Have we given up trying to prevent falls?

Like any good scientist trying to solve a problem, we like to start with the data.  

At Safer Tourism, we work with tour operators and travel providers to collect, aggregate and analyse anonymised traveller incident data. This allows us to look for patterns and design interventions that can be put in place to help minimise the recurrence of future incidents.  

And every year, our dataset shows that slips, trips and falls are a major category of injury to travellers. Some operators record more than a quarter of their total customer incidents under this heading.  

Many slips, trips and falls are minor; a painful albeit temporary inconvenience, rather than something requiring medical attention. But some are very serious, including falls from height and falls occurring to older travellers where injuries like fractures can be life changing. And each year a small number of falls sadly result in fatalities. 

Travel companies have tried over the years to reduce the likelihood of falls by installing handrails, signage, anti-slip stair edges and bathmats. Yet people continue to fall on holiday. Should we just accept falls as an inevitable risk for travellers? 

To some extent. Not all falls are easily or practically preventable, and the nature (and impact) of falls varies widely across travel companies, depending on the kind of travel they provide, and to whom. However, our data shows that the impact of falls tends to be more serious in a few easily identifiable sets of circumstances.  

We think it’s time to revisit falls prevention. 

The impact of falls tends to be greater for older travellers, for whom a fracture is not only more likely, but more serious with a more complicated recovery trajectory. We have identified three common falls scenarios which merit further preventative attention. If we could make a difference only in these scenarios, we could prevent some very serious injuries. 

Photo by Jason Dent on Unsplash

1. One or two steps down 

People tend to fall down steps more than they do up them. When there is a whole flight of steps our attention is firmly on those steps. But where there is a single step, perhaps in an unexpected place (such as between the reception and the dining room), or where there are one or two steps down off a bus or boat, or simply off the pavement, our attention may not be on the step. We may not see it, or we may misjudge the change in levels, and we stumble. It is often the most innocuous step that can cause the greatest damage. 

Photo by Jan Walter Luigi on Unsplash

2. Unexpected wetness 

Whilst many people do slip on surfaces that you might expect would be wet – such as pool surrounds – quite a number of us are caught out by unexpected patches of wet floor, especially where the floor surface itself is smooth and tiled. Leaking air conditioning units can drip on to the floor beneath without us noticing; heavy summer rain may create a puddle where we wouldn’t normally find it. When we don’t expect the floor to be wet we don’t think about taking care as we cross it. 

Photo by Rafiee Artist on Unsplash

3. Nighttime bathroom visits

Many of us need to use the toilet during the night, and this tends to become a more frequent need as we age. At home most of us probably know the way to our own bathroom with our eyes closed, but in our holiday accommodation we are much less familiar with the surrounds – the furniture, floor levels, obstacles – and we may be reluctant to turn on the light for fear of disturbing our holiday companions. One of the most common settings for serious falls, especially to older travellers, is the bathroom at night. Put together the risks of single steps and unexpected wetness, and bathroom floors can tick all the boxes. 

What’s the answer? 

Some of the solutions are about making physical changes, for example, in holiday accommodation. Some of the solutions draw instead on social and cognitive influences to encourage customer behaviour change. Most of them are cheap and easy to implement.  

For example, ensuring there is a motion sensitive night light plugged in in bedrooms and bathrooms could help make those nighttime toilet trips less hazardous. Clearing up wet puddles on shiny floors (and checking the AC unit for any drips) could reduce the slip coefficient of tiled floors. Alerting customers (in the moment, not in a welcome pack) to changes in floor levels and odd single steps, could draw attention at a point in time.  

There is no silver bullet to falls prevention and we cannot stop all falls. But concentrating on those falls which cause the most serious injuries to the most people, is surely worth our (and your) attention.