A prospective study of floor surface, shoes, floor cleaning and slipping in US limited-service restaurant workers

Santosh K. Verma, Wen Ruey Chang, Theodore K. Courtney, David A. Lombardi, Yueng Hsiang Huang, Melanye J. Brennan, Murray A. Mittleman, James H. Ware, Melissa J. Perry

Research output: Contribution to journalArticlepeer-review

59 Scopus citations


Objectives: Slips and falls are a leading cause of injury at work. Few studies, however, have systematically examined risk factors of slipping outside the laboratory environment. This study examined the association between floor surface characteristics, slip-resistant shoes, floor cleaning frequency and the risk of slipping in limited-service restaurant workers. Methods: 475 workers from 36 limited-service restaurants from three major chains in six states in the USA were recruited to participate in a prospective cohort study of workplace slipping. Kitchen floor surface roughness and coefficient of friction (COF) were measured in eight working areas and then averaged within each restaurant. The use of slip-resistant shoes was determined by examining the participant's shoes and noting the presence of a 'slip-resistant' marking on the sole. Restaurant managers reported the frequency of daily kitchen floor cleaning. Participants reported their slip experience and work hours weekly for up to 12 weeks. The survey materials were made available in three languages: English, Spanish and Portuguese. The associations between rate of slipping and risk factors were assessed using a multivariable negative binomial generalised estimating equation model. Results: The mean of individual slipping rate varied among the restaurants from 0.02 to 2.49 slips per 40 work hours. After adjusting for age, gender, BMI, education, primary language, job tenure and restaurant chain, the use of slip-resistant shoes was associated with a 54% reduction in the reported rate of slipping (95% CI 37% to 64%), and the rate of slipping decreased by 21% (95% CI 5% to 34%) for each 0.1 increase in the mean kitchen COF. Increasing floor cleaning frequency was significantly associated with a decreasing rate of slipping when considered in isolation but not after statistical adjustment for other factors. Conclusion: These results provide support for the use of slip-resistant shoes and measures to increase COF as preventive interventions to reduce slips, falls and injuries.

Original languageEnglish (US)
Pages (from-to)279-285
Number of pages7
JournalOccupational and Environmental Medicine
Issue number4
StatePublished - Apr 2011
Externally publishedYes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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