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The “Gaps Analysis to NIOSH” is a “Review of the scientific literature on injuries from falls from (and with) ladders” of the Advanced Technologies and Laboratories, Inc. (ATL) in Germantown, Maryland, in the USA.

The ATL-Report confirms many safety aspects in handling ladders :

• complacency about danger
• fatalities increase with age
• basic importance of dizziness and vertigo
• accessories are not effective

Furthermore the report confirms the gap in scientific research on accidents with portable ladders – including the difficulty of any sort of holistic approach and scientific analysis.

We need to fully understand the reasons behind this lack of insight as a premise to start searching new ways to reduce ladder accidents. So let me try to submit you some observations and suggestions.

1. first of all, we don’t know the real number of (fatal) accidents involving portable ladders; we can assume that most ladder accidents are not reported because:

• there is no witness
• describing an accident is not easy (a posteriori, nobody knows if the broken ladder is one of the causes or the result of an accident)
• the persons involved in ladder accidents fear bad reputation or simply remove/refuse the memory of crucial/shocking situations

2. Normally reports on ladder accidents are not real-time; accidents are reported by people which had suffered the ladder accident, and often are still shocked. Scientific research needs real time observation or simulation under laboratory conditions; both are very expensive projects, even if a standard photographic equipment availability in certain workplaces could help.

3. Scientific research of ladder accidents under real and lab conditions seems an easy task, as far as the “ladders” and “ambient conditions” are considered: both are completely known and easily described. This is not so when we consider the “vertigo” and “dizziness” variables: the person on the ladder itself is a variable, and not a well known one. Nonetheless, it is probably a more important variable than the “ladder” and “ambient conditions” for the sake of understanding the dynamics of ladder accidents.

See e.g. Barrett C. Miller, who wrote in 1998:
“To stand, walk, or climb without falling, we must maintain our center of mass over and within a base area. When someone is standing erect, the base can be considered the normal footprint. The shape, size, and position of the base changes depending on the pattern of movement and the activity. When walking, we constantly readjust our body segments over our base to maintain stability. The brain, vision, body condition, and the nature of the contact with the surface all contribute to the sensitive balance required to maintain walking stability. If a foot slips or is mis-positioned, the center of gravity shifts outside the base area. When this happens, we shift our body parts in an attempt to regain equilibrium. If the center of mass cannot be shifted back over the base area, we fall.”

See also the results stemming from a medical research branch called “Neurootology”:
The human beings are connected with their environment through their sense organs. Ears, eyes, nose and tongue are peripherical sensorial organs, that on being excited by an environmental stimulus, are able of registering said information and transferring same to the brain superior centers. An answer to these stimuli is produced by the brain or central computer. NEUROOTOLOGY is the branch of medicine devoted to studying the aforementioned process

4. So scientific research of ladder accidents is expensive because it needs:

• permanent observation of working on ladders under different ambient conditions
• permanent observation of working on ladders with different operators
• permanent observation of working on different types of ladders
• clinical control of operators
• development of kinetic models for different types of ladders and ambient conditions in order to reproduce fatal situations; without such models any effort in scientific research would remain uncontrollable and spoiled of practical results.

5. Probably ladder manufacturers and assurance companies are not inclined to promote scientific research of ladder accidents: “cost” seems only one of the reasons.

6. Ladders are low cost volume products, easy to handle, used in millions of different situations and jobs, perceived by the general public as a completely understood object and that makes it hard to find a reason to fund research of substantial innovations.

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Let me say – off records – that the functionality and technical structure of ladders have not changed in thousands of years, and ladder accidents like atavistic memories seem to belong to one of the best protected taboo-zones of our human societies.

Nevertheless, I think there is a way out, and the solution could be a policy encompassing:

• Permanent, standardized television monitoring of ladder works, in preparation and support of forthcoming
• Scientific research of ladder accidents (comment written by E. Rupp)

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