From The Ergoweb® Learning Center

Britain Boosts Campaign to Cut Slip, Trip and Fall Accidents

In British workplaces last year, 61 people died and more than 14,000 suffered serious injury after a slip, trip or fall from height. The country’s determination to cut the numbers shifted into high gear on February 9 with the launch of Phase Two of the Shattered Lives Campaign. In the United States, a leader in slip-trip-fall (STF) research, legislators are dusting off the campaign for an ergonomics standard. They could do worse than explore Britain’s combination of stiff regulations and an STF awareness campaign for promising strategies.

Britain’s Health and Safety Executive (HSE), which maintains that STF injuries can be avoided “by sensible and proportionate management of the risks,” is the prime mover in the effort to reduce the STF peril.  The agency launched Phase One of its Shattered Lives Campaign in August 2007. The 6-week national and regional advertising effort was designed to focus attention on the devastating consequences of slip, trips and falls from height in workplaces.

The campaign is directed primarily at workers at the highest risk and individuals in the best position to take action. The agency lists construction workers, electricians, gas fitters and other tradespeople, as well as site managers, kitchen managers and chefs, food retail staff, store managers, food operatives and their shift managers.

Hyper-realistic Images Add Impact

A series of ads, set in work environments where STF accidents are most common, featured photos that were edited to heighten the image of people shattering on impact. The ads directed people to the Shattered Lives webpage, where they could learn more about the circumstances of the accident and its consequences, and find guidance on reducing the risk.

The ads caught the public eye. They received the “Campaign of the Day” award by the Newspaper Marketing Agency and the Fresh Awards for Best Newspaper Campaign and Best Use of Photography; drove over 800,000 visitors to the campaign website; and generated 191 articles in the media between January and May of 2008. A survey commissioned by the HSE found 96 percent of the reports were favorable to the program and 4 percent were neutral.

When asked what they remembered about the ad, the highest percentages of respondents related to: “Someone tripping/falling,” and “Broken shattered person/head.” For most issues there was greater recognition of hazards in the workplace immediately following the campaign than before, but this dropped back six months later. Workers in construction were more aware than other workers. The survey found that respondents were “consistently very confident that they knew what to do to prevent accidents caused by slips, trips and falls,” but across three waves of research “there was no change in respondents’ views about what more they could do to prevent these accidents,” according to the FSE.

Respondents reported that the hyper-realistic image made the ads and publicity memorable.

Room for Improvement

The surveys also revealed areas where more work needed to be done. It was felt that real case studies of injured people talking about what happened to them and their families would make the message even stronger. And while the ads’ basic message was clear, a firm and unmistakable call to action was lacking. The survey of the overall impact revealed that it was often unclear what action managers were expected to take after having seen the ads or visited the website; and only a small number of people went on to seek further information or advice. 

The survey reported a small but significant rise in the proportion of respondents who said they had been asked to do something different over the last six months to reduce the STF risk. The changes included meetings, using different working-at-height equipment, new ladder-use guidelines, improved risk assessments and new policies. 


Phase Two takes in a wider view of STP accidents, and used the survey findings after Phase One to strengthen the prevention message. The HSE promotes Phase Two as the call to action after Phase One, which was aimed at raising awareness. The ad reads: “ stop accidents at work shattering lives. Go online and try our simple e-tool.”

There are actually two tools on the website, STEP and WAIT.

STEP (Slips and Trips eLearning Package) exploits quizzes, videos, animations, case studies and interactive sequences to identify STF risks at work and offers practical guidance to tackle them. The measures apply to virtually all premises and can be used by anyone, according to the agency, as STEP features three levels of information: introductory, intermediate, and advanced. The general course covers the basics, and four specific courses target sectors where slips and trips are common.

WAIT (Work at height Access equipment Information Tool) is designed for workers who occasionally need to work at height. It is targeted particularly to self-employed workers and small and medium enterprises, to help them “build on the outcome of their risk assessment, and to comply with Regulation 7 of the Work at Height Regulations of 2005.

Legislation Underpin the Shattered Lives Campaign

The 2005 regulation is secondary legislation to Britain’s Health and Safety at Work Act (HSWA) 1974. Promoted as “bold and far-reaching” when it was introduced, it is the primary piece of legislation covering occupational health and safety in the United Kingdom. The HSE enforces the HSWA and its secondary legislation.

The agency’s statistics for general workplace injuries between 1974 and 2008 supply a context for the STF injury statistics. In that period, fatal injuries to employees fell by 75 percent; and the number of reported non-fatal injuries fell by 70 percent. These are dramatic drops, which the FSE attributes mainly to the shift in employment away from manufacturing and heavy industry to lower-risk service industries. Research suggests the shift accounts for 24 percent of the drop in fatal injuries over the last 10 years, and for 50 percent of the drop in non-fatal injuries. The agency also concedes that changes in reporting requirements skew the figures. Even so, the decline is seen as significant enough to keep the 1974 HSWA in play, and to encourage secondary legislation made under specific Acts of Parliament. 

The 2005 Working at Height secondary regulation includes the requirement that employers conduct assessments to determine whether their employees are at risk of falling. The agency attributes recent encouraging changes in the STF picture to that 2005 legislation. Falls from heights claimed 37 percent of Britain’s total workplace accidents from 1996-2000. HSE figures also show that ladders accounted for almost three times as many of the falls when compared to scaffolding and work platforms. Slips and trips claimed second place at 20 percent. But since 2001-2002, the figures show fall injuries in steady decline. This is the case both for falls from high heights and low heights, although the decline is sharper for high falls (down 39 percent) than for low or unspecified falls (down 21 percent.) The agency notes that falls from ladders have only recently shown signs of reducing.

The HSE has commissioned surveys to check the effectiveness of its ongoing measures. In one, only employers who recognized a potential fall risk to their employees were asked fall-related questions. Similarly, only employees who said they worked at height were questioned further about the fall risk. The biggest change seen was in the percentage of employers who spontaneously mentioned conducting risk assessments as a way of controlling the fall risk. This increased from just 8 percent in 2005 to 29 percent in 2006, and the HSE says the improvement is “likely to coincide with the launch of Working at Height regulations in 2005.”

Regulations with Teeth

“Firm, properly targeted and proportionate enforcement underpins the action we need to take to deliver the HSE strategy,” according to the agency, and enforcement is exercised at both national and local level. It’s another way of saying there is no mere wrist-slapping for safety-careless employers. They can count on painful fines. On top of the standard workers’ compensation costs and the expense of filling in for workers who are absent because of disability, the fines give employers a financial incentive for taking STF risks seriously.

A driver’s fall from wooden decking at a diesel pump in November 2007 broke his ankle. On February 4, just as HSE was launching Phase Two of Shattered Lives, the court ordered his employer, Sunlight Services Group Ltd. in Basingstoke, to pay a fine of UK £5,600 (US $7,839) and costs of UK £8,951(US $12,524.66 ). The company was prosecuted for failing to ensure there was a suitable and sufficient risk assessment of the wooden decking near a diesel pump at its depot and failing to protect drivers using the pump.

Speaking after the case, HSE inspector Pamela Folsom, described wooden decking as the “incorrect selection of material for an outdoor area that was subject to weather conditions and fuel spillage.”

In 2006 a carpenter carrying an 8ft x 4ft section of chipboard fell from an extension ladder. The accident cost him a broken ankle and wrist and facial injuries, and his employer UK £11,100 (US $15,536) in fines and costs. Speaking after the hearing, the HSE inspector noted that the company “did not have a safe and suitable method of getting materials from ground level up to the loft space where they were working.”

International STF Expertise Available

November 8, 2008, gave the United States a Democratic administration. It is expected to be friendlier to workers’ wellbeing than the previous Republican government. The original or an amended version of the Ergonomics Program Standard of the Occupational Safety and Health Administration – it had a brief life between November 2000 and March 2001 before it was repealed by then-president George W. Bush – is expected to find its way into back Congress during the new administration.

Advocates see the standard as a plus for workers and an advantage for the economy because it would contribute to reductions in injuries and workers’ compensation costs. Opponents, including groups such as the National Federation of Business (NFIB), see it as a crippling charge on private enterprise. Charlie Owens, Michigan state NFIB director, calls the possibility of an ergonomics standard in his state "a terrible development,” adding that “an ergo rule would amount to a giant ‘do not enter’ sign for those seeking to do business in the state.” His argument echoes the national business community’s sentiments about the standard.

The advocates now have a wealth of experts to consult for the areas of the standard that relate to STP prevention, which has emerged as an ergonomics specialty served by the Contact Group for Slips, Trips, and Falls (CGSTF). This international forum for researchers to share scientific information on STF accidents is supported by the Liberty Mutual Research Institute for Safety (LMRIS) and the Finnish Institute of Occupational Health.

More than 70 government, industry, and academic representatives from seven different countries convened at the LMRIS facility for the 2007 International Conference on Slips, Trips, and Falls. The conference was the first major activity undertaken by the newly-formed International Ergonomics Association (IEA) Technical Committee on Slips, Trips, and Falls, and was sponsored by the IEA, the Ergonomics Society and LMRIS.

The STF contact group is virtually certain to be called in to help with new attempts to give the United States an ergonomics standard. As before, it is certain to be a tough fight. The STF data from Britain makes a case for setting aside ideological convictions for the benefits of fewer workplace injuries, and ultimately, lower costs to business. 


Preventing Slips Trips and Falls at Work:

Shattered Lives Campaign:

Slip falls statistics:

Statistics after health and safety act

HSE publishes a number of statistics rundowns

Contact Group for Slips, Trips, and Falls:

This article originally appeared in The Ergonomics Report™ on 2009-03-04.