ASTM F1694-96(2004)
(Guide)Standard Guide for Composing Walkway Surface Evaluation and Incident Report Forms for Slips, Stumbles, Trips and Falls
Standard Guide for Composing Walkway Surface Evaluation and Incident Report Forms for Slips, Stumbles, Trips and Falls
SIGNIFICANCE AND USE
This guide provides recommendations for recording walkway surface evaluation and incident report data pertaining to slips, trips, stumbles, and falls. It is intended to aid individuals or entities in the development of their own special reporting system. It is recognized that a user may use this guide in its entirety or may extract only those segments providing the level of information required. Depending on the intended use, a report form may be designed to be used alone or as a supplement to or incorporated within another report form. This guide is not a final report form. It lists items considered appropriate for inclusion into a questionnaire, document, or report.
Potential users include persons interested in the prevention and investigation of slip, trip, stumble, and fall phenomena, such as insurance company loss control specialists, industrial and commercial safety professionals, plant and facilities management personnel, forensic engineers, and research personnel concerned with factor correlation, statistics acquisition, loss control, and cost control. Data on record maintenance may be of special interest in the preparation of documents for firms seeking ISO 9000 certification.
This guide provides a systematic approach to creating a report form suitable for entry into a computerized database. Uniform data recording provides ready comparison of data between databases or evaluation within one database.
This guide provides uniform language appropriate for creating a form for manually recording information regarding pedestrian walkway evaluations and slip, trip, and fall incidents.
Requirements for Reporting—Information specific to site location and case identification is given in 6.2; information specific to walkway evaluation is given in 6.3; information specific to slip, trip, and fall incidents is given in 6.4.
SCOPE
1.1 This guide provides a listing of items that may be useful in recording and evaluating the conditions of a walkway surface, including ramps and stairs, that may involve a slip, stumble, or trip that may result in a fall.
1.2 This guide provides a listing of data that may be useful in evaluating a slip, stumble, trip, slip and fall, stumble and fall, or trip and fall incident.
1.3 Nomenclature is provided to obtain uniform language for reports.
1.4 Field lengths and codes are provided, in the appendixes, and are appropriate for recording data in a computerized database and for obtaining uniformity between databases.
1.5 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.
General Information
Relations
Standards Content (Sample)
NOTICE: This standard has either been superseded and replaced by a new version or withdrawn.
Contact ASTM International (www.astm.org) for the latest information
Designation:F1694–96(Reapproved 2004)
Standard Guide for
Composing Walkway Surface Evaluation and Incident
Report Forms for Slips, Stumbles, Trips, and Falls
This standard is issued under the fixed designation F 1694; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (e) indicates an editorial change since the last revision or reapproval.
1. Scope to slips, trips, stumbles, and falls. It is intended to aid
individuals or entities in the development of their own special
1.1 This guide provides a listing of items that may be useful
reportingsystem.Itisrecognizedthatausermayusethisguide
in recording and evaluating the conditions of a walkway
in its entirety or may extract only those segments providing the
surface, including ramps and stairs, that may involve a slip,
level of information required. Depending on the intended use,
stumble, or trip that may result in a fall.
a report form may be designed to be used alone or as a
1.2 This guide provides a listing of data that may be useful
supplement to or incorporated within another report form.This
in evaluating a slip, stumble, trip, slip and fall, stumble and
guide is not a final report form. It lists items considered
fall, or trip and fall incident.
appropriate for inclusion into a questionnaire, document, or
1.3 Nomenclature is provided to obtain uniform language
report.
for reports.
4.2 Potential users include persons interested in the preven-
1.4 Field lengths and codes are provided, in the appendixes,
tion and investigation of slip, trip, stumble, and fall phenom-
and are appropriate for recording data in a computerized
ena, such as insurance company loss control specialists,
database and for obtaining uniformity between databases.
industrial and commercial safety professionals, plant and
1.5 This standard does not purport to address all of the
facilities management personnel, forensic engineers, and re-
safety concerns, if any, associated with its use. It is the
search personnel concerned with factor correlation, statistics
responsibility of the user of this standard to establish appro-
acquisition, loss control, and cost control. Data on record
priate safety and health practices and determine the applica-
maintenance may be of special interest in the preparation of
bility of regulatory limitations prior to use.
documents for firms seeking ISO 9000 certification.
2. Referenced Documents 4.3 This guide provides a systematic approach to creating a
report form suitable for entry into a computerized database.
2.1 ASTM Standards:
Uniform data recording provides ready comparison of data
F 1646 Terminology Relating to Safety and Traction for
between databases or evaluation within one database.
Footwear
4.4 This guide provides uniform language appropriate for
3. Terminology
creating a form for manually recording information regarding
pedestrian walkway evaluations and slip, trip, and fall inci-
3.1 See Terminology F 1646 for the following term used in
dents.
this guide:
4.5 Requirements for Reporting—Information specific to
3.1.1 SIC
site location and case identification is given in 6.2; information
4. Significance and Use
specific to walkway evaluation is given in 6.3; information
specific to slip, trip, and fall incidents is given in 6.4.
4.1 This guide provides recommendations for recording
walkway surface evaluation and incident report data pertaining
5. Procedure
5.1 Preparing Report Form(s)—Use the requirements of
This guide is under the jurisdiction of ASTM Committee F13 on Pedestrian/
6.1-6.3 to prepare a floor evaluation report. Use all of the
Walkway Safety and Footwear and is the direct responsibility of Subcommittee
requirements of Section 6, including 6.4, to prepare slip and
F13.50 on Walkway Surfaces.
Current edition approved June 1, 2004. Published June 2004. Originally fall, stumble and fall, and trip and fall incident reports and
approved in 1996. Last previous edition approved in 1996 as F 1694 – 96.
reports of near falls.
For referenced ASTM standards, visit the ASTM website, www.astm.org, or
contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
Standards volume information, refer to the standard’s Document Summary page on
the ASTM website.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959, United States.
F1694–96 (2004)
6. Report 6.3.1 Slip Resistance Measurement—Theinvestigatordeter-
mineswhichmeasurementsarenecessaryandtheinstrument(s)
6.1 Form of Report—The report may be narrative or coded.
used to make the measurements. The choice of whether to test
The form may be written or computerized, or the original data
a walkway surface with a standard test foot, a test foot directly
may be written and then computerized.
related to an incident, or a test foot selected for other reasons
6.1.1 Field Length—Items for which the computer entry of
lies with the investigator. Details of the surface test are
data may be desirable are listed in Appendix X2, along with a
recorded in accordance with 6.3.1.1. The details of tests the
recommended field length.
investigator may require for a particular sole material, or a
6.1.2 This guide offers a multitude of possible answers for
particular heel material, with a surface other than the walkway
some requirements, as for footwear bottom materials and
under investigation, are recorded according to 6.3.1.2 and
walkway surface materials. A form may be composed with a
6.3.1.3.
simply stated question on the form. Possible responses may be
6.3.1.1 Walkway Surface Slip Resistance—Recordtheiden-
listed adjacent to the question, in a supplement, in instructions
tity of the instrument used to measure the surface slip resis-
that the entity issues regarding the form, or on the reverse side
tance. This may be the ASTM standard for the instrument or
of the form. The responses suggested in this guide may be
themakeandmodel.Recordadescriptionofthesurfacetested,
supplemented by responses or products unique to the entity
instrument test foot material, slip resistance of the surface
requiring the report.
clean and dry, and slip resistance of surface contaminated.
6.2 Case Identity:
Record contaminant(s).
6.2.1 Date of Report—Enter indicates the mmddyy, where
6.3.1.2 Footwear Sole Slip Resistance— Record theASTM
mmindicatesthemonth,01through12;ddindicatesthedayof
standard for the measuring instrument, or otherwise identify
the month, 01 through 31; and yy indicates the last two digits
the instrument. Record the instrument test foot sole material,
of the year.
test surface material, contaminant(s), slip resistance of the sole
6.2.2 Case Number or Identifier—Use a private alpha-
material dry, and slip resistance of the sole material contami-
numeric designation, as desired, for identifying a single case.
nated.
6.2.3 Report Type—Walkway evaluation only or incident.
6.3.1.3 Footwear Heel Slip Resistance— Record theASTM
An incident report will include a walkway evaluation. standard for the measuring instrument, or otherwise identify
the instrument. Record the instrument test foot heel material,
6.2.4 Owner Location—Report the company name, mailing
test surface material, contaminant(s), slip resistance of the heel
address, city, state, mail zip code, and country.
material dry, and slip resistance of the heel material contami-
6.2.4.1 Contact Person at Owner Location— Record the
nated.
lastname,firstname,andmiddleinitial;andtelephonenumber,
6.3.2 Walkway Structure:
including area code; telephone extension; and facsimile ma-
chine number. 6.3.2.1 Walkway Type—Record one of the following: curb,
floor, parking lot, ramp, sidewalk, stair, street, threshold,
6.2.4.2 Corporate Identifier—Use a designation, as desired.
unpaved ground, or other.
Examples are World Headquarters, XYZ Manufacturing Divi-
sion, Plant number, Organizational Unit, etc. 6.3.2.2 Walkway Construction Material—Recordoneofthe
following standard walkway constructions: abrasion-resistant
6.2.4.3 Accounting Code or Expense Code—Use a designa-
coating, asphalt plank flooring, asphaltic concrete paving,
tion, as desired. Examples are estimated cost, actual cost,
brick, carpet sheet, carpet tile, carpet indoor/outdoor type,
medical cost, compensation cost, and other contributing costs.
ceramic tile and mosaics, concrete, conductive elastomeric
6.2.5 Site Location—Record the site name, physical ad-
liquid flooring, conductive resilient, conductive terrazzo, cut
dress, city, state, zip code, country and specific location on the
natural stone tile, earth, elastomeric liquid flooring, epoxy
property, and SIC number.
marble chip, flagstone flooring, floor mat, fluid-applied resil-
6.2.5.1 Interior or Outdoors—Record as interior or out-
ient, foot grille, granite, granular paving, crushed stone or
doors.
cinders, grass, gratings, magnesium oxychloride, marble, mas-
6.2.5.2 Contact Person at Site Location—Record the last
tic fills, metal floor plates, pedestal flooring, plastic laminate
name, first name, and middle initial; telephone number, includ-
flooring, portland cement concrete paving, quarry tile, resilient
ing area code; telephone extension; and facsimile machine
tile flooring, resilient sheet flooring, resilient flooring static
number.
control, resinous, rugs, seamless quartz, slip-resistant finishes,
6.2.5.3 Date of Examination of Walkway—Enter mmddyy,
slate, steel deck, stone, thin brick tile, portland cement ter-
where mm indicates the month, 01 through 12; dd indicates the
razzo, precast terrazzo, conductive terrazzo, plastic matrix
day of the month; and yy indicates the last two digits of the
terrazzo, pressed concrete unit flooring, quarry tile, synthetic
year.
grass surfacing, vinyl composition tile or vinyl flooring, tile,
6.2.6 Person Preparing Report—Record the last name, first wood, wood decking, wood block, wood composition, wood
name, and middle initial; company name; mailing address first
parquet, wood strip, other, or as assigned by the Master List of
field, mailing address second field, city, state, mail zip code, Titles and Numbers for the Construction Industry (see X1.2).
and country; and telephone number, telephone extension, and
6.3.2.3 Surface Texture—Record whether abrasive, button,
facsimile machine number.
or cross-cut grooving; note the direction of grooves in relation
6.3 Walkway Evaluation: to the travel path, texturing, or other means intended to render
F1694–96 (2004)
the surface slip resistant; describe smooth, coarse, carpet 6.3.4.8 Contaminants and Refuse—Record whether spilled
unidentified surface, carpet runner plastic, or carpet runner contaminants and refuse are required to be cleaned up
otherthanplastic;anddescribecarpetshag,carpetwithsmooth promptly.Recordobservedorreportedfailurestocleanresidue
nap, or carpet with medium nap. promptly.
6.3.2.4 Walkway Structural Condition and Irregularities—
6.3.4.9 Surface Process—Record whether sealed, polished,
Note whether the walkway is stable, planar, flush, and even.
coated, or no surface process. Record the name by brand and
Record the nature of the irregularities. Examples for carpet manufacturer, polish, sealer, wax, ultra high-speed buffing
condition are as follows: regular, irregular carpet; and raised
polish, plastic type polish, or spray buff product.
edge, open seam, torn, worn, and buckled. Examples for other
6.3.4.10 Cleaning Method—Record the cleaning method as
surfaces are as follows: broken, even, rough, smooth, uneven.
mopped, wet mop, dry buff, dry mop, machine washed,
6.3.2.5 Walkway Load—Recordwhetherthewalkwaymeets
shampoo (carpet), spot clean, strip, dusted, or other. Describe
the requirements for safely sustaining intended loads. Record
other processes specific for wood, terrazzo, marble, concrete,
inawrittenreportcommentsandstipulationssuchasthenature
metal, or other types of walkway material.
of the irregularities or deviations from the requirements.
6.3.4.11 Buffıng or High-Speed Burnishing Method—
6.3.2.6 Surface Levelness—Record whether the walkway
Record the brand, model, and revolutions per minute of the
changes in level comply with standards. Record in a written
buffing or burnishing machine(s). Record the coarseness/color
report standards applying to the walkway and comments and
and manufacturer of the buffing pad.
qualifications such as the nature of the irregularities or devia-
6.3.4.12 Products Used on Floor—Record the brand name,
tions from the requirements.
manufacturer, and other identifying product information. Note
6.3.2.7 Handrails/Guardrails—Recordwhetherthelocation
known incompatibilities between products. Such products may
complies with the requirements for handrails and guardrails.
include stripper, sealer, polish or wax, spray buff product,
Note applicable requirements such as those in the building
general purpose cleaner, cleaner used in automatic scrubber,
code,thoserelatingtothedisabled,suchastheAmericanswith
spot cleaning product, aerosol products such as metal cleaners
Disabilities Act (ADA) and related regulations, and occupa-
used in vicinity of the floor (as on door guards), buffing
tional safety and health (OSHA) regulations and standards.
burnishing machine, buffing pads, dust mop, wet mop, and
Describe the construction of those not in compliance, and note
other products.
how they are deficient.
6.3.4.13 Compliance with Standards—Record which janito-
6.3.2.8 Intended Use—Record whether this surface is in-
rial products are in compliance with the applicable slip
tended for use as a walkway.
resistance or safety standards and which are not in compliance.
6.3.3 Surface Contaminants:
Record the standard(s).
6.3.3.1 Contaminants Present—Record the contamination
6.3.5 Maintenance Records—Record whether there are ser-
status at the time of examination: clean, cleaning solution, dirt
vice and maintenance records and whether the maintenance
(soil, unidentified), dust, grease, ice, liquid (other than sub-
records are maintained regularly.
stances in this listing), oil, overspray, particulate (paper clips,
6.3.5.1 Record Retention Policy—Summarize the record
paper, or food waste), refuse, snow, water, or other (identify).
retention policy. Record whether the required records are
6.3.3.2 Expected Contaminants—Record the contaminants
maintained in accordance with the policy.
expected to be present even though not present when the
6.3.5.2 Janitorial Products—Record whether a record is
walkway was examined.
kept for the brand and name of each janitorial product used on
6.3.4 Janitorial Practices:
the floor.
6.3.4.1 Manufacturer’s Instructions for Use—Record
6.3.5.3 Janitorial Pr
...
Questions, Comments and Discussion
Ask us and Technical Secretary will try to provide an answer. You can facilitate discussion about the standard in here.