Older folks at higher risk of escalator injuries

NEW YORK (Reuters Health) - Older people should treat escalators with caution, and may want to use elevators instead if they have trouble keeping their balance, according to the authors of the first national study of escalator injuries in seniors.

Most injuries were due to slips, trips and falls, and typically involved the legs or head, Dr. Joseph O'Neil of the Indiana University School of Medicine in Indianapolis and colleagues found. The injury rate was higher among older people, who were also more likely to require hospitalization.

"While all age groups could be at risk for an escalator-related injury, older adults may experience a more serious outcome," the researchers write in the journal Accident Analysis and Prevention.

O'Neil and his team looked at US Consumer Product Safety Commission Data on escalator-related injuries among adults 65 and older between 1991 and 2005 representing an estimated 39,850 emergency room visits nationwide.

The rate of injuries steadily rose during the study period, the researchers found, doubling between 1991 and 2005. Injured individuals' average age was about 80, and nearly three-quarters were female.

People had hurt themselves by slipping, tripping or falling in 84.9 percent of cases. Fourteen percent of injuries took place while a person was stepping on or off the escalator, while losing one's balance or fainting accounted for 6 percent. Three percent of injuries were due to clothing, shoes, bags, purses or body parts getting caught in the escalator, while 3 percent were caused by contact with another passenger.

About one-quarter of the injuries were to the lower extremities, while another quarter involved the head. Soft tissue injuries were the most common, accounting for 54.2 percent of the injuries, followed by lacerations (22.3 percent) and fractures (15.6 percent). The older a person was, the more likely they were to sustain a head injury.

The researchers estimate that there are 4.4 escalator-related injuries for every 100,000 people aged 65 to 69, and 13.3 per 100,000 for people 80 to 84 years old.

"Older adults should not try to walk up a moving escalator, carry large objects, or wear loose garments while riding an escalator since these behaviors appear to be associated with an increased risk of falling," the researchers advise. "Older adults who have difficulty walking or maintaining balance may want to consider using elevators when traversing multiple level buildings."

SOURCE: Accident Analysis and Prevention, March 2008.