Bicycle helmet use to reduce the impact of head injuries in ladder users

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Ladder‐related injuries are common and result in a large number of presentations to hospitals.1 Over half of these events occur in a non‐occupational setting.1 The rate of injuries sustained from ladder falls is increasing in Australia,1 particularly in those over 50 years of age.1 Individuals in this age group are also more likely to be admitted to hospital following a fall from a ladder.4 Head injuries have been reported to occur in between 5.7 and 19.4% of patients admitted to hospital after falling from a ladder,3 ranging from minor concussion to significant traumatic brain injury (TBI). Significant TBI also appears to be closely associated with fatalities from ladder falls, with one recent study finding that 85% of patients who died following a fall from a ladder had sustained a head injury.3 The use of protective helmets while using a ladder, particularly in the non‐occupational setting, is thought to be rare.
We noted a number of significant head injuries sustained from ladder falls in our institution. We hypothesized that wearing a bicycle helmet when using a ladder would reduce the incidence and severity of head injury. Although not specifically designed for this purpose, bicycle helmets were thought to be a practical preventative option as they are relatively cheap and readily accessible in many households. Bicycle helmets have been shown to be effective in models replicating a bicycle accident;7 however, to our knowledge there have been no studies specifically assessing the efficacy of bicycle helmets in falls from a height.
The aim of our study was to determine if wearing of a bicycle helmet during ladder use could reduce the incidence and severity of head injury in the event of a fall.
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