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Fall risk index for elderly patients based on number of chronic disabilities

. 1986 Mar;80(3):429-34.

doi: 10.1016/0002-9343(86)90717-5.

M E Tinetti, T F Williams, R Mayewski

• PMID:

  3953620

• DOI:

  10.1016/0002-9343(86)90717-5

M E Tinetti et al.

Am J Med.

1986 Mar.

. 1986 Mar;80(3):429-34.

doi: 10.1016/0002-9343(86)90717-5.

Authors

M E Tinetti, T F Williams, R Mayewski

• PMID:

  3953620

• DOI:

  10. 1016/0002-9343(86)90717-5

Abstract

The present study was designed to identify prospectively the individual chronic characteristics associated with falling among elderly persons and to test the hypothesis that risk of falling increases as the number of chronic disabilities increases. Seventy-nine consecutive admissions to three intermediate care facilities were evaluated. Twenty-five of the subjects became recurrent fallers. The nine risk factors included in the fall risk index were mobility score, morale score, mental status score, distant vision, hearing, postural blood pressure, results of back examination, postadmission medications, and admission activities of daily living score. A subject’s fall risk score was the number of index factors present. The proportions of recurrent fallers increased from 0 percent (0 of 30) in those with 0 to three risk factors, to 31 percent (11 of 35) in those with four to six factors, to 100 percent (14 of 14) in those with seven or more factors. Falling, at least among some elderly persons, appears to result from the accumulated effect of multiple specific disabilities. Some of these disabilities may be remediable. The mobility test, the best single predictor of recurrent falling, may be useful clinically because it is simple, recreates fall situations, and provides a dynamic, integrated assessment of mobility.

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Publication types

MeSH terms

1926.760 – Fall protection. | Occupational Safety and Health Administration

1. By Standard Number
2. 1926.760 – Fall protection.

1926.760(a)

General requirements.

1926.760(a)(1)

Except as provided by paragraph (a)(3) of this section, each employee engaged in a steel erection activity who is on a walking/working surface with an unprotected side or edge more than 15 feet (4. 6 m) above a lower level shall be protected from fall hazards by guardrail systems, safety net systems, personal fall arrest systems, positioning device systems or fall restraint systems.

1926.760(a)(2)

Perimeter safety cables. On multi-story structures, perimeter safety cables shall be installed at the final interior and exterior perimeters of the floors as soon as the metal decking has been installed.

1926.760(a)(3)

Connectors and employees working in controlled decking zones shall be protected from fall hazards as provided in paragraphs (b) and (c) of this section, respectively.

1926.760(b)

Connectors. Each connector shall:

1926.760(b)(1)

Be protected in accordance with paragraph (a)(1) of this section from fall hazards of more than two stories or 30 feet (9. 1 m) above a lower level, whichever is less;

1926.760(b)(2)

Have completed connector training in accordance with § 1926.761; and

1926.760(b)(3)

Be provided, at heights over 15 and up to 30 feet above a lower level, with a personal fall arrest system, positioning device system or fall restraint system and wear the equipment necessary to be able to be tied off; or be provided with other means of protection from fall hazards in accordance with paragraph (a)(1) of this section.

1926.760(c)

Controlled Decking Zone (CDZ). A controlled decking zone may be established in that area of the structure over 15 and up to 30 feet above a lower level where metal decking is initially being installed and forms the leading edge of a work area. In each CDZ, the following shall apply:

1926.760(c)(1)

Each employee working at the leading edge in a CDZ shall be protected from fall hazards of more than two stories or 30 feet (9.1 m), whichever is less.

1926.760(c)(2)

Access to a CDZ shall be limited to only those employees engaged in leading edge work.

1926.760(c)(3)

The boundaries of a CDZ shall be designated and clearly marked. The CDZ shall not be more than 90 feet (27.4 m) wide and 90 (27.4 m) feet deep from any leading edge. The CDZ shall be marked by the use of control lines or the equivalent. Examples of acceptable procedures for demarcating CDZ’s can be found in Appendix D to this subpart.

1926. 760(c)(4)

Each employee working in a CDZ shall have completed CDZ training in accordance with § 1926.761.

1926.760(c)(5)

Unsecured decking in a CDZ shall not exceed 3,000 square feet (914.4 m ²).

1926.760(c)(6)

Safety deck attachments shall be performed in the CDZ from the leading edge back to the control line and shall have at least two attachments for each metal decking panel.

1926.760(c)(7)

Final deck attachments and installation of shear connectors shall not be performed in the CDZ.

1926.760(d)

Criteria for fall protection equipment.

1926. 760(d)(1)

Guardrail systems, safety net systems, personal fall arrest systems, positioning device systems and their components shall conform to the criteria in § 1926.502 (see Appendix G to this subpart).

1926.760(d)(2)

Fall arrest system components shall be used in fall restraint systems and shall conform to the criteria in § 1926.502 (see Appendix G). Either body belts or body harnesses shall be used in fall restraint systems.

1926.760(d)(3)

Perimeter safety cables shall meet the criteria for guardrail systems in § 1926.502 (see Appendix G).

1926.760(e)

Custody of fall protection. Fall protection provided by the steel erector shall remain in the area where steel erection activity has been completed, to be used by other trades, only if the controlling contractor or its authorized representative:

1926. 760(e)(1)

Has directed the steel erector to leave the fall protection in place; and

1926.760(e)(2)

Has inspected and accepted control and responsibility of the fall protection prior to authorizing persons other than steel erectors to work in the area.

[66 FR 5272, Jan. 18, 2001]

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