Self-reported risk taking predicts handrail use on a stepladder in older adults

Identify individual factors that predict handrail use and quantify the impact of handrail use on balance while using a stepladder.

Ladders are among the riskiest consumer products especially for older adults. Individual factors such as physiological capacity or risk-taking propensity have been found to influence safety behaviors and fall risk. When available, the use of a handrail is a common safety strategy for stabilizing balance. Thus, there is potential for individual factors to influence handrail use, and for their combined effect to influence balance while using a ladder.

Participants (n = 104) over 65 years completed physiological, cognitive, risk-taking, and stability assessments and were subsequently asked to undertake a lightbulb changing task using a stepladder. A force plate measured the center of pressure under the ladder and videos were analyzed to characterize participant handrail use during the task. Univariate and multivariate logistic regression analyses were performed to determine the individual factors associated with handrail use. The effect of handrail use (controlling for individual factors) on stability while completing the ladder task was analyzed.

Self-reported risk-taking was a predictor of handrail use, where a lower risk-taking score correlated with a higher probability of using the handrail. Individuals with poor balance were more likely to use the handrail, but self-reported risk-taking was a stronger mediator of handrail use. Neither the use of the handrail nor the individual factors were found to influence stability during the ladder task, suggesting a more complex relationship between individual behavior and physical ability on stability in hazardous working conditions.

This study suggests that self-reported rating of risk-taking is associated with observable behaviors during ladder use.

Such ratings may be useful in screening safety behaviors of older ladder users.