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624 Healthcare: Slip, Trip, and Fall Prevention
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Stairs and Handrails

Each year stairway accidents cause over one million injuries and 12,000 deaths at home, work, and other locations. Proper construction and maintenance of stairs and handrails can reduce hazards. Stairs that are poorly marked or uneven, as well as handrails that are not the appropriate height, size, or are poorly maintained can lead to missteps and cause employees to trip and fall.

The handrail in this image was lowered in order to hang a large picture above. The handrail is too low to be of use.

You don't have to fall far to suffer a fatality when descending stairs. An employee was descending a staircase when he fell down the first few stairs to the landing below and hit his head on the floor causing blunt force trauma. He was taken to a local hospital, where he died. (OSHA Accident Report - 1/4/2021)

Where does the Hazard Occur?

  • Indoor and outdoor stairs
  • Steps inside classrooms or conference rooms
  • Elevated and/or sloping walkways
  • Parking structures
  • Ramps
Maximum Overhang for
Stair Tread Nosing

Prevention Strategies

  • Create visual cues. Paint safety yellow or other high contrast paint, tape, or highlight the edge (nosing) of each step, including the top and bottom, to provide a cue of a change in elevation.
  • Check that stair treads and nosing are slip resistant and along the whole tread. This is especially important for outside stairs exposed to the elements or stairways exposed to wet conditions.
  • Ensure that stairs are kept free of ice, snow, water, and other slippery contaminants.
  • Check that stairwells have adequate lighting.
  • Consider adding a handrail at locations that have less than 4 steps (such as employee shuttle bus stop, building entrances, conference theaters).
  • Confirm all handrails are within an appropriate height range (34 to 38 inches from the stepping surface).
  • Check that discontinuous handrails are of a consistent height.
  • Check that handrails extend full length of stair and extend 12 inches at top and one tread depth at bottom.
  • Check that handrails are available on both sides. For stairs greater than 44 inches wide, two handrails are recommended. For stairs less than 44 inches, at least one handrail on the right side of the descending stairway should be available.
  • For open stairways, check to ensure a two-rail system is present; a top rail at 42 inches and a second handrail at 34 inches minimum and 38 inches maximum vertically above stair nosings. Protect the open area under the top rail to the stairway steps by installing a fixed barrier.

Knowledge Check Choose the best answer for the question.

1-10. To help prevent stairway injuries, check that stair treads and nosing are _____.