Human-centred approaches in slipperiness measurement.

A number of human-centred methodologies--subjective, objective, and combined--are used for slipperiness measurement. They comprise a variety of approaches from biomechanically-oriented experiments to psychophysical tests and subjective evaluations. The objective of this paper is to review some of the research done in the field, including such topics as awareness and perception of slipperiness, postural and balance control, rating scales for balance, adaptation to slippery conditions, measurement of unexpected movements, kinematics of slipping, and protective movements during falling. The role of human factors in slips and falls will be discussed. Strengths and weaknesses of human-centred approaches in relation to mechanical slip test methodologies are considered. Current friction-based criteria and thresholds for walking without slipping are reviewed for a number of work tasks. These include activities such as walking on a level or an inclined surface, running, stopping and jumping, as well as stair ascent and descent, manual exertion (pushing and pulling, load carrying, lifting) and particular concerns of the elderly and mobility disabled persons. Some future directions for slipperiness measurement and research in the field of slips and falls are outlined. Human-centred approaches for slipperiness measurement do have many applications. First, they are utilized to develop research hypotheses and models to predict workplace risks caused by slipping. Second, they are important alternatives to apparatus-based friction measurements and are used to validate such methodologies. Third, they are used as practical tools for evaluating and monitoring slip resistance properties of footwear, anti-skid devices and floor surfaces.     

Association of subjective ratings of slipperiness to heel displacement following contact with the floor

Falls precipitated by slipping are listed among the leading causes of occupational injuries. Several factors may influence the risk of slips and falls, including perception of surface conditions. The current research examined the relationship between perceptions of slipperiness and slip distance at heel strike. The investigation compared objective and subjective measures for 31 participants ranging in age from 19 to 67 years old. Subjective slipperiness ratings for several floor surface and walking velocity conditions were obtained. Small slips were not generally perceived, but a uniform slip distance threshold could not be identified due to the large variability in ratings. The Pearson correlation coefficient between slip distance and subjective ratings for slides (30-100mm) was r=-0.17. Results indicate that subjective ratings should be used cautiously as a measure of slipperiness, partially due to possible underestimation of slipperiness and the variability in perceptions.     

Measurement of slipperiness: fundamental concepts and definitions

The main objective of this paper is to give an overview of basic concepts and definitions of terms related to the ‘measurement of slipperiness’ from the onset of a foot slide to a gradual loss of balance and a fall. Other unforeseen events prior to falls (e.g. tripping) are sparingly dealt with. The measurement of slipperiness may simply comprise an estimation of slipping hazard exposures that initiate the chain of events ultimately causing an injury. However, there is also a need to consider the human capacity to anticipate slipperiness and adapt to unsafe environments for avoiding a loss of balance and an injury. Biomechanical and human-centred measurements may be utilized for such an approach, including an evaluation of relevant safety criteria for slip/fall avoidance and procedures for validation of slip test devices. Mechanical slip testing approaches have been readily utilized to measure slipperiness in terms of friction or slip resistance but with conflicting outcomes. An improved understanding of the measurement of slipperiness paradigm seems to involve an integration of the methodologies used in several disciplines, among others, injury epidemiology, psychophysics, biomechanics, motor control, materials science and tribology.     

Measurement of slipperiness: fundamental concepts and definitions.

The main objective of this paper is to give an overview of basic concepts and definitions of terms related to the 'measurement of slipperiness' from the onset of a foot slide to a gradual loss of balance and a fall. Other unforeseen events prior to falls (e.g. tripping) are sparingly dealt with. The measurement of slipperiness may simply comprise an estimation of slipping hazard exposures that initiate the chain of events ultimately causing an injury. However, there is also a need to consider the human capacity to anticipate slipperiness and adapt to unsafe environments for avoiding a loss of balance and an injury. Biomechanical and human-centred measurements may be utilized for such an approach, including an evaluation of relevant safety criteria for slip/fall avoidance and procedures for validation of slip test devices. Mechanical slip testing approaches have been readily utilized to measure slipperiness in terms of friction or slip resistance but with conflicting outcomes. An improved understanding of the measurement of slipperiness paradigm seems to involve an integration of the methodologies used in several disciplines, among others, injury epidemiology, psychophysics, biomechanics, motor control, materials science and tribology.     

Feet kinematics upon slipping discriminate between recoveries and three types of slip-induced falls

This study investigated the relationship between feet kinematics upon slipping while walking and the outcome of the slip. Seventy-one slips (induced by walking over an unexpectedly slippery surface) were analysed, which included 37 recoveries, 16 feet-split falls, 11 feet-forward falls and seven lateral falls. Feet kinematics differed between recoveries and three types of slip-induced falls, and a discriminant model including six measures of feet kinematics correctly predicted 87% of slip outcomes. Two potentially modifiable characteristics of the feet kinematics upon slipping that can improve the likelihood of successfully averting a fall were identified: (1) quickly arresting the motion of the slipping foot and (2) a recovery step that places the trailing toe approximately 0–10% body height anterior to the sacrum. These results may inform the development of task-specific balance training interventions that promote favourable recovery responses to slipping.

Practitioner Summary: This study investigated the relationship between feet movements upon slipping and outcomes of the slip. Potentially modifiable characteristics that can reduce the likelihood of falling were: (1) quickly arresting slipping foot motion and (2) a recovery step that places the trailing toe approximately 0–10% body height anterior to the sacrum.     

The influence of elderly vision degradation on subjective rating of floor slipperiness

This study investigated the influence of elderly vision degradation on subjective rating of floor slipperiness and the correlation between the subjective ratings and objective measures. Slips and falls are common causes of injures and fatalities in the elderly population. Many slips and falls may be attributed to environmental risks and misjudgment of floor slipperiness by vision degradation. Environmental risks are generally caused by a slippery floor. The coefficient of friction (COF) is one of the most commonly used indices to assess floor slipperiness. The measurements conducted in this study acquired the COF on four floors under three surface conditions (dry, sand‐covered, and wet). The results showed that the dry condition has the highest COF and the wet condition has the lowest. Thirty elderly persons and thirty younger persons were recruited for vision screening. The vision degradation in elders was significant, with most elders having eye diseases. The subjective ratings of floor slipperiness were recorded for these subjects. Although both age groups had a similar rating trend with the COF measures, the correlation between rating and COF for younger persons was significantly stronger than that for elders. The results also showed that the smooth floor and the sand‐covered condition both cause lower correlation coefficients between rating and COF for elders. The results could be used to reduce slip and fall accidents by elderly persons. © 2011 Wiley Periodicals, Inc.     

Detection of near accidents by measurement of horizontal acceleration of the trunk

The aim of the study was to develop a method for the detection and recording of sudden movements caused by a person's effort to regain balance during slipping and tripping. The method is based on the assessment of the horizontal acceleration of the trunk. A portable device was developed for recording sudden movements at work sites. The device was tested in laboratory conditions with 20 test persons. The experiments showed that the device is capable of detecting slips and even slight losses of balance which do not lead to actual falls. The acceleration levels of the trunk increased significantly in slipping incidents compared to normal walking, both in antero-posterior and medial-lateral direction.     

Biomechanics of slips.

The biomechanics of slips are an important component in the prevention of fall-related injuries. The purpose of this paper is to review the available literature on the biomechanics of gait relevant to slips. This knowledge can be used to develop slip resistance testing methodologies and to determine critical differences in human behaviour between slips leading to recovery and those resulting in falls. Ground reaction forces at the shoe-floor interface have been extensively studied and are probably the most critical biomechanical factor in slips. The ratio of the shear to normal foot forces generated during gait, known as the required coefficient of friction (RCOF) during normal locomotion on dry surfaces or 'friction used/achievable' during slips, has been one biomechanical variable most closely associated with the measured frictional properties of the shoe/floor interface (usually the coefficient of friction or COF). Other biomechanical factors that also play an important role are the kinematics of the foot at heel contact and human responses to slipping perturbations, often evident in the moments generated at the lower extremity joints and postural adaptations. In addition, it must be realized that the biomechanics are dependent upon the capabilities of the postural control system, the mental set of the individual, and the perception of the environment, particularly, the danger of slipping. The focus of this paper is to review what is known regarding the kinematics and kinetics of walking on surfaces under a variety of environmental conditions. Finally, we discuss future biomechanical research needs to help to improve walkway-friction measurements and safety.     

Occupational slip,trip, and fall-related injuries can the contribution of slipperiness be isolated?

To determine if the contribution of slipperiness to occupational slip, trip and fall (STF)-related injuries could be isolated from injury surveillance systems in the USA, the UK and Sweden, six governmental systems and one industrial system were consulted. The systems varied in their capture approaches and the degree of documentation of exposure to slipping. The burden of STF-related occupational injury ranged from 20 to 40% of disabling occupational injuries in the developed countries studied. The annual direct cost of fall-related occupational injuries in the USA alone was estimated to be approximately US$6 billion. Slipperiness or slipping were found to contribute to between 40 and 50% of fall-related injuries. Slipperiness was more often a factor in same level falls than in falls to lower levels. The evaluation of the burden of slipperiness was hampered by design limitations in many of the data systems utilized. The resolution of large-scale injury registries should be improved by collecting more detailed incident sequence information to better define the full scope and contribution of slipperiness to occupational STF-related injuries. Such improvements would facilitate the allocation of prevention resources towards reduction of first-event risk factors such as slipping.     

Occupational slip, trip, and fall-related injuries--can the contribution of slipperiness be isolated?

To determine if the contribution of slipperiness to occupational slip, trip and fall (STF)-related injuries could be isolated from injury surveillance systems in the USA, the UK and Sweden, six governmental systems and one industrial system were consulted. The systems varied in their capture approaches and the degree of documentation of exposure to slipping. The burden of STF-related occupational injury ranged from 20 to 40% of disabling occupational injuries in the developed countries studied. The annual direct cost of fall-related occupational injuries in the USA alone was estimated to be approximately US$6 billion. Slipperiness or slipping were found to contribute to between 40 and 50% of fall-related injuries. Slipperiness was more often a factor in same level falls than in falls to lower levels. The evaluation of the burden of slipperiness was hampered by design limitations in many of the data systems utilized. The resolution of large-scale injury registries should be improved by collecting more detailed incident sequence information to better define the full scope and contribution of slipperiness to occupational STF-related injuries. Such improvements would facilitate the allocation of prevention resources towards reduction of first-event risk factors such as slipping.     

Biomechanics of slips

The biomechanics of slips are an important component in the prevention of fall-related injuries. The purpose of this paper is to review the available literature on the biomechanics of gait relevant to slips. This knowledge can be used to develop slip resistance testing methodologies and to determine critical differences in human behaviour between slips leading to recovery and those resulting in falls. Ground reaction forces at the shoe-floor interface have been extensively studied and are probably the most critical biomechanical factor in slips. The ratio of the shear to normal foot forces generated during gait, known as the required coefficient of friction (RCOF) during normal locomotion on dry surfaces or ‘friction used/achievable’ during slips, has been one biomechanical variable most closely associated with the measured frictional properties of the shoe/floor interface (usually the coefficient of friction or COF). Other biomechanical factors that also play an important role are the kinematics of the foot at heel contact and human responses to slipping perturbations, often evident in the moments generated at the lower extremity joints and postural adaptations. In addition, it must be realized that the biomechanics are dependent upon the capabilities of the postural control system, the mental set of the individual, and the perception of the environment, particularly, the danger of slipping. The focus of this paper is to review what is known regarding the kinematics and kinetics of walking on surfaces under a variety of environmental conditions. Finally, we discuss future biomechanical research needs to help to improve walkway-friction measurements and safety.     

The role of surface roughness in the measurement of slipperiness.

Surface roughness has been shown to have substantial effects on the slip resistance between shoe heels and floor surfaces under various types of walking environments. This paper summarizes comprehensive views of the current understanding on the roles of surface roughness on the shoe and floor surfaces in the measurement of slipperiness and discusses promising directions for future research. Various techniques and instruments for surface roughness measurements and related roughness parameters are reviewed in depth. It is suggested that a stylus-type profilometer and a laser scanning confocal microscope are the preferred instruments for surface roughness measurements in the field and laboratory, respectively. The need for developing enhanced methods for reliably characterizing the slip resistance properties is highlighted. This could be based on the principal understanding of the nature of shoe and floor interface and surface analysis techniques for characterizing both surfaces of shoe and floor. Therefore, surface roughness on both shoe and floor surfaces should be measured and combined to arrive at the final assessment of slipperiness. While controversies around the friction measurement for slipperiness assessment still remain, surface roughness measurement may provide an objective alternative to overcoming the limitations of friction measurements.     

Effects of mental fatigue on biomechanics of slips

The objective of this study was to investigate the effects of mental fatigue on biomechanics of slips. A total of 44 healthy young participants were evenly categorised into two groups: no fatigue and mental fatigue. Mental fatigue was induced by performing an AX-continuous performance test. The participants in both groups were instructed to walk on a linear walkway, and slips were induced unexpectedly during walking. We found that mental fatigue has adverse effects in all the three phases of slips. In particular, it leads to increased likelihood of slip initiation, poorer slip detection and a more insufficient reactive recovery response to slips. Based on the findings from the present study, we can conclude that mental fatigue is a risk factor for slips and falls. In order to prevent slip-induced falls, interventions, such as providing frequent rest breaks, could be applied in the workplace to avoid prolonged exposures to cognitively demanding activities.     

The role of surface roughness in the measurement of slipperiness

Surface roughness has been shown to have substantial effects on the slip resistance between shoe heels and floor surfaces under various types of walking environments. This paper summarizes comprehensive views of the current understanding on the roles of surface roughness on the shoe and floor surfaces in the measurement of slipperiness and discusses promising directions for future research. Various techniques and instruments for surface roughness measurements and related roughness parameters are reviewed in depth. It is suggested that a stylus-type profilometer and a laser scanning confocal microscope are the preferred instruments for surface roughness measurements in the field and laboratory, respectively. The need for developing enhanced methods for reliably characterizing the slip resistance properties is highlighted. This could be based on the principal understanding of the nature of shoe and floor interface and surface analysis techniques for characterizing both surfaces of shoe and floor. Therefore, surface roughness on both shoe and floor surfaces should be measured and combined to arrive at the final assessment of slipperiness. While controversies around the friction measurement for slipperiness assessment still remain, surface roughness measurement may provide an objective alternative to overcoming the limitations of friction measurements.     

Slip resistant properties of footwear on ice

Current research on slipperiness of footwear has mainly focused on floors and lubricated floors. Slips and falls on icy and snowy surfaces involve not only outdoor workers, but also pedestrians and the general public; and occur in cold regions and in winter season in many parts of the world. However, in comparison with the size of the problem, research on slips and falls on icy and snowy surfaces has been scarce. The objective of this paper is to explore the slip resistant properties of footwear (soling materials, roughness and hardness) on ice. The coefficients of kinetic friction of four different soling materials (synthetic rubber, nitrile rubber, natural rubber and polyurethane) were measured on ice (? 12°C). The outsole roughness and hardness were also measured. Results showed that the polyurethane soling did not perform better than synthetic rubber, nitrile rubber and natural rubber on pure hard ice (? 12°C). Soling roughness was positively correlated with the coefficient of kinetic friction. The most slip resistant soling material (polyurethane) on floors and lubricated floors may not provide sufficient slip resistance on ice.     

Slip resistant properties of footwear on ice

Current research on slipperiness of footwear has mainly focused on floors and lubricated floors. Slips and falls on icy and snowy surfaces involve not only outdoor workers, but also pedestrians and the general public; and occur in cold regions and in winter season in many parts of the world. However, in comparison with the size of the problem, research on slips and falls on icy and snowy surfaces has been scarce. The objective of this paper is to explore the slip resistant properties of footwear (soling materials, roughness and hardness) on ice. The coefficients of kinetic friction of four different soling materials (synthetic rubber, nitrile rubber, natural rubber and polyurethane) were measured on ice (-12 degrees C). The outsole roughness and hardness were also measured. Results showed that the polyurethane soling did not perform better than synthetic rubber, nitrile rubber and natural rubber on pure hard ice (-12 degrees C). Soling roughness was positively correlated with the coefficient of kinetic friction. The most slip resistant soling material (polyurethane) on floors and lubricated floors may not provide sufficient slip resistance on ice.     

Assessing floor slipperiness in fast-food restaurants in Taiwan using objective and subjective measures

Slips and falls are major problems in occupational injuries in which floor slipperiness is a critical issue. Most of the studies on slipperiness assessments were conducted in laboratories. Field assessments are rarely reported in the literature. This study investigated floor slipperiness in seven kitchen areas of 10 western-style fast-food restaurants in Taiwan using both objective and subjective measurements which were conducted by friction measurements and by employees' ratings of floor slipperiness, respectively. The friction measurement results showed that the sink area had the lowest average friction in the kitchens. Employees, however, rated both the sink and back vat (chicken fry) areas as the most slippery areas. The Pearson's and Spearman's correlation coefficients between the averaged friction coefficients and subjective ratings for all 70 evaluated areas across all 10 restaurants were 0.49 and 0.45, respectively, with p < 0.0001 for both. The results indicate that average friction coefficient and perception are in fair agreement, suggesting that both might be reasonably good indicators of slipperiness.     

Coefficient of friction and subjective assessment of slippery work surfaces.

Research was conducted to determine how well subjects could distinguish between surfaces with different coefficient of friction (COF) values and to evaluate how well subjective ratings of slipperiness correlated with the actual COF values. Thirty-three ironworkers experienced in working and walking on steel surfaces and 23 university students inexperienced with these tasks participated in the study. Subjective slipperiness ratings for a variety of climbing and walking conditions were obtained from the subjects. It was found that subjects could identify differences in the slipperiness of four types of steel coatings tested in the study. There was a high correlation between the subjective ratings and the measured COF values. Subjects did not slip at a COF of 0.41 but did lose footing at a COF of 0.20.