Slips and Falls Are surfaces of sidewalks level and in good condition? Due to the number of people coming and going on a daily basis to various church-related functions, sidewalk maintenance is crucial in preventing slip and fall injuries. Many churches underestimate how common, severe and costly falls can be, so it's important to become proactive instead of reactive in preventing slips and falls. Regular periodic inspections of sidewalks should be conducted and any substandard conditions corrected as soon as possible. Hazard Example: An 80-year-old woman was attending a function at church and tripped over an area of raised sidewalk, fracturing her hip. The loss was in the amount of $227,150. Recommendations: The guidelines below should be incorporated to prevent slips and falls on sidewalks: Sidewalks Sidewalks should be in good condition and free of cracks or potholes. If cracks in sidewalks are greater than ¼ inch, this can create a trip hazard because it is unexpected. The use of a simple measuring stick, or four pennies stacked on top of each other will equal ¼ inch. If these variances are found, repairs should be made. Surfaces should be free from gravel, rocks and mud. Sidewalks that have depressions in the walking surface can trap water and mud, creating slip hazards. These areas should be repaired. Items placed in the path of travel, such as trash cans and garden planters should be removed. Landscaping that is planted too close to sidewalks should be kept pruned. If unchecked, the vegetation can overtake the sidewalk creating trip and fall hazards. Tree roots can cause sidewalks to heave and buckle causing serious trip and fall hazards. These areas should be identified and corrected. If construction operations create an alternate route, these walking surfaces should not create additional trip and fall hazards. Also, pedestrians should not be allowed to walk through areas under construction. Inadequate patching to sidewalks can create trip and fall hazards from raised/lowered edges, depressions and changes to the surface texture. These areas also should be closely watched. Tasks: Sidewalk slip and fall inspection Inspect all sidewalks for any slip and fall hazards. Sidewalk slip and fall repair Repair any slip and fall hazards found when conducting the sidewalk inspections. Are parking lots and driveways level and in good condition? Due to the large number of people attending various church-related functions, churches will often have large parking lots to handle the influx of people. However, over time, parking lots can become a real liability hazard for slips and falls if items in the parking lot like potholes, speed bumps and curbs are not properly maintained. Regular periodic inspections of parking lots should be conducted and any substandard conditions corrected as soon as possible. Hazard Example: While attending a church program, a visitor tripped over an unpainted speed bump in the parking lot. Total cost of loss was $116,000. Recommendations: The guidelines below should be incorporated to prevent slips and falls in parking lots: Parking Lots These surfaces are similar to sidewalks and should be in good condition and free of cracks or potholes. Also, snow plows can cause damage. The ¼ inch variance in walking surface should be followed here as well. Surfaces should be free from debris and slippery material, such as rocks, mud and sand. Tire stops are a potential tripping hazard. These require maintenance and are exposed to damage from snowplows and vehicles. If tire stops are present, the below guidelines should be followed:They should not be taller than 6.5 inches and there should be at least three feet between wheel stops. Tire stops should not extend beyond the width of the wheels. They should be marked with a contrasting color, such as yellow. Reinforcing rods used to anchor the stops should be level with the top of the stop and not extend above the surface. Speed bumps used to slow the speed of vehicles also present a tripping hazard. These are usually constructed of asphalt and will break down quicker from being exposed to the weather and vehicles driving over them. This will compound the slip and fall exposure. If speed bumps are installed, the following guidelines should apply:They should not be installed next to natural pedestrian walkways (sidewalks, ramps, etc.), exit and entrance areas. They should be marked with a contrasting color so as not to blend in with the parking lot surface. Make sure that areas around speed bumps are adequately lit so that they do not become a tripping hazard in the dark. "Speed Bump" signs should be installed to give warning of their presence. Curbing Curbs should be six inches in height. If this is not maintained, due to settling or design, this can create an unforeseen trip hazard. Curbs leading to entrances and sidewalks should be painted a contrasting color, such as yellow, white or red. Curb cutouts that are installed to provide handicapped access also should be marked with contrasting paint, and grit should be added to the paint to create surface roughness. Tasks: Parking lot slip and fall inspections Inspect all parking lots for any slip and fall hazards. Parking lot slip and fall repair Repair any slip and fall hazards found when conducting the parking lot inspections. Are entrances and exits from the building in good condition and level? Entrance and exit areas should receive special attention for controlling slips and falls. Due to heavy foot traffic at these areas, the floor surface over time becomes smooth and will have less traction. Dirt and water deposits commonly tracked in from the outside will be higher in these areas and make the floor more susceptible to slip and falls. Recommendations: To prevent slips and falls from these areas, the following guidelines should be followed: Identify areas that show a high level of smoothness and other defects. Changes in surface floor types also should be identified. This is important, as the person would encounter an unexpected condition (rough to smooth), increasing the chances for a fall. Ideally, the floor surfaces should be consistent. Doors should open and shut smoothly with appropriate door closing mechanisms so that, upon closing or opening, there is no risk of people being knocked over. The doorsill should be flush with the floor. If not, the change in elevation between the two should be no more than ¾ of an inch. If there is a threshold installed, the edges should be sloped, have a non-slip surface and be adequately secured to the floor. Having umbrella stands available next to entrances will help keep water from dripping off umbrellas onto the floor. With the potential of ice, snow, mud, etc. to be present at entrances, these areas should be designed to minimize the slip and fall potential. The best design consists of a grate system with a catch basin installed at high traffic areas to effectively remove moisture from footwear. If a grate system is not feasible, mats should be installed. The following guidelines should be followed concerning mats:Floor mats and/or runners should be installed where the floor surface is not slip resistant.Floor mats specifically designed for removal of dust, dirt and moisture at building entrances and other appropriate locations should be used. Make sure that they do not have openings large enough to trap a high-heeled shoe and cause a fall.Examples of other areas which may benefit from mat installation include the following:Areas adjacent to water fountains and drink stations. Food counters and food preparation areas. Under and around sinks, dishwashers and washing machines. Ice stations, freezers and coolers. Near machinery and other areas where spills may occur.Floor mats should be designed for removal of dust, dirt and moisture. Carpet remnants, scatter rugs, or cheap mats (vinyl backing, or no backing) should not be used. The edging should be beveled in order to provide a smooth transition from the floor to the mat. The mat should not have curled up edges and should be replaced prior to it becoming dog-eared. Mats should not be stacked on top of each other in use. This increases the potential for tripping due to the uneven edge from the floor. To decrease the potential of the mat from sliding, a single larger mat should be used instead of multiple smaller mats. The larger mat is heavier due to its size, which reduces the sliding potential. The Carpet and Rug Institute (CRI) recommends selecting mats long enough to take two full steps (6 to 8 ft) before stepping onto other floor surfaces. Mats and runners should receive proper cleaning and maintenance to ensure their integrity. Once the mats become filled with soil and water, they cannot effectively remove these contaminants from entering the building. Tasks: Entrance and exit slip and fall inspection Inspect all entrances and exits from the building for any slip and fall hazards. Entrance and exit slip and fall repair Repair any slip and fall hazards found when conducting inspections on the building’s entrances and exits. Are interior flooring surfaces installed and maintained correctly? Aesthetics always play a major role in deciding what type of interior flooring should be installed inside the church. A priority for church leaders should be to determine what type of flooring will be aesthetically pleasing, but also to provide adequate protection from slips and falls. Carpet, ceramic tile, vinyl and hardwoods are all appropriate types of interior floor surfaces, however, due to their design characteristics, one may be more appropriate than the others for certain areas of your church. Flooring also should be correctly installed, as poor installation can contribute to slip and fall hazards, such as a poorly stretched carpet that becomes loose and bunches. Of course, maintenance always plays a role in preventing slips and falls as over time, poorly maintained flooring will deteriorate and become a hazard. Even regularly maintained flooring can become a hazard if the cleaning agent would affect the slip resistance of the flooring. Recommendations: The following guidelines should be followed: Every floor surface has a degree of traction or slip resistance. Although not a formal standard, the flooring should have a coefficient of friction (slip resistant rating) of .50 or higher. Flooring material should be suitable for the environment. Areas prone to the presence of water (entryways, bathrooms, etc.) should have high slip resistance characteristics. Cleaning and waxing of flooring also should be considered. The use of floor waxes should be done according to the manufacturers' recommendations and should maintain the slip resistance rating. Non-skid wax should be used on floors. Your cleaning supply company should be contacted for advice. It's also not a good idea to wax floors immediately prior to big events involving a lot of people. Dust mops used for floor cleaning should not be treated with oil. Flooring should be level and in good condition. If there are any variances in level of more than ¼ inch, this can lead to a trip and fall. Carpeting has the best slip resistance rating, but should be kept clean and free from holes, rips and tears. Carpeting also should be adequately stretched to prevent it from bunching and becoming a trip hazard. Tasks: Interior flooring surfaces slip and fall inspection Inspect all interior flooring surfaces for any slip and fall hazards. Interior flooring surfaces slip and fall repair Correct any problems found when conducting inspections on the building’s interior flooring surfaces. Is there a policy in place for dealing with wet surfaces? During a recent Christmas season, a congregation member arrived at church for a Tuesday morning Bible study carrying presents in both arms for the other members of the group. The church’s outdoor automatic sprinkler system had been left on, even though temperatures had recently dropped below freezing. This created an icy condition on the church’s sidewalk. The member slipped backward on the ice and struck her head on the sidewalk. She never regained consciousness and passed away due to head injuries caused by the fall. Obviously, a death caused by a slip and fall is the worst possible scenario. But, it’s important to recognize how frequently people get hurt when they slip and fall. Based on GuideOne's claims history, slips and falls are the number one cause of injuries at churches. What’s more, churches are frequently sued by people who are injured on the premises. So, instead of keeping your fingers crossed that an injury will not occur, churches are advised to be proactive in preventing slips and falls. Wet surfaces, whether they’re inside or outside the church, can pose a severe slip and fall hazard. To be proactive in preventing slips and falls from occurring on wet surfaces, appropriate policies and procedures should be developed to address various wet surface exposures, including spills, irrigation systems, inclement weather and many other sources. Recommendations: Interior Employees and volunteers should be trained to identify wet conditions and clean up spills immediately. Equipment and supplies should be available to deal with the wet conditions including:Adequate number and placement of mops and buckets. Warning cones or signs that can be used to warn people of wet surfaces, slippery or unsafe areas. Adequate number of floor mats to place at entrances and other areas where wet conditions may exist. Exterior Grading of land should be away from the building to allow for adequate drainage. Drainage for storm water run-off should be adequate, and blocked drains and gutters should be kept clear. Gutter downspouts should not drain onto walkways. Condensation from air conditioners should not accumulate on walkway areas. Growth of moss on walkways also can be present on shady walkway areas where drainage is not adequate. This moss should be eliminated. Excess water from lawn sprinklers also can cause pooling of water on walkways. Test the spray pattern of the sprinklers to ensure that they do not cover the walking surface and make adjustments as needed. Tasks: Wet surfaces policy Develop and implement a written policy regarding the churches procedures on handling slip and fall exposures that are created from wet surfaces Wet surfaces policy staff training Train all employees and/or volunteers whose jobs are impacted by the procedures outlined in your church’s policy on handling slip and fall exposures that are created from wet surfaces. Is the premises inspected for any unusual or miscellaneous slip and fall hazards? Oftentimes, churches may have a miscellaneous slip and fall hazard that may be less obvious than a more common area like a set of stairs. However, conducting a thorough inspection of the entire facility and church grounds is important, as these miscellaneous hazards are often the areas most likely for a fall to occur, as they are commonly overlooked. Recommendations: The following items are some examples of miscellaneous walking surface hazards, which should be looked for when conducting inspections. Holes and depressions formed as a result of settling should be monitored and filled in. Old posts, temporary pole supports, etc. should be removed. These only create unnecessary trip and fall hazards. Access covers used to gain access to utilities should be present and flush with the surface. Drain covers that are typically found in parking lots usually have wide openings to provide drainage. This creates a severe trip hazard especially with high-heeled shoes. Grates should have openings no greater than ½ inch and they should be painted a contrasting color, such as yellow. Elevators should be adjusted so they are even with the floor surface. Electrical, telephone and microphone cords should be routed around walkways and doorways. Where this is not possible, they should be securely taped down or covered with cord protectors. Use of cordless microphones whenever possible will eliminate excessive cords. Sprinkler heads used for irrigation should be level with the ground surface when not in use. Tasks: Miscellaneous slip and fall hazard inspection Inspect the building and premises for any miscellaneous slip and fall hazards. Miscellaneous slip and fall hazard repair Repair any slip and fall hazards found when conducting inspections for any miscellaneous slip and fall hazards. Does the church have any stairs? According to the Centers for Disease Control and Prevention (CDC), over one million Americans suffer a slip, trip, and fall injury and over 17, 000 people die in the U.S. annually because of these injuries. Slip, trip and fall injuries make up 15 percent of all job related injuries, which account for between 12 and 15 percent of all Workers' Compensation expenses. GuideOne's loss experience shows that slips and falls are the number one liability claim from a frequency and severity standpoint. Numerous factors can contribute to these types of injuries, including inadequate lighting, missing or damaged handrails, poor maintenance/condition, slippery conditions, loose floor coverings, irregular design of stairs and housekeeping. Hazard Example: A 56-year-old woman grabbed on to a railing while descending exterior stairs. When the railing broke loose, the woman fell and the railing landed on top of her. She lay on the ground for about 45 minutes before someone found her. Here injuries included a fractured hip and a broken bone in her left ankle. Upon later inspection, the railing had been missing most if its attachment screws. Recommendation(s): The guidelines below should be incorporated to prevent slips and falls on stairs: Stair Treads The stairway should be at least 44 inches in width. The height of each step (riser) should be between seven and 7.5 inches and the width (tread) should be between nine and 10 inches. Nosing on the stair should not protrude more than 1.5 inches and should be beveled to reduce trip potential. If the steps have a smooth surface, install anti-slip material to the tread. This will provide traction. If the stairs are carpeted, ensure that the edge is noticeable. Stair Landings The landing of the stairway should be at least as wide as the width of the stairway. Stairways and landings should be kept clear of storage or any other materials. Never use a stairway for temporary storage. Handrails If stairs or stairways exit into any area where vehicles will be operated, adequate warnings and barriers should be installed to prevent individuals from stepping into the path of traffic. Any flight of stairs having four or more risers should be equipped with a handrail and include the following:Handrails should be accessible within 44 inches of all portions of the stair width. This will allow for a person standing on any portion of the stairs to be able to reach out and grasp the handrail. Additional handrails may be necessary depending on the width of the stairway. Handrails should be between 34 inches and 38 inches in height. Handrails must have a diameter of 1.25 inches to 1.5 inches, must be positioned at least 1.5 inches from the wall and should extend beyond the stairway so the user can maintain a hold while taking the last step to the floor. Handrails should be in good condition without any physical damage and adequately secured in place Lighting Lighting should be provided for stairways. Look for shadows that may be created and adjust lighting accordingly. If applicable for stairwells, provide a light switch at the top and the bottom of the stairs. Inspect all lighting on a daily basis and replace light fixtures or bulbs that do not work. Routine Inspections and Maintenance Routinely check the stairs for damage to the carpeting, tile, etc., and immediately make any necessary repairs. Look for cracks, decay or uneven points in the concrete in outdoor stairs. Older stairs have more potential to have these types of hazards. Tasks: Stairway slip and fall hazard inspection Inspect all stairways for any slip and fall hazards. Stairway slip and fall hazard repair Repair any slip and fall hazards found when conducting inspections on the building’s stairways. Does the church have any ramps? In general, ramps are installed to allow access for persons with disabilities. With the passage of the Americans with Disabilities Act (ADA) of 1990, injuries associated with ramps have increased over the years. Recommendation: The following precautions should be taken to prevent slips and falls from ramps: Ramp slopes are calculated by rise (vertical distance) over run (length of the ramp). The slope of the ramp should be no greater than 1 (vertical) by 8 (horizontal), or 7 degrees. If the ramp will be used by individuals with disabilities, the slope should be no greater than 1 by 12. The ramp should be kept clear with no projections onto the ramp. Handrails should be provided on ramps that have a rise of 6 inches or more. Tasks: ADA Ramp inspections Inspect all entrance ramps to determine if they meet the standards set by the Americans with Disabilities Act (ADA). ADA Ramp repairs Repair all ramps noted during the inspection that do not meet ADA standards. Does the church have a balcony? Balconies are typically found in the rear of church sanctuaries. They are often used for the choir, sound system equipment and for overflow seating of the public. Falls can occur here due to poor design of steps, inadequate lighting and lack of guardrails. Hazard Example: As a church member was exiting the balcony, she did not see the step down, causing her to fall and fracture her hip. She was hospitalized for 10 days. It was determined that the carpeting on the steps made it difficult to see that there was a step down to the exit. This loss amounted to $106,000. Recommendation(s): To prevent falls from balconies: All stairways for balconies should be equipped with sturdy handrails. Stairways should have non-slip treads and be free from obstructions. Guardrails should be installed on any open sides of the balcony and should be 42 inches high. This guardrail should consist of a top rail, intermediate rail located halfway between the top rail and floor, and posts. Tasks: Balcony slip and fall inspection Inspect the church balcony for any slip and fall hazards. Balcony slip an fall repair Repair any slip and fall hazards found when conducting inspections on the building’s balcony. Do interior and exterior walking surfaces have adequate lighting? Church functions are no longer limited to Sundays, as many churches have activities seven days a week, many of which run into the late evening hours. Therefore, congregation members often find themselves using or leaving the church during times when there is little or no natural light. Inadequate lighting can be a major contributor to slips and falls, as hazards can be difficult, if not impossible, to see when proper lighting is not provided. Hazard Example(s): After attending a night activity at the church, a 59-year-old woman was descending an outdoor staircase. She thought she was at the last step and fell off. The stairway was not lit and the railing ended before the stairs. The woman fractured both ankles. The incurred loss was $300,000. A church was holding a play in the sanctuary. To enter into the sanctuary from the back, a person must open a door that leads into a hallway. The hallway has four steps leading down to another door that leads into the sanctuary. Once the play began, the lights in the sanctuary and the rear hallway entrance and exit were darkened. One of the performers entered the dark hallway, not noticing the steps leading down. She fell and broke her leg in several places. Due to the accident's severity, she could not take care of herself and had to be placed in a nursing home. She underwent surgery for an infection that developed in the wound and was hospitalized for quite some time. Recommendation(s): Illumination of interior and exterior walking surfaces should include the following: Lighting is measured in foot candles. At a minimum, 10 foot candles should be mandatory for all lighting. Higher levels of illumination may be needed in high use areas. Lighting should be provided for walkways, parking lots, stairways, hallways and basements. Look for shadows that may be created and adjust lighting accordingly. In stairwells, provide a light switch at the top and the bottom of the stairs whenever feasible. Inspect all lighting on a weekly basis and replace light fixtures or bulbs that do not work. Tasks: Lighting slip and fall inspection Inspect all interior and exterior walking surfaces for adequate lighting. Lighting slip and fall repair Install lighting in those areas where insufficient lighting is present and/or repair any current lighting fixtures that are not properly functioning. Does the church sponsor or host special events that will attract large groups of people? Holidays, fundraisers and other special events can draw large numbers of people. This will increase the chances of accidents from slips and falls from congested walkways, overcrowded rooms, etc. These gatherings may also pose other exposures by having outdoor activities such as rummage sales, and concerts. Temporary tents may be installed. Precautions should be taken to reduce the chances of slips and falls from these special events. Hazard Example: A member of the church was attending a garage sale at the church and tripped over a tree stump while walking outside. She fell to the ground and injured her shoulder. Recommendation(s): To prevent slips and falls during special events, the following guidelines should apply: Sturdy tables and racks should be used for displaying merchandise. Aisles should be sufficiently wide to accommodate pedestrian traffic. Depressions and holes in grassy areas should be marked or moved from the playing field. If large outdoor tents are used, make sure the stakes and ropes are visibly marked and protected. Furthermore, the tents should be erected by a professional company and inspected by a qualified individual prior to use. Make sure all cords (power, speakers, microphones, etc.) are not installed on walkways, and if they are present, have them properly held down with tape or covered with cord protectors. Tasks: Special events equipment hazards Prior to holding any events that may attract large groups of people, inspect all equipment for any defects and repair before being used. Special events slip and fall hazards Prior to holding any events that may attract large groups of people, inspect the building and grounds to locate any potential slip and fall hazards and repair any conditions that would be considered potential slip and fall hazards. Are procedures in place to properly remove snow and ice? Slips and falls at churches from snow and ice covered walking surfaces are a common cause of injuries to church employees, members and guests. Churches are faced with the added exposure of people coming and going at all times during the day, seven days a week, increasing the need to monitor snow and ice conditions. To reduce the slip and fall exposures with snow and ice, formal procedures should be developed and followed. Hazard Example(s): A volunteer for the church slipped and fell on ice in the church parking lot. Injuries from this accident resulted in a broken ankle and a blood clot. Total cost of loss was $306,250. A pastor was leaving the church, slipped and fell on an ice covered sidewalk, breaking his elbow in six places, requiring extensive surgery. The total cost of this loss was$120,000. Recommendation(s): Snow and Ice Removal Policies and Procedures Some churches may have only their employees and/or volunteers perform snow and ice removal. For churches with large parking lots and extensive sidewalks, the church may not have the resources to do this alone, and will hire a contractor. Others may employ a combination of using their own staff and outside contractors. In any case, procedures should be put in place to address snow and ice removal, including the following: Designate someone to monitor snow and ice conditions. This individual will be responsible to coordinate snow/ice removal operations. During the months when snow and ice will be a concern, monitor weather reports daily. This will give you advanced warning of approaching weather. Snow and ice removal equipment should be available and ready to go, including shovels, ice melt, snow blowers, etc. Snow removal should occur when one inch or more of snow has fallen, or if ice conditions are present. Walkways in front of entrances should have de-icing products applied. Snow and ice will melt and water can accumulate inside the building at the entrances from foot traffic. These areas should be monitored closely for wet conditions. Make sure mats are in place and replaced if they become water logged. Consider providing additional ushers or volunteers to assist the elderly at the entrances. Look for ice conditions that could develop on walking surfaces from runoff from roofs, downspouts and other areas. Isolate problem areas by closing them to the general public, or install signs warning of the potential slip hazard. Make sure that by closing an area off, you are not redirecting foot traffic to other slip and trip hazards (i.e., re-routing sidewalk requiring user to step off curb into parking lot). Hiring a Contractor If a contractor is used, the following guidelines should apply: The workload of the contractor should be considered. The contractor should not have too many jobs that they are unable to fulfill their responsibilities. The contractor should have the appropriate equipment required to adequately provide snow removal. The contractor should provide you with a certificate of insurance, which names the church as an additional insured under the contractor's insurance policy. A written contract should be used with a hold harmless/indemnification clause included. The areas of the church the contractor is responsible for should be documented, (i.e., front and rear parking lots, sidewalks, etc.). The contractor should have guidelines as to a maximum timeframe in which to complete the snow removal, such as after the precipitation has ended (i.e., two hours) or the amount of snow that has accumulated (i.e., more than one inch). Tasks: Snow and ice removal Develop and implement a written policy regarding your church’s operating procedures for the removal of snow and ice. Snow and ice removal training Train all employees and/or volunteers whose jobs are impacted by the procedures outlined in your church’s policy on the removal of snow and ice. Are investigations of slip and fall incidents completed? It is important to document the facts about slip and fall accidents as soon as possible. Documenting who, what, when, where and why, can be critical to determine the cause of the slip and fall, as well as actions that are needed to prevent it from occurring again. It also provides details about the accident that would be important in the event legal action is brought against the church. Recommendation(s): The following should be incorporated into slip and fall accident investigation procedures: Designate a person to investigate accidents. This person should know the procedures on what to do. Create an accident report form. It is critical to obtain all of the facts related to the accident. Document and detail as many facts as you can about the accident. If the individual is injured, make sure they receive prompt medical attention. After the person has left the scene, photographs should be taken of the area where the slip and fall occurred. This will document if there was anything that may have contributed to the slip and fall, such as ice, debris, etc. Do not admit any liability and do not make any offer of payment. Tasks: Slip and fall investigation Develop and implement a written policy regarding the church’s operating procedures on the investigation of slips and falls Slip and fall investigation staff training Train all employees and/or volunteers whose jobs are impacted by the procedures outlined in your church’s policy on investigating slips and falls.