Draping electric icicles around the eaves, hanging wreathes and placing the angel atop a tall tree are only three parts of holiday decorating that often require the use a ladder. Paramedics at American Medical Response say falls from ladders and stepladders pose a hazard and can cause serious injury.

The National Safety Council and Centers for Disease Control and Prevention report that several thousand people in the United States are injured in falls from ladders each year. The American Academy of Orthopedic Surgeons reports that men and the elderly are at higher risk of injury from falling.

“Elderly persons are more likely to fall from ladders because their vision and balance may have changed, and when they fall, they often require longer rehabilitation, said AMR spokesperson Devin Miracco. “Men are more likely to be overconfident about using ladders and therefore take greater risks using them.”

People who fall from ladders can suffer head injuries as well as multiple orthopedic injuries, Miracco said.

According to the Home Safety Council, misuse of the ladders is widespread. In a recent survey, the council found more than half of those injured placed the ladder on uneven ground. Nearly half reached farther than they should. Almost 40 percent fell after dark, and more than a third fell after standing on the top two ladder steps. More than 20 percent drank alcohol while using the ladder.

Miracco offers the following tips to prevent ladder injuries:

• Before climbing a ladder, think about your health. If you have lost strength or it is harder to keep your balance, stay off the ladder. If your instincts warn you to beware of climbing ladders, stay off of them.

• Keep your ladders in good condition. Check ladders for cracks or weak spots. Be sure rungs are sturdy and locking devices work properly.

• The feet of the ladder must rest on a surface that is firm, level, dry and not slippery.

• If you’re using power equipment with cords, be absolutely sure the cords are in good condition. Metal ladders will carry an electrical jolt if a frayed cord is touching the ladder when the cord is plugged in.

• Wear shoes that are dry and have enough tread to prevent slipping.

• Never use a ladder in front of a door someone may open.

• Insist that another person hold the ladder anytime someone is on it.

• Follow manufacturer’s warnings on weight limits.

• Keep both feet on the same rung while you are working. It’s safer to maintain three points of contact with the ladder at all times.

• Do not stand on either of the top two rungs. Never stand on the top level of a ladder.

• Do not reach or lean so far in any direction that you cannot keep both feet flat on the rung you are standing on. If necessary, climb down, move the ladder closer to the spot you need to reach, then climb back up and reach safely.

• Keep your tools on a belt or in your pockets so both hands will be free when you’re going up or down the ladder.

• Do not use ladders when you have consumed alcohol.

• Do not use ladders outside on days with stiff winds.

• When leaning a ladder against a wall, move the bottom of the ladder away from the wall one fourth of the height of the ladder.

• Do not lean ladders against gutters or other weaker parts of a building that may break away. Some ladders have built-in stand-off bars that hold the ladder off gutters and other soft parts of a structure.

• Climbing onto the roof from a ladder can be especially dangerous.

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Reporters seeking more information or interviews may call county Public Information Director Jess Williams at (575) 525-5801.