Ladder-related injuries treated in emergency departments in the United States, 1990-2005

Background: Ladder use is involved in many occupational and non-occupational activities. Falls from ladders can result in serious injury and affect people of all ages. The purpose of this study was to comprehensively examine nonfatal ladder-related injuries on a national level. Methods: Using the National Electronic Injury Surveillance System (NEISS) database, cases of nonfatal ladder-related injuries treated in U.S. emergency departments (EDs) from 1990 through 2005 were selected using NEISS ladder product codes. Analysis was conducted from June 2006 to August 2006. Results: An estimated 2,177,888 (95% confidence interval [CI] = 1,885,311-2,470,466) individuals ranging in age from 1 month to 101 years were treated in U.S. EDs for ladder-related injuries during the 16-year study period, yielding an average of 136,118 cases annually, an average of 49.5 per 100,000 people. Males predominated in ladder-related injuries (76.5%, 95% CI=75.8-77.2). Fractures were the most common type of injury (31.5%, 95% CI=30.5-32.6). The body parts most frequently injured were the legs and feet (30.4%, 95% CI=29.5-31.2). Nearly 10% of injuries resulted in hospitalization (8.5%, 95% CI=7.4-9.6) or transfer to another hospital (1.4%, 95% CI=1.1-1.8), approximately twice that of consumer product-related injuries overall. The number of ladder-related injuries increased by more than 50% from 1990 to 2005. Ladder-related injuries per 100,000 people rose almost 27% during the 16-year study period. Of the cases for which locale of injury was recorded, 97.3% occurred in non-occupational settings, such as homes and farms. Conclusions: Given the 50% increase in ladder-related injuries during the study period, the relatively high likelihood of hospital admission, and the predominance of injuries in non-occupational settings, increased efforts are needed to prevent ladder-related injuries.