Slips, trips, and falls are the second most common type of fatal work-related injuries and the third most common type of non-fatal work-related injuries in the United States (1, 2). Although falls from heights are more likely to result in a fatality, falls on the same level (which often start as a slip or trip) occur more frequently and can cause injury. Recent US Bureau of Labor Statistics data shows that 50% of all same-level falls resulted in more than 10 days away from work (1, 2, 3). Sprains, strains, dislocations, and tears to the lower extremities are the most common injuries after a same-level slip, trip, or fall (4–7). These injuries are estimated to cost nearly $13 billion in direct workers’ compensation-related costs each year and are the most expensive category of injuries (8).
Laboratory studies of slip-resistant footwear to reduce slips, trips, and falls have shown promise in reducing slips, but limited field research made it difficult to demonstrate if slip-resistant footwear actually reduced injuries. NIOSH researchers evaluated the effectiveness of a no-cost-to-workers, highly-rated slip-resistant shoe program in preventing workers’ compensation injury claims caused by slipping on wet or greasy floors among food services workers. The study, Effectiveness of a no-cost-to-workers, slip-resistant footwear program for reducing slipping-related injuries in food service workers: a cluster-randomized trial, was recently published in the Scandinavian Journal of Work, Environment and Health.
Approximately 17,000 food services workers from 226 school districts, serving students in kindergarten through 12th grade participated in the study. Workers were clustered by the school district and the districts were randomly assigned either to a group that received no-cost, 5-star rated slip-resistant shoes or to a group that generally bought their own slip-resistant shoes.
Investigators looked specifically at workers’ compensation injury claims caused by slipping on wet or greasy surfaces, the type of incident that the shoes were designed to prevent. The school districts provided with highly-rated slip-resistant shoes saw a 67% reduction in claims for slip injuries; whereas, there was no decline seen in the group who did not receive the highly-rated slip-resistant shoes. See the infographic above. The findings revealed a baseline measure of 3.54 slipping injuries per 10,000 months worked among the intervention group, which was reduced to 1.18 slipping injuries per 10,000 months worked in the follow-up period when slip-resistant shoes were provided.
Another finding from this research was that prior to the no-cost slip-resistant footwear intervention, workers over 55 years old had a higher probability of a slip-related workers’ compensation injury claim (4.2 injuries per 10,000 worker months) than workers under age 55 (2.3 injuries per 10,000 worker months). This is of public health significance because more workers over age 55 continue to remain active in the US workforce (9). Without intervention, slipping injuries may be an increasing injury problem for older workers.
To our knowledge, this is the first randomized controlled trial evaluating the effectiveness of a no-cost –to-workers slip-resistant footwear program for reducing slipping-related workers’ compensation injury claims in food service workers in the field. This research helps to bridge the gap between understanding the performance of slip-resistant footwear in laboratory settings to understanding the effectiveness of slip-resistant footwear at preventing injuries in a functional work environment. Additionally, this study attempted to isolate the effect of a single intervention as much as possible through the study design.
The findings from this study provide evidence of the effectiveness of slip-resistant footwear and may assist employers, managers, and workers in their decision on whether to invest time and resources in a slip-resistant footwear program.
This study examined the effectiveness of slip-resistant footwear among food service workers. What other industries or workers could benefit from the use of slip-resistant footwear? If you have used slip-resistant footwear at work please share your experiences below.
A Spanish translation of this blog is available here.
Jennifer L. Bell, Ph.D., is a Research Epidemiologist in the NIOSH Division of Safety Research.
Jim Collins, Ph.D., MSME, is a Branch Chief in the NIOSH Division of Safety Research.
Sharon Chiou, Ph.D., is a Health Scientist in the NIOSH Office of Extramural Programs.
Sydney Webb, Ph.D., is a Health Communication Specialist in the NIOSH Division of Safety Research.
More Information from NIOSH
- Falls in the Workplace
- Slip-Resistant Shoes Reduce Food Services Worker Slip Injuries
- Preventing Slips, Trips, and Falls in Wholesale and Retail Trade Establishments
- Slip, Trip, and Fall Prevention for Healthcare Workers
- Preventing Slips, Trips, and Falls in Mining
- Bureau of Labor Statistics (BLS). Table A-1. Fatal occupational injuries by industry and event or exposure, all United States, 2015. 2015a. Bureau of Labor Statistics, U.S. Department of Labor, Washington, DC., Survey of Occupational Injuries and Illnesses in cooperation with participating State agencies.
- Bureau of Labor Statistics (BLS). Table R8. Incidence rates for nonfatal occupational injuries and illnesses involving days away from work per 10,000 full-time workers by industry and selected events or exposures leading to injury or illness, 2014. 2015b. Bureau of Labor Statistics, U.S. Department of Labor, Washington, DC., Survey of Occupational Injuries and Illnesses in cooperation with participating State agencies.
- Bureau of Labor Statistics (BLS). Table R70. A number of nonfatal occupational injuries and illnesses involving days away from work by event or exposures leading to injury or illness and number of days away from work, 2015. 2015c. Bureau of Labor Statistics, U.S. Department of Labor, Washington, DC., Survey of Occupational Injuries and Illnesses in cooperation with participating State agencies.
- Bell JL, Collins JW, Wolf L, Grönqvist R, Chiou S, Chang WR et al. Evaluation of a comprehensive slip, trip and fall prevention program for hospital employees. Ergonomics 2008 Dec;51(12):1906–25. https://doi. org/10.1080/00140130802248092.
- Bell JL, Collins JW, Tiesman HM, Ridenour M, Konda S, Wolf L et al. Slip, trip, and fall injuries among nursing care facility workers. Workplace Health Saf 2013 Apr;61(4):147– 52. https://doi.org/10.1177/216507991306100402.
- Nenonen N. Analysing factors related to slipping, stumbling, and falling accidents at work: application of data mining methods to Finnish occupational accidents and diseases statistics database. Appl Ergon 2013 Mar;44(2):215–24. https://doi.org/10.1016/j.apergo.2012.07.001.
- Lipscomb HJ, Glazner JE, Bondy J, Guarini K, Lezotte D. Injuries from slips and trips in construction. Appl Ergon 2006 May;37(3):267–74. https://doi.org/10.1016/j. apergo.2005.07.008.
- Liberty Mutual Research Institute for Safety. Liberty Mutual Workplace Safety Index. 2016. Liberty Mutual, Hopkinton, MA.
- Toossi M, Torpey E. Older workers: Labor force trends and career options. Career Outlook, U.S. Bureau of Labor Statistics, May 2017. Accessed 21 July 2017. Available from: https://www.bls.gov/careeroutlook/2017/article/older-workers.htm.