R&I Exclusive

The Science of Slips and Falls

A new study from CNA Risk Control dives into the root causes of slips and falls, promoting floor safety through maintenance and risk awareness.
By: | October 24, 2017 • 4 min read

Slips and falls are the second greatest cause of accidental deaths each year, according to OSHA data, right behind motor vehicles.

Nearly 25 percent of reported claims stem from a slip, trip or fall, and many of them could have been prevented, which is why CNA chose to take a deep dive into the unique factors behind these all-too-frequent events.

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“The American National Standards Institute provides guidance on hard surface flooring materials for slip resistance testing. CNA used tribometry as a baseline for determining the slipperiness of the floor,” said Shari Falkenburg, assistant VP, Risk Control, CNA. Tribometry is the measurement of friction on a surface, in this case measuring the traction between an individual’s feet and the floor.

In a new study entitled “Enhancing Floor Safety Through Slip Resistance Testing, Maintenance Protocols and Risk Awareness,” CNA Risk Control walkway specialists reviewed slip and fall liability claims from Jan. 1, 2010 to Dec. 31, 2016 to gain insight as to how and why these accidents occur.

The specialists then spent two years testing floors in commercial settings — from retail trade to construction — during pre- and post-cleaning, breaking the research into two main components: cleaning agents and floor material.

“Depending on the type of floor, selecting the wrong cleaning agent could impact the slipperiness of the floor,” said Steve Hernandez, senior VP, Risk Control, CNA. “In addition, selecting improper cleaning equipment and tools could also contribute to floor slipperiness. This information helped to better understand the root cause behind slip and fall claims.”

CNA’s findings are that floor type and the cleaners used on them play significant roles in a surface’s coefficient of friction — the presence of traction between an individual’s feet and a surface. Cleaners react with floor types differently, which in turn can create a number of workplace hazards.

Materials Matter

Cleaning agents used on floors were broken down into four categories: alkaline-based, acidic-based, pH neutral and microbial enzymatic.

Each cleaning agent was found to react differently to flooring and a floor finish.  According to CNA’s study, the varying products used to clean a floor often are the direct cause of a slip or fall.

“There’s no exact percent, but I would estimate that on average 20 to 25 percent of the businesses we tested weren’t using the proper cleaning agent,” said Falkenburg.

Steve Hernandez, senior VP, Risk Control, CNA

While seemingly a small part of the floor maintenance process, choosing the right cleaner can have a significant impact on overall floor safety. Cleaning products are designed to sustain a floor’s original COF, so when improperly applied, the friction measurement can be changed.

CNA also looked at nine different categories of flooring in its study. The researchers recorded the natural COF levels, each floor type’s level of slipperiness when wet and what they were made of, from laminated to honed stone.

Linoleum, a resilient flooring typically used in hospital and health care settings, for example, was deemed to have a naturally low COF. It’s a surface that tends to have some type of polymer coating and is intended for dry applications only.

“Insurance carriers and brokers educated [in slip resistance testing and floor maintenance protocols] have a better understanding of the risks. This helps start the conversation on what a business needs to prevent liability and workers’ compensation incidents from occurring.” — Steve Hernandez, senior VP, Risk Control, CNA

CNA dug deeper by testing the floors for DCOF — dynamic coefficient of friction — pre- and post-cleaning, noting how certain cleaners interacted with each floor type. Acidic-based cleaners required a thorough rinsing to achieve maximum cleanliness, while microbial enzymatic cleaners required no surface rinsing post-cleaning.

Overall, CNA advised business owners to look at five things when maintaining their flooring: material used, surface type, condition of the floor, cleaners used and whether the material has a finish on it. (Alkaline-based cleaners removed finishes in some cases. A neutral pH-based cleaner would be better for such flooring.)

Retail and real estate businesses continue to present the greatest potential for slip and fall accidents. But construction and health care have seen steady increases as well.

Businesses should obtain the designated COF for each of their floor surfaces directly from the manufacturer, the study said.

“Insurance carriers and brokers educated [in slip resistance testing and floor maintenance protocols] have a better understanding of the risks,” said Hernandez. “This helps start the conversation on what a business needs to prevent liability and workers’ compensation incidents from occurring.”

“Risk managers can have conversations with their vendors to discuss floor maintenance procedures, including selection and application of cleaning agents and cleaning equipment utilized. Vendor agreements should incorporate these elements.”

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“There’s more risk awareness needed, based on the findings in the study,” added Falkenburg. “Business owners should conduct a needs analysis of their walkway safety management to recognize hidden walkway risks including floor contaminants.”

For instance, she said, they may come across an entrance way with a glare. This glare can lead to poor visibility and increased slips and falls. To prevent such accidents, businesses can add a rug or a plant to the area. “Give the brain something else to look at and observe,” she said.

Slips and falls are a physical peril. “Therefore, it’s a risk we can measure and take actions to reduce or mitigate. With the proper focus on floor testing, we can use trial and error until we have the proper controls in place to yield a passing DCOF value,” said Falkenburg. &

Autumn Heisler is a staff writer at Risk & Insurance. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

2017 Teddy Awards

The Era of Engagement

The very best workers’ compensation programs are the ones where workers aren’t just the subject of the program, they’re a part of it.
By: | November 1, 2017 • 5 min read

Employee engagement, employee advocacy, employee participation — these are common threads running through the programs we honor this year in the 2017 Theodore Roosevelt Workers’ Compensation and Disability Management Awards, sponsored by PMA Companies.

A panel of judges — including workers’ comp executives who actively engage their own employees — selected this year’s winners on the basis of performance, sustainability, innovation and teamwork. The winners hail from different industries and regions, but all make people part of the solution to unique challenges.

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Valley Health System is all-too keenly aware of the risk of violence in health care settings, running the gamut from disruptive patients to grieving, overwrought family members to mentally unstable active shooters.

Valley Health employs a proactive and comprehensive plan to respond to violent scenarios, involving its Code Atlas Team — 50 members of the clinical staff and security departments who undergo specialized training. Valley Health drills regularly, including intense annual active shooter drills that involve participation from local law enforcement.

The drills are unnerving for many, but the program is making a difference — the health system cut its workplace violence injuries in half in the course of just one year.

“We’re looking at patient safety and employee safety like never before,” said Barbara Schultz, director of employee health and wellness.

At Rochester Regional Health’s five hospitals and six long-term care facilities, a key loss driver was slips and falls. The system’s mandatory safety shoe program saw only moderate take-up, but the reason wasn’t clear.

Rather than force managers to write up non-compliant employees, senior manager of workers’ compensation and employee safety Monica Manske got proactive, using a survey as well as one-on-one communication to suss out the obstacles. After making changes based on the feedback, shoe compliance shot up from 35 percent to 85 percent, contributing to a 42 percent reduction in lost-time claims and a 46 percent reduction in injuries.

For the shoe program, as well as every RRH safety initiative, Manske’s team takes the same approach: engaging employees to teach and encourage safe behaviors rather than punishing them for lapses.

For some of this year’s Teddy winners, success was born of the company’s willingness to make dramatic program changes.

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Delta Air Lines made two ambitious program changes since 2013. First it adopted an employee advocacy model for its disability and leave of absence programs. After tasting success, the company transitioned all lines including workers’ compensation to an integrated absence management program bundled under a single TPA.

While skeptics assume “employee advocacy” means more claims and higher costs, Delta answers with a reality that’s quite the opposite. A year after the transition, Delta reduced open claims from 3,479 to 1,367, with its total incurred amount decreased by $50.1 million — head and shoulders above its projected goals.

For the Massachusetts Port Authority, change meant ending the era of having a self-administered program and partnering with a TPA. It also meant switching from a guaranteed cost program to a self-insured program for a significant segment of its workforce.

Massport’s results make a great argument for embracing change: The organization saved $21 million over the past six years. Freeing up resources allowed Massport to increase focus on safety as well as medical management and chopped its medical costs per claim in half — even while allowing employees to choose their own health care providers.

Risk & Insurance® congratulates the 2017 Teddy Award winners and holds them in high esteem for their tireless commitment to a safe workforce that’s fully engaged in its own care. &

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More coverage of the 2017 Teddy Award Winners and Honorable Mentions:

Advocacy Takes Off: At Delta Air Lines, putting employees first is the right thing to do, for employees and employer alike.

 

Proactive Approach to Employee SafetyThe Valley Health System shifted its philosophy on workers’ compensation, putting employee and patient safety at the forefront.

 

Getting It Right: Better coordination of workers’ compensation risk management spelled success for the Massachusetts Port Authority.

 

Carrots: Not SticksAt Rochester Regional Health, the workers’ comp and safety team champion employee engagement and positive reinforcement.

 

Fit for Duty: Recognizing parallels between athletes and public safety officials, the city of Denver made tailored fitness training part of its safety plan.

 

Triage, Transparency and TeamworkWhen the City of Surprise, Ariz. got proactive about reining in its claims, it also took steps to get employees engaged in making things better for everyone.

A Lesson in Leadership: Shared responsibility, data analysis and a commitment to employees are the hallmarks of Benco Dental’s workers’ comp program.

 

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]