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Work-Related Injuries Associated with Falls During Ice Storms --
National Institutes of Health, January 1994
Although some environmental cold-related occupational health
problems have been described previously (e.g., hypothermia and
related thermal conditions) (1), the risks associated with
pedestrian injuries related to surface ice are not well
characterized. During January 18-31, 1994, freezing rain and
record cold temperatures created icy conditions in the
Washington, D.C., area that were sufficiently severe to prompt
early or complete closure of the operations of the National
Institutes of Health (NIH) and many other public- and
private-sector organizations. During this period, the
Occupational Medical Service (OMS) of NIH and a local hospital
that provides most initial care for workplace-related problems
among NIH employees noted a substantial increase in fall-related
injuries. This report summarizes an analysis of OMS data
regarding these injuries during January 18-31, 1994.
OMS logs were reviewed for work-related acute
musculoskeletal injuries sustained by NIH employees (total
estimated: 18,000) during January 18-31. Additional details about
diagnosis and disposition were obtained for each case from
clinical charts and workers' compensation claims files. In June
1994, all injured employees were contacted by telephone to assess
the presence of persisting symptoms and/or need for ongoing
medical care, and 2) lost work time attributable to the injury.
For those unavailable by telephone, an attempt was made to obtain
this information from clinical and compensation files.
During the 2-week period, OMS recorded 53 NIH employees with
acute musculoskeletal injuries. Of these, 22 (42%) injuries were
bruises and contusions; 24 (45%), strains or sprains; and seven
(13%), fractures. When calculated as quarterly rates and compared
with the first quarter of 1993, the type-specific rates during
1994 increased fourfold, 15-fold, and fivefold, respectively. Of
the 53 injuries, 39 (74%) resulted from falls on ice on NIH
campuses, including all seven fractures (four coccygeal and three
upper extremity), 15 (63%) strain/sprains, and 17 (77%)
bruises/contusions. Based on follow-up contact in June 1994, 12
(38%) of the 32 who had fallen on the ice and for whom current
information could be obtained continued to have symptoms and to
receive treatment. Based on referrals for outside medical care,
bills paid, and work time lost, the overall direct cost
attributable to the ice-related injuries among NIH employees was
estimated to be $20,000.
Reported by: LG Stansbury, MD, AA Swinson, MD, JM Schmitt, MD, MB
Stevens, KR Kobayashi, CP Vangellow, Occupational Medical Svc; D
Lampkins, Grounds and Maintenance, National Institutes of Health.
Div of Safety Research, National Institute for Occupational
Safety and Health, CDC. Editorial Note
Editorial Note: The substantial increase in outdoor ice-related
falls among NIH employees is consistent with reports for
communities characterized by consistently severe winters or by
only occasionally severe winter weather (2,3). However, because
the comparison period in this report included a major blizzard
(March 1993), the increased rates of fall-related injury during
early 1994 highlighted the risks especially associated with icy
conditions (4,5).
Although icy conditions persisted in the Washington, D.C.,
area during February 1994, the number of outdoor fall-related
injuries on NIH campuses declined to predicted levels, probably
reflecting the availability and spreading of dry sand by NIH
grounds and maintenance staff and the clearing to dry pavement of
outdoor parking areas and major walkways. In addition, coverage
by local news media promoted awareness of the needs for
appropriate foot-gear and avoiding unsanded or otherwise
unmaintained areas. Prompt implementation of such measures during
future icy conditions should reduce the occurrence of
fall-related injuries.
An NIH requirement that information about occupational
injuries sustained by NIH employees be recorded enabled the
assessment of the incidence, severity, and estimated costs of the
ice-related injuries described in this report. The establishment
and maintenance of such occupational injury surveillance systems
by employers permits assessment of the need for and effectiveness
of injury intervention strategies.
References
McClellan WB. Work under low temperatures and reactions to
cold stress. In: Zenz C, ed. Occupational medicine. 2nd ed.
St. Louis: Mosby, 1988:357-62.
Kopjar B, Nordhagen R. The patient slipped on the
ice....non-traffic related fractures among pedestrians,
occurrence and seasonal variations {Norwegian}. Tidsskr Nor
Laegefor 1994;114:1209-11.
Ralis ZA, Barker EA, Leslie IJ, Morgan WJ, Ross AC, White
SH. Snow-and-ice fracture in the UK, a preventable epidemic
{Letter}. Lancet 1988;85:589-90.
Lewis LM, Lasater LC. Frequency, distribution, and
management of injuries due to an ice storm in a large
metropolitan area. Southern Med J 1994;87:174-8.
Malmivaara A, Heliovaara M, Knelet P, Reunanen A, Aromaa A.
Risk factors for injurious falls leading to hospitalization
or death in a cohort of 19,500 adults. Am J Epidemiol 1993;
138:384-94.
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