Preventing Ice-Related Falls: Understand the Risks and Protect Yourself

Kentucky has experienced a particularly harsh winter this year, with heavy snowfall and icy conditions that have created hazardous environments for pedestrians. As temperatures fluctuate and surfaces freeze and refreeze, the risk of slipping on ice significantly increases—especially for older adults and those with mobility challenges. Recent data show that 10.8% of inpatient hospitalizations due to falls on ice involve a traumatic brain injury (TBI), making it critical to understand both the risks and prevention strategies.

"Of all types of falls on the same level, falls on ice and snow yield the highest percentage of TBIs. While TBIs are more commonly associated with motor vehicle crashes, pedestrian injuries, and cycling incidents, it's important to recognize that even a seemingly minor fall on ice can result in serious head trauma," said Alaina Murphy, MPH, Epidemiologist at the Kentucky Injury Prevention and Research Center (KIPRC).

Understanding who is most at risk, how TBIs from falls on ice compare to other injuries, and what steps can be taken to prevent them is essential for staying safe during winter weather.

Who Is Most at Risk for Severe Falls on Ice?

Certain groups are more vulnerable to severe falls on ice, with males and older adults experiencing higher hospitalization rates than others. Several factors contribute to this trend:

• Males are more likely to work in outdoor occupations, engage in riskier behaviors, and delay seeking medical care, all of which increase their chances of severe ice-related injuries.
• Older adults face a higher risk of falling due to age-related balance issues, decreased muscle strength, and medical conditions like osteoporosis that make fractures more likely. They are also more prone to severe complications from falls, such as TBIs and hip fractures.

However, fall risk is influenced not only by individual behaviors but also by external factors like weather conditions and major societal events. One striking example of this is the impact of the COVID-19 pandemic on ice-related falls.

COVID-19 Impact on Ice-Related Falls

During the pandemic, ice-related falls followed an unusual trend. In 2020, fall-related hospitalizations dropped significantly, likely due to lockdowns and stay-at-home orders. With fewer people commuting to work, attending events, or traveling, exposure to icy conditions was reduced.

However, by 2021, as restrictions lifted and normal activities resumed, the number of ice-related falls surged again. Additionally, colder winter temperatures that year may have contributed to more hazardous conditions.

"We saw a dip in fall-related hospitalizations in 2020, which aligns with people staying home due to COVID-19. But by 2021, as normal activities resumed, numbers went back up," noted Murphy. 

Common Types of TBIs from Ice-Related Falls

Falls on ice can lead to serious head injuries, with concussions being the most common type of TBI. Concussion symptoms include headaches, dizziness, confusion, and memory loss.

More severe TBIs—such as contusions, hematomas, and skull fractures—are also possible, particularly among older adults.

"While concussions are the most common type of TBI from ice-related falls, older adults face a higher risk of severe outcomes, including skull fractures and brain bleeds, which can have serious, long-term effects," said Murphy.

Long-Term Effects of Ice-Related TBIs

The long-term impact of a TBI from an ice-related fall varies based on severity. Even mild TBIs, such as concussions, can lead to lasting cognitive and physical effects, while more severe injuries may result in permanent impairments.

Common long-term effects include:

• Cognitive impairments: Memory loss, difficulty concentrating, and brain fog
• Physical symptoms: Chronic migraines, dizziness, fatigue, and sensory sensitivities (such as light and noise intolerance)

"Symptoms like headaches, dizziness, and memory issues can persist long after the initial injury, impacting daily life for some individuals. Recovery times vary, but being aware of the risks and taking proactive steps—like wearing appropriate footwear and avoiding icy areas when possible—can significantly reduce the likelihood of a serious fall," said Murphy.

Preventing Ice-Related Falls and Injuries

While ice-related falls can have severe consequences, there are many strategies individuals and communities can take to reduce risk:

• Wear proper footwear with good traction.
• Use railings whenever possible.
• Walk slowly and take short steps.
• Stay alert—black ice is hard to see.
• Avoid carrying heavy objects that affect balance.
• Use mobility aids if needed.
• Stick to well-lit paths and limit unnecessary trips outside.
• Keep hands out of pockets to react quickly if you slip.

 “Being proactive about safety measures can make all the difference,” said Murphy. By staying informed, Kentuckians can reduce the risk of serious falls this winter.

KIPRC is a unique partnership between the Kentucky Department for Public Health (DPH) and the University of Kentucky’s College of Public Health. KIPRC serves both as an academic injury prevention research center and as the DPH’s designee or “bona fide agent” for statewide injury prevention and control.