A tall order – getting to the bottom of working at height

IOSH President, Kelly Nicoll, has prioritised working at height as a theme for her presidential term. “Working at height is one of the biggest causes of death and significant injury across the world,” she recounted on the eve of her presidency back in November. “Some of the worst incidents I have ever dealt with during my career have involved falls from heights, and the impact of those incidents has followed me ever since.”

A couple of statistics help to tell the story. In the UK, a third all work-related fatalities are caused by falls from height.^{[ref 1]} It is a similar story in Sweden, where falls are the most common cause of workplace fatality.^{[ref 2]} In Australia, meanwhile, falls from a height were the second highest contributor to worker fatalities in the latest statistics, up 71 per cent on the previous year.^{[ref 3]}

Four out of every five fatal falls occur in lower to middle-income countries, predominantly in the Western Pacific and Southeast Asia.^{[ref 4]}

It almost goes without saying that we have not yet figured out a universal formula for work at height. But for an issue widely recognised as a global burden, the lack of improvement over time is alarming. With this in mind, we recently put the issue to IOSH’s Thought Leadership Panel to get their thoughts on the current state of play and potential ways to tackle it.

Behind the headlines

One gateway to improvement is to better understand the granular details behind the headline figures. One panellist posed a number of questions, whose answers might help tailor the thrust of future messaging, the tenor of future guidance and the shape of future interventions. “Where exactly are these incidents happening? What’s the reason for them? What is the sector? Is it a particular size of company? Is it planned work or is it response to something going wrong?”

Some of the hotspots are well-known – construction, agriculture and forestry always feature high up on the list. However, the difficulty of accessing a more comprehensive picture of the factors behind the accidents holds back improvement efforts. 

Good evidence is not the only challenge around accessibility. “The inability to reach small and medium enterprises (SMEs) is something we are still to overcome,” one panellist remarked. This is borne out in the evidence: dedicated safety and health training, guidance and personnel are provided only in a minority of SMEs.^{[ref 5]}

“Someone who is climbing to ‘dead limb’ a diseased or dying tree up a tree on an MEWP (mobile elevating work platform) is different to someone who’s going up on a rope system,” one panellist noted. The available guidance needs to reflect the uniqueness of the work being done. “If you’re trying to tell a forester, ‘this is what they do in construction’, the message is unlikely to land.”

What can we do?

So, how do we begin addressing the issue? There is no doubt that the many factors leading to falls from height mean that interventions must be wide-ranging, addressing:

• the design and planning of work
• the rigour and usefulness of documentation
• the provision and maintenance of equipment
• good management and supervision
• the cultivation of broader cultures of safety. 

More rounded evidence on the causes of falls is a start, but we need to be realistic about the limits of its impact. As one panellist put it, “How quickly would any research find impact on a couple of workers on an industrial estate making independent decisions? I think the likelihood of that is zero.”

The discussion led the panel to consider the potential of more direct, hands-on interventions. Examples and experiences of the panellists reveal there is also a societal dimension, that is, to recognise unsafe work at height and know what to do in the event of it.

“We’re going to see bad stuff happening. We have to know how to do something about it.” This might involve informing people on how to report incidents to authorities or enforcement agencies. There is also a more fundamental need for the public to recognise the societal value of safe and sustainable work. 

And that is a tall order.

References

1. Statistics – work-related fatal injuries in Great Britain | HSE
2. Falls from height are the biggest killer in Sweden, data says | HSI
3. Key work, health and safety statistics | Safe Work Australia
4. Falls | WHO
5. SMEs have further to go with their health and safety provisions | Open Access Government