Study on Reducing Workplace Slips with Slip-Resistant Footwear

1. Gillian Frost, Epidemiologist, HSL Health, Safety and Risk Management Network 2016 The SSHeW study: Stopping Slips among Healthcare Workers

2. Outline • Background and motivation • Study design • Participant journey • Timeline

3. Why slips at work? Kinds of specified injury to employees, 2014/15p (RIDDOR) Source: Health & Safety Executive 42% Over-seven-day injuries to employees, by kind of injury, 2014/15p (RIDDOR) Source: Health & Safety Executive 24%

4. Impact Source: Health & Safety Executive

5. Why healthcare? Numbers and rates of specified injuries due to slips and trips, by industry, 2014/15p (RIDDOR) Over-7-day injuries to employees, due to slipping, tripping, by industry sector, 2014/15p (RIDDOR) Source: Health & Safety Executive

6. The problem Flooring? • Perceptions of hygiene • Cost • Logistics and disruption • Some people need to shuffle Source: Health & Safety Executive • Community workers

7. The solution Slip Resistant Footwear! (but where’s the evidence?)

8. Previous research • An observational study in the USA found that restaurant workers who wore slip resistant shoes were 54% less likely to slip • A before and after study among fishermen suggested slip resistant boots led to a reduction in slips • A cluster randomised controlled trial of food service employees in the USA found a 64% reduction in slips

9. Which shoes are ‘slip resistant’? • Performance of ‘slip resistant’ footwear can vary widely

10. GRIP rating scheme • Based on HSL’s ramp test

11. GRIP rating scheme For more information visit: www.hsl.gov.uk/products

12. GRIP case studies • Utilities companies reduced lost time incidents from 74 to 1 • Supermarket invested £600,000 and saved £1m in claims alone in the first year • Pet food manufacturer eliminated slips and saved £12,000 within the 6 month trial period • Oil company changed their footwear and slips increased dramatically. They now only buy footwear if it’s been tested by HSL.

13. Aim To confirm, in a large pragmatic trial, that GRIP-rated slip resistant footwear can reduce slips among healthcare workers (+ economic analysis)

14. Study design • Randomised controlled trial – gold standard, best evidence • Recruit individuals and randomly allocate them to either • Intervention: Receive a pair of GRIP-rated slip resistant footwear • Control: Continue to wear their usual shoes

15. Study population • NHS employees • UK’s largest employer • Has a high number of slip injuries • Flooring where slip resistant footwear performs well • Range of occupations – for example, nurses, kitchen staff, porters, community workers • 4,400 employees across 4/5 trusts • Trusts will run one after the other

16. Data collection • 16/18 week duration • Primary outcome • Slips (whether or not they lead to a fall/injury) • Collected by weekly text message • Paper diary to aid recall

17. Data collection: Secondary outcomes • Consequence/injury; reason for slip; location • Follow-up texts? • Follow-up telephone calls? • Collect diaries? • Questionnaire at the end? • Compliance • Monthly texts • Questionnaire at the end • Telephone/face-to-face interviews

18. Data collection: Secondary outcomes • Footwear testing • To assess the typical service life of the GRIP rated footwear • 15 pairs tested at 6, 9 and 12 months (45 pairs in total) • Cost effectiveness

19. Participant timeline Week 0 Week 6 Week 18 Recruitment Run-in period Main study period Run-in Randomise Distribute • Stalls • Emails • Posters • Twitter • Informed consent • Baseline questionnaire • Assess eligibility • Slip diary • Weekly texts begin • Systems check • Baseline data • Compliance check • Weekly texts continue • Follow-up of slips • Monthly compliance texts(footwear group only) • Compliance questionnaire /interviews (footwear grouponly) • Footwear for control group

20. Trust timeline 1 year The plan Trust 1 Trust 2 Trust 3 Trust 4 The reality Trust 1 Trust 2 Trust 3 Trust 4 Trust 5…

21. Internal pilot • Will involve 2 trusts and 800 participants • Objectives: • To test and refine the recruitment strategy • To check the sample size calculations • To check loss to follow-up • To address and explore any issues regarding footwear compliance • Will have defined stop/go criteria

22. Right now… • Early stages (started October 2016) but progressing quickly • Putting together study protocol and related documentation • In talks with various trusts • Hoping to start the pilot in the New Year • Due to complete April 2019

23. Summary • Slips are the main source of injury in the workplace • They can have serious consequences for the individual and result in large cost to industry • Particular problem in healthcare

24. Summary • This study will provide high quality evidence on the effectiveness and cost-effectiveness of slip resistant footwear at preventing slips in healthcare • Other industries could use this evidence when considering use of slip resistant footwear

25. Thank you for listening Do you know a trust that may be interested in taking part or would you like more information? Gillian Frost, Epidemiologist, HSLGillian.Frost@hsl.gsi.gov.uk Mark Liddle, Falls Prevention Specialist, HSLMark.Liddle@hsl.gsi.gov.uk Any questions?

26. HSL is the commercial arm of the Health and Safety Executive, HSE. Our commercial work delivers high quality science to meet the needs of industry and government in the UK and overseas. Our commercial customers can commission services and research using our state-of-the- art scientific laboratory in Buxton, as well as analytical expertise from other parts of HSE’s science base.