What to do if a Worker Falls


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Falls are the leading cause of jobsite deaths in the construction industry, and account for 30% of nonfatal injuries. Fall prevention is also the most frequently violated OSHA standard, according to the agency.

[Related: How to design safety training materials workers will read]

A webinar hosted by the Center for Construction Research and Training (CPWR) makes clear that it’s not just a fall that can be dangerous. Workers suffer serious health consequences when their fall arrest equipment works as expected.

Suspension trauma or hanging syndrome, also called orthostatic intolerance, occurs when workers suffer a fall but are saved by their harness. It’s caused by blood pooling in the veins, and can come on quickly.

“Unconsciousness can occur in under one minute if conditions are appropriate,” Chad Riddleberger, captain and leader of the Technical Rescue Team at Roanoke Fire-EMS in Virginia, explained. “If you become unconscious and stop breathing, we have about six minutes to start providing some type of respiratory support. … After eight minutes, you become brain dead.”

Riddleberger described what happens to the human body when it is suspended in a fall protection harness.

“When we start having pooling of blood, it is starting to build up toxins in the body,” he said.

Early warning signs mimic the flu, including faintness, sweating, paleness, hot flashes, increased heart rate and nausea, he said. Over time, dizziness, slower heart rates, low blood pressure and loss of vision may set in.

Riddleberger noted that these are the same symptoms that occur during a trench collapse and a worker is pinned from the waist down.

Orthostatic intolerance doesn’t only happen after an arrested fall. Workers who stand for long periods of time without moving their legs may also suffer orthostatic intolerance. Riddleberger noted that anything that affects circulation, from blood pressure medications to dehydration, as well as environmental factors or a recent illness, can contribute to orthostatic intolerance.

‘Time is brain’

Education for builders’ entire crew is critical. As Riddleberger noted, from the time it takes rescue crews to get a call, arrive at the scene, find the injured person, analyze the situation and determine what needs to be done, and begin administering care, it could be as much as 30 minutes. Employers and workers need to understand how to react when a worker falls so that recovery efforts can begin immediately.

“If you can get yourself in what we consider the ‘position of refuge,’ you are buying time for yourself. Not only are you buying time for yourself, now you’re buying time for me,” he said.

Colorado Builder
Colorado Builder
Colorado Builder content specialist


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