A prospective study of floor surface, shoes, floor cleaning and slipping in US limited-service restaurant workers
- Santosh K Verma1,2,3,
- Wen Ruey Chang4,
- Theodore K Courtney1,2,
- David A Lombardi1,2,
- Yueng-Hsiang Huang5,
- Melanye J Brennan1,
- Murray A Mittleman2,6,
- James H Ware7,
- Melissa J Perry2
- 1Center for Injury Epidemiology, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts, USA
- 2Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
- 3Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts, USA
- 4Center for Physical Ergonomics, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts, USA
- 5Center for Behavioral Sciences, Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts, USA
- 6Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
- 7Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA
- Correspondence to Dr Melissa J Perry, Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, Building 1 Room 1413, Boston, MA 02115, USA;
- Accepted 8 August 2010
- Published Online First 8 October 2010
Objectives Slips and falls are a leading cause of injury at work. Few studies, however, have systematically examined risk factors of slipping outside the laboratory environment. This study examined the association between floor surface characteristics, slip-resistant shoes, floor cleaning frequency and the risk of slipping in limited-service restaurant workers.
Methods 475 workers from 36 limited-service restaurants from three major chains in six states in the USA were recruited to participate in a prospective cohort study of workplace slipping. Kitchen floor surface roughness and coefficient of friction (COF) were measured in eight working areas and then averaged within each restaurant. The use of slip-resistant shoes was determined by examining the participant's shoes and noting the presence of a ‘slip-resistant’ marking on the sole. Restaurant managers reported the frequency of daily kitchen floor cleaning. Participants reported their slip experience and work hours weekly for up to 12 weeks. The survey materials were made available in three languages: English, Spanish and Portuguese. The associations between rate of slipping and risk factors were assessed using a multivariable negative binomial generalised estimating equation model.
Results The mean of individual slipping rate varied among the restaurants from 0.02 to 2.49 slips per 40 work hours. After adjusting for age, gender, BMI, education, primary language, job tenure and restaurant chain, the use of slip-resistant shoes was associated with a 54% reduction in the reported rate of slipping (95% CI 37% to 64%), and the rate of slipping decreased by 21% (95% CI 5% to 34%) for each 0.1 increase in the mean kitchen COF. Increasing floor cleaning frequency was significantly associated with a decreasing rate of slipping when considered in isolation but not after statistical adjustment for other factors.
Conclusion These results provide support for the use of slip-resistant shoes and measures to increase COF as preventive interventions to reduce slips, falls and injuries.
- slip-resistant shoes
- floor cleaning
- coefficient of friction
See Commentary, p 238
Competing interests None.
Ethics approval Ethics approval was provided by the Institutional Review Board of the Liberty Mutual Research Institute for Safety and the Office of Human Research Administration at the Harvard School of Public Health.
Provenance and peer review Not commissioned; externally peer reviewed.