scaffold collapsed in North Dakota. Fortunately, he was wearing a safety harness which prevented serious injury.

Tragically, these incidents are neither unusual nor unique. The National Institute for Occupational Safety and Health (NIOSH) reports that falls are a leading cause of traumatic occupational death. For the period 1980-1985, the NIOSH National Traumatic Occupational Fatalities (NTOF) database indicates that 3,491 workers fell to their deaths while trying to earn a living. Of those workers identified, 461 (17%) fell while working from a scaffold.

Alert: Preventing Worker Injuries and Deaths Caused by Falls From Suspension Scaffolds
NIOSH Publication No. 92-108 (August 1992)
The National Institute for Occupational Safety and Health (NIOSH) requests assistance in preventing worker injuries and deaths caused by falls from suspension scaffolds. “Suspension scaffold” means one or more working platforms suspended by ropes or other means from an overhead structure. Recent investigations by NIOSH suggest that fatal falls occur as a result of defective scaffold equipment, improper installation or operation, improper training of workers, or a failure to use appropriate personal fall protection equipment. This Alert describes five incidents resulting in six deaths caused by falls from suspension scaffolds.

Preventing Falls and Electrocutions During Tree Trimming
NIOSH Publication No. 92-106 (August 1992)
The National Institute for Occupational Safety and Health [NIOSH] requests assistance in preventing falls and electrocutions during tree trimming or cutting. Recent NIOSH investigations conducted under the Fatal Accident Circumstances and Epidemiology (FACE) program suggest that many tree trimmers and their employers lack training and knowledge of Occupational Safety and Health Administration (OSHA) standards and may be unaware of the risk posed by inadequate or improper safety procedures and equipment. This Alert describes eight incidents involving five electrocutions and three fatal falls of tree trimmers.
En español

Preventing Worker Deaths and Injuries from Falls Through Skylights and Roof Openings
NIOSH Publication No. 90-100 (December 1989)
The National Institute for Occupational Safety and Health (NIOSH) requests assistance in preventing deaths from work near skylights, skylight openings, and other types of roof openings. Recent investigations by NIOSH suggest that many fatal falls involve such openings. This Alert describes eight deaths resulting from falls that occurred during work around these openings.
En español

Infographics for the National Campaign to Prevent Falls in Construction
NIOSH Infographics
Each year, NIOSH, CPWR, along with the NORA Construction Sector Council Falls Working Group work together to develop a new series of infographics in English and Spanish. View and download the infographics as PDFs or JPEGs for use in social media, presentations, and print materials.

Slip-Resistant Shoes Reduce Food Services Worker Slip Injuries
NIOSH Infographic (2019)
Learn how 5-star rated slip-resistant shoes can reduce food services worker slip injuries.
En español

Preventing slip and fall accidents: focus on the footwear
National Institute for Occupational Safety and Health: National Occupational Injury Research Symposium 2018, (NOIRS 2018): October 16-18, 2018 / :126-127

Same-level fall injuries in US workplaces by age group, gender, and industry
American Journal of Industrial Medicine: February 2018 / 61(2):111-119

Construction Chart Book
Silver Spring, MD: CPWR-The Center for Construction Research and Trainings, February 2018 / :1-74
The sixth edition of The Construction Chart Book – The U.S. Construction Industry and Its Workers continues to present the most complete data available on all facets of the U.S. construction industry: economic, demographic, employment/income, education/training, and safety and health issues, plus much more all in one place. This edition not only offers on-demand access to the charts and data, but also includes interactive features that enhance the user’s experience. Users can click on terms to access definitions instantly, and easily enlarge charts and tables within each page. References, citations, and databases are also hyperlinked to enable users to further explore these sources.

Twenty years of workers&apos compensation costs due to falls from height among union carpenters, Washington State
American Journal of Industrial Medicine: April 2014 /:[Epub ahead of print]

Falls as a work place hazard
Chicago, IL: University of Illinois Chicago, School of Public Health, Environmental and Occupational Health Sciences Division, 2013 Jun; :1

Slip, trip, and fall injuries among nursing care facility workers
Workplace Health & Safety: April 2013 / 61(4):147-152

Personal fall arrest system anchors in residential construction
Wood Design Focus: March 2013 / 23(1):20-27

Fatal falls from roofs among U.S. construction workers
Journal of Safety Research: February 2013 / 44(Special Issue):17-24

Non-fatal occupational falls on the same level
Ergonomics: February 2013 / 56(2):153-165

Functional levels of floor surface roughness for the prevention of slips and falls: clean-and-dry and soapsuds-covered wet surfaces
Applied Ergonomics: January 2013 / 44(1):58-64

Worker Health Chartbooks
NIOSH webpage
Using worker health information gathered by NIOSH and the Bureau of Labor Statistics, here you can create your own charts to assess current rates, distribution, and trends in workplace injuries, illnesses and deaths.

Preventing Slips, Trips, and Falls in Wholesale and Retail Trade Establishments
NIOSH Publication No. 2013-100 (October 2012)
Employees in Wholesale and Retail Trade (WRT) establishments suffer high rates of slip, trip, and fall (STF) injuries. The National Institute for Occupational Safety and Health (NIOSH) recommends measures to ensure a safe workplace and prevent injuries.

Effect of boot weight and sole flexibility on gait and physiological responses of firefighters in stepping over obstacles
Human Factors: June 2012 / 54(3):373-386

The epidemiology of slips, trips, and falls in a helicopter manufacturing plant
Human Factors: June 2012 / 54(3):387-395

Slip, Trip, and Fall Prevention for Healthcare Workers
NIOSH Publication No. 2011-123 (2010)
According to the U.S. Bureau of Labor Statistics [2009], the incidence rate of lost-workday injuries from slips, trips, and falls (STFs) on the same level in hospitals was 38.2 per 10,000 employees, which was 90% greater than the average rate for all other private industries combined (20.1 per 10,000 employees). STFs as a whole are the second most common cause of lost-workday injuries in hospitals.

Causes, sources and costs of falls in a helicopter manufacturing plant
Proceedings of the 2010 International Conference on Fall Prevention and Protection May 19-20, 2010, Morgantown, WV. Morgantown, WV: National Institute for Occupational Safety and Health, May 2010 / :35

Effect of boot weight on gait characteristics of men and women firefighters negotiating obstacles
Proceedings of the 2010 International Conference on Fall Prevention and Protection May 19-20, 2010, Morgantown, WV. Morgantown, WV: National Institute for Occupational Safety and Health, May 2010 / :34

Focus on: risk management. Don&apost let costly slip and fall injuries trip you up
Chain Store Aget: March 2010 / 86(3):40,42-43

Age-related joint moment characteristics during normal gait and successful reactive-recovery from unexpected slip perturbations
Gait Posture: October 2009 / 30(3):276-28

The effects of obesity and standing time on postural sway during prolonged quiet standing
Ergonomics: August 2009 / 52(8):977-986

Effects of foot placement on postural stability of construction workers on stilts
Applied Ergonomics: July 2009 / 40(4):781-789

Biomechanics of trailing leg response to slipping – evidence of interlimb and intralimb coordination
Gait & Posture: June 2009 / 29(4):565-570

Analysis of musculoskeletal loadings in lower limbs during stilts walking in occupational activity
Annals of Biomedical Engineering: June 2009 / 37(6):1177-1189

Effects of external loads on balance control during upright stance: experimental results and model-based predictions
Gait Posture: January 2009 / 29(1):23-30

Evaluation of a comprehensive slip, trip and fall prevention programme for hospital employees
Ergonomics: 2008 / 51(12):1906-1925

Impact of joint torques on heel acceleration at heel contact, a contributor to slips and falls
Ergonomics: December 2008 / 51(12):1799-1813

Slip, trip and fall injuries in potato, sugar beet and open field vegetable production in Finland
Ergonomics: December 2008 / 51(12):1944-1959

Multidisciplinary research to prevent slip, trip, and fall (STF) incidents among hospital workers
Contemporary Ergonomics 2008: Proceedings of the International Conference on Contemporary Ergonomics (CE2008), 1-3 April 2008, Nottingham, UK. Bust BD, ed., London: Taylor & Francis: April 2008 / :693-698

Worker Health Chartbook, 2004
NIOSH Publication No. 2004-146 (September 2004)
This publication is a descriptive epidemiologic reference on occupational morbidity and mortality in the United States. A resource for agencies, organizations, employers, researchers, workers, and others who need to know about occupational injuries and illnesses, the Chartbook includes more than 400 figures and tables describing the magnitude, distribution, and trends of the Nation’s occupational injuries, illnesses, and fatalities.

Alert: Preventing Injuries and Deaths of Workers Who Operate or Work Near Forklifts
NIOSH Publication No. 2001-109 (June 2001)
The National Institute for Occupational Safety and Health (NIOSH) requests assistance in preventing injuries and deaths of workers who operate or work near forklifts. Most fatalities occur when a worker is crushed by a forklift that has overturned or fallen from a loading dock.

Alert: Preventing Worker Injuries and Deaths From Moving Refuse Collection Vehicles
NIOSH Publication No. 97-110 (May 1997)
The National Institute for Occupational Safety and Health (NIOSH) requests assistance in preventing worker injuries and deaths associated with moving refuse collection vehicles. Data from the NIOSH National Traumatic Occupational Fatalities (NTOF) Surveillance System indicate that many fatalities occur when workers fall from or are struck by refuse collection vehicles. Recent NIOSH investigations conducted under the Fatality Assessment and Control Evaluation (FACE) Program suggest that employers and workers may not be fully aware of or may be complacent about the hazards of riding on and working near moving refuse collection vehicles. This Alert describes six fatal incidents involving these vehicles and offers recommendations for preventing such incidents.
En español

One of the initial emphasis areas for the FACE fatality investigation program was fall from elevation fatality. Since the inception of the FACE program in 1982, hundreds of fatal incidents involving fall from elevation have been investigated by NIOSH and State investigators. These links provide a list of those cases which in turn links to the full-text reports.

• NIOSH Investigation Reports of Falls from Elevation
• State-based Fatality Investigation Reports of Falls from Elevation

NIOSHTIC-2 is a searchable bibliographic database of occupational safety and health publications, documents, grant reports, and journal articles supported in whole or in part by NIOSH.