Are elevators really hazardous to your health?

It’s a question many people are asking after two elevator accidents killed two women in two weeks. Last week, Annette Lujan was crushed by an elevator at Cal State Long Beach after she tried to climb out of a stuck car. On Wednesday, Suzanne Hart died after an elevator door in her Manhattan office building closed on her leg as she was stepping in and dragged her body up into the elevator shaft.

The incidents were tragic but also very rare. According to ConsumerWatch.com, “U.S. elevators make 18 billion passenger trips per year.” Those trips result in about 27 deaths annually, according to estimates from the U.S. Bureau of Labor Statistics and the Consumer Product Safety Commission. That works out to a fatality rate of 0.00000015% per trip.

Injuries and deaths are so uncommon that there isn’t much written about them in the medical literature. A 2009 report in Occupational Health and Safety notes that people who install and maintain elevators may become injured in a variety of ways, including, “falls, electrical shocks, muscle strains and other injuries related to lockout/tagout, confined spaces, scaffolds, cranes, rigging, hoisting and heavy equipment.”

The safety profile for passengers is much better. “Because of the intricate, redundant and regulated safety features built in to every elevator, catastrophes are rare outside of movies and TV,” according to the report. So-called rope elevators require only one woven steel cable, but they usually have four to eight cables just in case. In addition, elevators are equipped with “automatic braking systems” that are backed up by “electromagnetic brakes.” Finally, the report notes, “at the bottom of the shaft is a heavy-duty shock absorber system designed to save passengers if all else fails.”

The Journal of Forensic and Legal Medicine has a case report of a 48-year-old elevator maintenance worker who died when an unfinished elevator suddenly dropped about 10 feet. A team of doctors and a physicist in Europe concluded that the initial drop wasn’t necessarily fatal. But because the elevator car was much heavier than the man, it reached the bottom first and transferred kinetic energy to the man when he hit the floor – catapulting him about 20 feet back into the air. His fall from that height crushed his skull and caused his brain to hemorrhage, the team reported.

If an escalator is an option, it might be an even safer way to go. A 2008 study in the journal Accident Analysis and Prevention examined 14 years’ worth of data on escalator injuries sustained by senior citizens in the U.S. Researchers tallied nearly 40,000 escalator-related injuries among the study population (average age 80.1 years) and calculated that the injury rate was 7.8 per 100,000 -- but there were no deaths.

A 2006 report in the journal Pediatrics found that children were generally safe on escalators as well, with an injury rate among 0-to-19-year-olds of 2.6 per 100,000. Children under 5 were most likely to be hurt, though their injury rate was only 4.8 per 100,000. More than half of the injuries observed over the 13-year period studied were a result of falls. There were no reports of fatalities, but 833 of the roughly 26,000 injuries involved amputations or avulsions.

In 1992, researchers from two British hospitals examined 50 consecutive cases of patients with escalator injuries and found that 64% of them were a result of tripping or being pushed while walking as the escalator was moving. (Alcohol was involved in nearly half of those cases.) The rest of the injuries occurred because people fell when they tried to step on or off of the escalator. The findings were published in the journal Injury.

Or you could take the stairs.

Return to Booster Shots blog.