In the first large scale national study of escalator-related injuries to older adults, researchers led by Joseph O'Neil, M.D., MPH, and Greg Steele, Dr.PH., MPH, of the Indiana University School of Medicine, report that the rate of these injuries has doubled from 1991 to 2005.
Using U.S. Consumer Product Safety Commission data, the researchers found nearly 40,000 older adults were injured on escalators between 1991 and 2005. The most frequent cause of injury was a slip, trip or fall resulting in a bruise or contusion. The most common injuries were to the lower extremities. However, most injuries were not serious. Only 8 percent of the 39,800 injured were admitted to the hospital after evaluation in an emergency department.
"Although escalators are a safe form of transportation, fall-related injuries do occur. Older adults, especially those with mobility, balance or vision problems, should use caution while riding an escalator and especially when stepping on or off. They should not try to walk up or down a moving escalator, carry large objects, or wear loose shoes or clothing while riding since these appear to be associated with an increased risk of falling," said Dr. O'Neil, associate professor of clinical pediatrics at the IU School of Medicine.
Older adults who have difficulty walking or maintaining balance should use elevators rather than escalators, the study authors caution.
"What really surprised us was the reckless behavior exhibited by some older adults on escalators," said Dr. Steele, associate professor of epidemiology in the IU School of Medicine's Department of Public Health. "One emergency department reported a fall by an escalator rider who attempted to squeeze past an individual in a wheelchair and the individual's attendant who were also on the escalator. Obviously, the wheelchair should not have been on the moving stairs. And of course the injured individual should not have attempted to beat them down the stairs."
"People may wonder why a pediatrician is studying older adults, but it's not really a stretch. Older adults have many of the same mobility and balance issues as young children," said Dr. O'Neil, a developmental pediatrician at Riley Hospital for Children. He is an expert on injury prevention who says that injury should be considered as much a medical illness as heart disease, stroke or diabetes. "We have to stop thinking of unexpected injuries as accidents, which implies that they are unpreventable. Escalator injuries, like auto crashes and many other so-called accidents, can be prevented," he said.
Journal reference: Joseph O'Neil, Gregory K. Steele, Carrie Huisingh and Gary A. Smith; Escalator-related injuries among older adults in the United States, 1991--2005; Accident Analysis & Prevention, Volume 40, Issue 2, March 2008, Pages 527-533. Co-authors of the study are Carrie Huisingh, MPH, of the Massachusetts Department of Public Health and Gary A. Smith, MD, DrPH, of Children's Hospital, Columbus, Ohio.
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