Risk Management: Fall Protection – Whoops, I’ve Fallen and I Can’t Get Up

Joe is a laborer sweeping and cleaning up on the fifteenth floor of a new building under construction.  He is wearing a Personal Fall Arrest System (PFAS) harness and is tied off to the cable the super told him to.  While picking up some loose lumber near the edge, Joe slips on a patch of ice that he didn’t see and slides off the edge.  Joe’s fall arrest lanyard stops his fall, but he is now dangling off the side of the building.  The fire department and emergency services take almost 15 minutes to arrive and take almost the same amount of time to set up.  Almost 45 minutes after Joe fell, he is lowered by the fire department to safety and is taken to the hospital complaining of leg and hip pain.

Even before the super calls 911, an office worker in the next building takes a video and posts it on Youtube.  It is an instant viral hit, and the local TV stations rush to the site.  The unfolding drama is broadcast on all the local stations.  And it has come to the attention of the local and regional OSHA offices.

Well, all’s well that ends well, right!  Hold it; before you break your arm patting yourself on the back about how good your fall protection program is, ask yourself one question.  When the OSHA compliance officer shows up tomorrow morning, are you going to pass muster?

Workers should be trained in proper wearing of PFAS harness and what to do in case of fall.  (c) SLAC today; 2008.

Workers should be trained in proper wearing of PFAS harness and what to do in case of fall. (c) SLAC today; 2008.

Those of you who have visited this blog before know that one of my pet passions is fall protection.  I really believe that we need better attention to fall protection; too many people are getting hurt needlessly. Too many people think that “If I give out fall harnesses whenever I have a 6 foot fall exposure, I am covered for fall protection.”

But, a fall protection program is a lot more than that. It is a written plan that involves:

  • Inspection and analysis of the job and the job site
  • Planning of the job with attention to all safety hazards and exposures
  • Planning for fall protection with emphasis on hazard elimination and engineering before PPE selection
  • Planning and/or provisions for the prompt rescue or self rescue in the event of a fall
  • Communication of the planning to all those involved
  • Training for all employees on the plan and any PPE
  • Training for supervision on the plan and any PPE, and
  • Surveillance and feedback.

Most companies try to perform these functions to many varying degrees of success. But there is one often overlooked fall protection requirement. Or if not overlooked, it is usually poorly addressed. OSHA requires that the employer shall provide for prompt rescue of employees in the event of a fall or shall assure that employees are able to rescue themselves when using personal fall arrest systems [§1926.502(d)(20)]. Many employers miss this requirement or poorly address it by stating that the local fire department will perform the rescue.

The standard does not define “prompt.” OSHA acknowledges that in its interpretation letters but states that “…the word “prompt” requires that rescue be performed quickly — in time to prevent serious injury to the worker [Michael Wright (December 18, 2003)].” The standard also does not require that a written rescue plan be prepared or that a preplanning event be held.

I hope that OSHA will in the near future require a written rescue plan and require that those involved in fall rescue to train periodically.  Without this requirement, fall protection is a plan in name only and does not address the important need for prompt rescue.

The key concept here is prompt rescue. Why is it necessary to perform the rescue quickly? What is the serious injury that we are protecting workers from? Hanging in a fall protection harness can lead to suspension trauma.

What is suspension trauma? It is the potentially fatal reduction of return blood flow from the legs to the heart and brain. This occurs after a successful arrested fall when the worker is not quickly rescued or when the fall protection harness does not fit properly.

What causes suspension trauma?  Suspension trauma is caused by hanging motionless in the harness; causing blood to pool in the legs. Also, the harness leg straps may contact a key pressure point not allowing the blood to circulate.  This can result in symptoms similar to shock; feeling faint, sweating, pale skin, nausea, dizziness and loss or “graying” of vision.  Except that those people who experience shock at ground level often pass our and fall flat on the ground.  Then the body is able to better distribute blood to all organs in the prone position.

Why is this important?  If unchecked, it can lead to unconsciousness and even death.  Those who are already unconscious, or injured so that they cannot move their legs, are most at risk.  Symptoms may start in less than 5 minutes, unconsciousness in as little as 10 minutes, though usually 15 minutes or more.  Other injuries suffered in the fall can make the situation worse.  NIOSH research shows that other worker injuries result from poor fit, improper size selection, or the failure to don the harness properly.

What can I do if it happens to me?  Pay attention during fall protection training or refresher training, the information given should tell you what to do in the case of an emergency.  If you need to wear a PFAS harness, make sure that you adjust it and wear it correctly.  If you fall and remain conscious, try to remain calm and swing your feet as often as you can without tiring yourself out.  Swinging your feet will force some of the blood back towards the heart and the brain.  Not all of the blood will go back but some of it will.  If your company has bought and trained you to use a self rescuing device, then use it.  There are many different self rescuing devices on the market so I will not endorse one over another by discussing some of them.

What can I do as a manager?  Make sure that all your workers that need PFAS gear are properly trained.  Make sure that all workers know what to do in the case of an emergency.  Make sure that each worker has his/her own PFAS harness that has been properly fitted to them and is kept in good condition.  Watch your workers to make sure that they are wearing their harnesses correctly and that they are kept in good condition.  If you are relying on the local fire department for rescue, invite them to your work site and allow them to train for this type of rescue.  This will drastically reduce the fire department set up time in the event of a real rescue.  If you allow lone workers using PFAS, you need to check up on them periodically as well.


  1. There is an increased risk for unconscious (motionless) workers who have fallen wearing harnesses, including possible death within 5 minutes
  2. The attitude of the worker influences your fall protection program- motivated workers take better care of equipment
  3. Where harnesses are concerned:  One size does not fit all
  4. Training needs to spend some time on what to do in an emergency
  5. There are serious implications for prompt rescue and quick response times – it’s a matter of life and death
  6. Lone workers who are unconscious cannot self rescue nor can they call for help.

About homelandsafety

John Burke, CSP, ARM is currently seeking new opprtunties in the Safety and Risk Managment field. Previously, John was manager of health and safety compliance of Homeland Safety. John is a Certified Safety Professional and holds a designation as an Associate in Risk Management. He has been in the safety business since 1997 as a safety consultant, developer of emergency response plans, trainer and safety engineer and manager. John was also a Facility Security Officer and trainer under DHS/USCG regulations. Prior to joining Homeland, John was a technical consultant for a major insurance company and environmental and safety manager for a NY based utility. John also has experience as a firefighter and EMT. John has been an authorized OSHA construction outreach instructor and has developed and conducted training courses for construction and general safety, fire safety, incident command and emergency response. John previously taught first aid and CPR under the American Red Cross. John is a former marine engineer. He graduated from the US Merchant Marine Academy (BS), Adelphi University (MBA), and NY Institute of Technology (Graduate Certificate).
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4 Responses to Risk Management: Fall Protection – Whoops, I’ve Fallen and I Can’t Get Up

  1. Gwendolyn Arps says:

    John, is it ok if I share portions of this blog with our ASSE chapter members? We’ll certainly provide you the proper credit if we decide to use your information.

  2. deborah erchul says:

    Great information-thank you

  3. Ryan LeClaie says:

    What a way to die. I have been in the industry for 25+ years and this was the first year of hearing about this? Protection from the fall yes indeed. Best have a plan in place for the rescue. Wait until the lawyers see this?

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