Low level risks

Low level risks

Wagstaff, Dave

Injuries caused by slippery floors hurt managers as well as clinical staff and patients, though the right floor can provide a safe environment even when wet. Dave Wagstaff reports for HD.

A recent Nuffield Trust report entitled `Improving the health of the NHS workforce’ states that sickness absence costs the NHS 700m per year. According to the Health and Safety Executive (HSE), injuries to NHS staff include slip/trip accidents, manual handling accidents, and injuries sustained through physical violence. Of course with Crown Immunity having been abolished, the manager or executive directly responsible for health and safety is accountable for injuries to NHS employees and members of the public. The HSE can prosecute resulting in fines or imprisonment if the responsible person is found to be negligent for breaches of the Health And Safety At Work Act.

Of the injuries sustained, the HSE reports that slip/trip accidents account for 54% of all major injuries to employees within the NHS. Equally disturbing is the fact that 71% of all major injuries to members of the public were caused through slip/trip accidents. In all, a total of 32 255 slip/trip accidents were reported to the HSE in 1996 with an estimated 39 665 days lost through absenteeism. The injuries sustained included back injuries (41%), strains and sprains (21%) to fractures (9%). The direct cost to the NHS has been estimated at L24.6m for major injuries alone in that year.

Wet conditions account for 99% of slip/trip accidents. Slippages in wet conditions are primarily caused by a liquid film being trapped between the sole of the foot/boot and the surface of the floor. The thicker the film, the less the resistance to motion, the greater the chance of slippage. It follows that a more porous floor has less chance of liquid build up on the surface and hence less likelihood of slippage.


Floors with very low porosity, such as glazed tile, marble, sealed terrazzo, vinyls, sealed wood and concrete all experience high rates of slippage. Floors with high porosity, such as quarry tiles, unsealed concrete and wood experience lower rates of slippage. However, for floors with high porosity, staining is much more prevalent leading to cleaning and hygiene problems. As cleaning operations become less effective porosity is gradually reduced until the onset of slippage occurs. This is frequently experienced with quarry tiles in kitchen areas.

It is still common for flooring manufacturers to specify high coefficients of friction (resistance to slippage) implying allround performance for both wet and dry conditions. However this is seldom the case, making the architect’s job extremely difficult when specifying floors for wet environments.

The vast majority of the floor safety systems on the market today mimic sandpaper design whereby a hard aggregate protrudes the main bulk of the floor surface to provide the resistance to slippage. These surfaces provide both good resistance in dry and wet conditions. The main criticism levelled at such systems is the accelerated level of wear in high traffic areas and the difficulty of cleaning experienced as dirt particles pick up static charge and bond to the aggregate.

This effect of dirt accumulation has been reduced somewhat by some flooring manufacturers who now seal around the aggregates preventing attraction. Safety flooring manufacturers adopting this technique include manufacturers of anti-slip vinyls, epoxy resin coatings and antislip paints.

The other main type of floor safety system available on the market is in situ treatments which cause roughening of the original surface. Processes such as etching and sandblasting transform smooth original surfaces such as ceramic tile, terrazzo and marble into a roughened anti-slip finish. The troughs within the roughened surface can be sealed to prevent dirt build-up. However to achieve a roughened state the surface gloss is usually damaged in the process, reducing its aesthetic appearance and increasing the wear rate of the original surface.

Building/facilities managers often turn to in situ treatments when faced with slippery floors when the only alternative option is to replace a floor which is extremely expensive, ranging from L50 to L100 per square metre.

As more pressure is exerted by the Government to reduce accident rates and reduce absenteeism costs, more emphasis is being placed on health and safety issues and overall improvement of the worker environment.

With limited budgets it is essential that facilities and health and safety managers make informed decisions on choosing appropriate safety systems to remedy slippery floors.


Issis has developed a new onestop shop service geared towards identifying and solving slip/trip risks for the health sector. A survey is conducted to identify potential `high risk’ areas. The company operates a ‘BATWEB’ (Best Available Treatment Within Existing Budgets) approach to remedy medium-high risk areas on a long-term basis.

The system is proving highly successful within the health service. The company works with risk, health and safety and facilities managers to produce a risk reduction plan allocating appropriate funds to the level of risk for each floor area.

One trust that has used the concept is the Royal Victoria Infirmary Trust in Newcastle, which has applied the Issis BATWEB approach to its premises in order to reduce the levels of slip accidents. High-risk areas identified for treatment include ward areas with wooden floors, walkways with vinyl floors and bathroom/toilet areas with glazed tiles.

The treatments cause minimal disruption to operations, lasting between 2-4 hours and are carried out at times convenient to the hospital. Emphasis is placed on maintaining the aesthetic appearance of the original floor with ease of cleaning, hygiene and long term wearabilty.

Copyright Wilmington Publishing Ltd. Nov 1998

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