B.F. Ribeiro, British Medical Journal

In the six months I spent in the same way as an accident official by the side of the Middlesex hospital I treated seven window cleaners who had been injured by falls. Four were permanently disabled and unable to return to their occupation. In the sphere of observe of the disabilities produced by the injuries and to re-evaluation the safety values used by window cleaners I undertook a presentation survey of a supplementary 13 patients with related injuries.

All the injuries resulted from falls from ladders or else window sills and the patients fell into two groups: Crowd 1 consisted of nine patients with minor fractures or else soft tissue injuries requiring outpatient healing, and crowd 2 consisted of 11 patients with multiple injuries, who were all admitted to hospital; four necessary emergency surgery. Falls from heights less than 6-1 m (20 ft) produced relatively minor injuries to the arms in the sphere of seven of the nine patients in the sphere of crowd 1, while falls from greater heights produced multiple injuries to the legs or else trunk in the sphere of 10 of the 11 patients in the sphere of crowd 2 (see table). In the sphere of the arm fractures around the wrist common predominated. In the sphere of the prop injuries concerning the ankle common and calcaneum were nearly everyone nothing special; in the sphere of three patients the injury was bilateral. In the sphere of three patients compression fractures of the vertebrae complicated prop fractures. Common dislocations occurred in the sphere of four patients and in the sphere of single (case 15) involved three separate joints. Interior injuries occurred in the sphere of just single long-suffering and proved fatal (case 20).

Near were rebuff disabilities reported amongst the patients in the sphere of crowd 1. The nearly everyone nothing special disability in the sphere of crowd 2 resulted from fractures of the calcaneum. As soon as the breakage involved the subtalar common the resultant loss of inversion and version produced instability with the aim of made exert yourself on uneven surfaces unfeasible. All six patients with fractures of the calcaneum complained of torture in the sphere of the heel from single to four years subsequently injury. Two patients residential extraordinary complications. In the sphere of issue 16 an ischaemic contracture of the prolonged flexors of the toes produced a heavy-going claw end. In the sphere of issue 15 subluxation of the subtalar and middle tarsal joints persisted subsequently disarticulation; despite the combined varus de formity and instability the long-suffering refused surgical correction. The common stay in the sphere of hospital of patients in the sphere of crowd 2 was two months, and rehabilitation was necessary in the sphere of eight, nothing of whom may well return to window cleaning. Two patients returned to window cleaning in place of six months sooner than decision other exert yourself by the side of ground level. By the side of 'the moment of symbols, seven panients were employed by the side of various jobs by the side of ground level and three patients were unemployed. The other long-suffering died.

Near are two types of defending equipment to be had to window cleaners: A body harnesses underneath the in one piece body and body belts worn around the waist with a linking line to allow space in place of manoeuvring. All permitted appliances ought to bear a British Standard smudge giving impermeable of their capability to support the burden of the falling body. Regulations in place of the addiction of anchors require steel hooks; or else staples to be located embedded in the sphere of the outside fence so in the same way as to allow the cleaner to affix and free his line from the inside of the building.

Ladders ought to be located well held and prevented from stirring on slippery surfaces. The recommended greatest height in place of using a ladder is 9'2 m (30 ft). Not surprisingly, therefore, nearly everyone cleaners in the sphere of this succession used window sills or else parapets as soon as working over this height. In the sphere of two patients injuries occurred while the cleaner was stepping from single ridge to the subsequently to save moment. The building of administrative center blocks with hefty break the surface areas of goblet income with the aim of these windows arrange to be located cleaned from the outside using mechanical hoists and cellular phone platforms. Elder buildings were designed to be located cleaned from the inside and. Only some, therefore, provide the crucial attachments in place of safety belts or else harnesses.

Despite the obvious difficulties in the sphere of claiming compensation only some of the cleaners had insured themselves contrary to injuries. Just three in the sphere of crowd 2 were insured; the end prearranged by the other seven cleaners in place of not seeking insurance cover were habitually with the aim of of superior insurance premiums and poor cover in the sphere of the event of fatality. Round about window cleaners who contracted their services to cleaning agencies assumed with the aim of they were insured by them in place of individual injuries as soon as in the sphere of piece of evidence they were just covered in place of death.