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More Seniors Falling Victim to Escalator Injuries

A doubling of accidents in 15-year span may reflect increasingly mobile lifestyles, experts say

FRIDAY, March 21 (HealthDay News) -- Older Americans are being injured during slips and falls on escalators at increasing rates, a new study finds.

The rate of injuries to older adults riding escalators more than doubled from 1991 to 2005, said study lead author Dr. Joseph O'Neil, an associate professor of pediatrics at the Indiana University School of Medicine, and an expert on injury prevention.

"Escalators are a safe means of getting from one floor to another for older Americans, but you do need to be careful, especially if you have mobility, balance or vision problems," he said.

O'Neil and his colleagues published their findings in the March issue of the journal Accident Analysis and Prevention.

Reviewing records from the U.S. Consumer Product Safety Commission, the research team found that nearly 40,000 adults age 65 and older were injured on escalators between 1991 and 2005. In fact, the rate rose more than two-fold during that period: from 4.9 injuries per every 100,000 older Americans in 1991 to 11 injuries per 100,000 people by 2005.

The trend of increasing escalator accidents is likely related to shifts in lifestyle, O'Neil speculated. "Older adults are now more active at an older age than probably ever before," he noted, adding that the mean age of the accident victims in the study was 80 years old.

But while escalator accidents are an important matter of public safety for the elderly, they should not be blown out of proportion, O'Neil said. "This is a small portion of the total number of injuries that occur in older adults," he said.

Most of the injuries were not serious. Only 8 percent of the injured were admitted to a hospital after evaluation in an emergency department. The most common injuries were to the lower extremities (about 26 percent) and the head (25 percent). The leading type of injury was soft-tissue injuries (54 percent), such as sprains, followed by cuts (about 22 percent) and fractures (almost 16 percent). Women accounted for more than 73 percent of escalator injuries.

The new study does provide insight into the ways in which injuries take place on escalators among older adults, however.

The most frequent cause of escalator injury was a slip, trip or fall, which accounted for 85 percent of all injuries in the study, the researchers said.

"Most of the slip-trip-or-fall injuries happened while a person was standing on the escalator, not trying to step on or off or pass by another person," O'Neil said.

Stepping on or off the escalator only accounted for a small portion (14 percent) of slips, trips and falls. Injuries caused by walking up or down while riding an escalator were rare. Also, only 3 percent of the total injuries resulted from a garment, shoe, bag or purse becoming caught in the escalator, the study found.

The reasons that older adults slip, trip and fall on escalators are likely very similar to the causes of injuries in other situations, O'Neil said. "Factors that could contribute to a fall include poor equilibrium, decreased visual acuity, coordination problems, changes in muscle strength and balance, and lack of agility," he said.

According to Jessie VanSwearingen, associate professor of physical therapy at the University of Pittsburgh, vision problems are probably the most important cause of escalator falls.

"Older people are more reliant on vision for their balance than younger people are," she said.

Escalators are very disruptive to vision because both the escalator and the surrounding environment are moving, she added.

One way to prevent these accidents is to "stabilize your vision," VanSwearingen said, offering the following tips:

  • Do not look down at the moving steps, which is disorienting.
  • Find an object ahead of you and focus on it.
  • Don't look side to side at distractions or displays.

"If you need a cane or walker to get around, then you should definitely use an elevator," O'Neil added.

More information

For more on preventing falls among older adults, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Joseph O'Neil, M.D., M.P.H., associate professor, pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis; Jessie VanSwearingen, Ph.D., PT, associate professor of physical therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh; March 2008, Accident Analysis and Prevention

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