By Alan Gettelman
Slips and falls are a serious public safety issue that can be mitigated through healthcare facility design. According to the Canadian Patient Safety Institute (CPSI), healthcare costs resulting from falls in Canada are estimated at $2 billion annually. Slip, trip, and fall (STF) injuries in healthcare facilities present significant concerns and are common in acute-care hospitals where patient STF incidents are 11.5 times per 1000 patient days, according to a 2015 study in the Journal of Hospital Administration. Further, patients who experience serious fall injuries while in the hospital incur healthcare costs that are on average $30,696 higher, and experience 34 days longer length of stay. Elderly patients may suffer from poor balance or decreased motor skills, and medications may complicate matters.
The cost of STF injuries for hospitals and healthcare workers is also high. An independent survey of 6000 healthcare workers in the United States, conducted by a global insurance organization, revealed that 19 per cent of hospital workers’ compensation claims are attributed to STF injuries, and 32 per cent of incurred losses on hospital workers’ compensation claims payments are from the same.
National Building Code of Canada implications
The 2015 version of the National Building Code of Canada (NBC) requires grab bars to have a ‘slip-resistant’ finish. The 2015 NBC defines ‘slip-resistant’ as “provides additional traction in wet areas.” A slip-resistant finish provides surface traction, enabling secure gripping of a grab bar.
Individual provinces have either adopted the 2015 NBC grab-bar surface requirement, or have included similar language in their building codes. The reference to ‘a slip-resistant finish’ is a major change, shifting the language from a type of grab bar surface (peened- or knurled-finish) to the resulting effect of the grab bar surface (slip-resistance).
The following list describes the language used in Canadian national and provincial building codes’ grab bar surface requirements or the code standard adopted by each province:
- the 2018 edition of the Canadian Standards Association (CSA) B651, Accessible Design For The Built Environment, says “grab bars shall be slip-resistant;”
- the 2015 edition of NBC says “grab bars shall be slip-resistant and free of any sharp or abrasive elements;”
- the 2018 edition of the Alberta Building Code (ABC) and the upcoming 2019 version of the Alberta Barrier Free Design Guide will reflect the most recent version of NBC by requiring a slip-resistant grab bar finish;
- the 2012 edition of the British Columbia Building Code (BCBC) and 2014 British Columbia Building Access Handbook recommends “grab bars have a non-slip finish;”
- the 2012 edition of the Ontario Building Code (OBC) requires a “slip-resistant surface,” and the 2005 edition of the Accessibility for Ontarians with Disabilities Act (AODA) requires “a slip-resistant surface for grab bars” in transportation only;
- Manitoba reflects the most recent version of NBC;
- Saskatchewan has adopted the most recent version of NBC;
- Newfoundland and Labrador, New Brunswick, and Nova Scotia building codes have also adopted the 2015 NBC;
- major municipalities in Prince Edward Island have adopted the 2010 NBC, which does not address grab bar surface finish type; and
- the Northwest Territories, Nunavut, and Yukon building codes have adopted the 2015 NBC.
Designers continue to specify grab bars with a peened or knurled finish. However, ASTM F2961, Standard Test Method for Characterizing Gripping Performance of Gloves Using a Torque Meter, places satin-finish grab bars atop the consideration set, especially for healthcare facilities that must satisfy the 2015 NBC, CSA B651 2018, or various provincial codes.
For areas where a slip-resistant grab bar is not required by the building code, specifying one exceeds the minimum requirement providing added traction supporting universal design.
Since the change in code language is relatively recent, there is no a specific ASTM testing methodology for establishing the slip-resistance attributes of grab bars in order to meet the various building code requirements. However, existing ASTM testing methodologies, such as F2961, provide a reliable standard manufacturers can use to provide quantitative analysis of slip-resistance of satin-finish grab bars compared to peened finish grab bars.