Holiday Decorating Falls: Ladder and Roof Injury Study (2016 to 2025)
A CRS Roofing & Construction data study. Source: U.S. Consumer Product Safety Commission, National Electronic Injury Surveillance System (NEISS), 2016 through 2025. All totals are national estimates.
Headline finding
An estimated 46,400 Americans went to the emergency room over the last 10 years after a ladder or roof accident while decorating or hanging lights, and 74% of those visits came in November and December. In those two months the average is about 1,700 visits per month, versus about 120 in a typical month the rest of the year.
~4,600
Estimated ER visits per year, ladder or roof incidents while decorating
74%
Share in November and December (plus 14.9% in January)
31.8%
Patients age 65 and older
36.3%
Diagnosed with a fracture, the most common injury
Key Findings
- The spike is real and it is huge. November and December averaged about 1,700 estimated ER visits per month, roughly 14 times the 120 per month seen from February through October and January combined. December alone accounted for an estimated 21,000 visits over 10 years.
- Thanksgiving weekend kicks it off. Thanksgiving Thursday through Sunday held 13.1% of all November and December visits, about twice what four days would get if visits were spread evenly (6.6%). That is about 450 estimated ER visits each Thanksgiving weekend. December 1 to 15 was the busiest stretch of the season.
- Weekends are riskier. Saturdays and Sundays held 38.8% of November and December visits, compared with the 28.6% they would hold if every day were equal.
- Older adults are hit hardest. 51.6% of patients were 55 or older and 31.8% were 65 or older. 33.4% of patients 65 and older were admitted or transferred to another hospital, compared with 19.3% of younger patients.
- Ladders cause most of it, roofs cause the worst of it. 87.4% of estimated visits involved a ladder only. 10% involved a roof without a ladder, and 2.6% involved both. 93.5% of narratives describe a fall.
- Fractures and head injuries lead. 36.3% of visits were fractures. The head (18.5%), lower trunk including hips and lower back (17.2%) and upper trunk including ribs (13.4%) were the most injured body parts. 65.6% of patients were male.
Holiday Decorating Ladder and Roof Injuries by Month
Estimated ER visits by month of treatment, average per year, 2016 through 2025.
The Season, Half Month by Half Month
Total estimated ER visits over 10 years in each half of November and December.
Who Gets Hurt: Age Groups
| Age | Est. ER visits (10 yrs) | Share | Sample cases |
|---|---|---|---|
| Under 18 | 626 | 1.3% | 26 |
| 18 to 39 | 11,168 | 24.1% | 223 |
| 40 to 54 | 10,683 | 23% | 218 |
| 55 to 64 | 9,168 | 19.8% | 197 |
| 65 to 74 | 8,969 | 19.3% | 165 |
| 75 and older | 5,794 | 12.5% | 103 |
Most Common Injuries and Body Parts
| Diagnosis | Est. visits | Share |
|---|---|---|
| Fracture | 16,829 | 36.3% |
| Internal organ injury | 6,643 | 14.3% |
| Other | 6,479 | 14% |
| Strain or sprain | 5,148 | 11.1% |
| Contusion or abrasion | 5,029 | 10.8% |
| Laceration | 3,419 | 7.4% |
| Concussion | 1,053 | 2.3% |
| Dislocation | 887 | 1.9% |
| Body part | Est. visits | Share |
|---|---|---|
| Head | 8,599 | 18.5% |
| Lower trunk (lower back, hip, pelvis) | 7,992 | 17.2% |
| Upper trunk (ribs, chest, back) | 6,212 | 13.4% |
| Shoulder | 3,232 | 7% |
| Ankle | 2,681 | 5.8% |
| Wrist | 2,594 | 5.6% |
| Foot | 2,480 | 5.3% |
| Knee | 2,003 | 4.3% |
Ladder vs. Roof
| Incident involved | Est. ER visits (10 yrs) | Share | Sample cases |
|---|---|---|---|
| Ladder only | 40,545 | 87.4% | 803 |
| Roof, no ladder mentioned | 4,651 | 10% | 101 |
| Ladder and roof | 1,213 | 2.6% | 28 |
What the CPSC Says
- About 14,800 people were treated in hospital emergency departments for holiday decorating related injuries in the 2022 holiday season (Nov 1, 2021 to Jan 31, 2022), about 160 per day, with over 40% involving falls. (CPSC)
- About 14,700 holiday decorating related ER-treated injuries in the prior holiday season; falls were the most frequent incident type (41%), followed by lacerations (10%) and back strains (5%). (CPSC)
The CPSC figures cover all holiday decorating injuries, including cuts from ornaments and strains from lifting trees. This study looks only at the subset involving a ladder or a roof.
Safety Tips for Panhandle Homeowners
NEISS has no state or city data, so these numbers are national. But Amarillo and Lubbock homes add their own risks: strong wind, sudden ice, and many steep or metal roofs.
Hire a pro for roofline lights
- Second story eaves, steep pitches and metal roofs are where a fall does the most damage. A crew with harnesses, roof anchors and the right ladders is safer than a holiday afternoon on your own.
- Use clips made for shingles or gutters. Nails, staples and screws through roofing can cause leaks that show up months later.
- If you are not sure your roof is safe to walk, our Amarillo roofing and Lubbock roofing crews can look at it first.
Ladder safety basics
- Set an extension ladder on firm, level ground at about a 1 to 4 angle: one foot out for every four feet up. Extend it 3 feet above the edge you step onto.
- Keep three points of contact. Do not reach past your belt buckle; climb down and move the ladder.
- Never stand on the top cap or top step of a stepladder. Have a helper hold the base.
- Check the duty rating against your weight plus what you carry, and keep metal ladders away from power lines.
Steep, icy and windy roofs
- Stay off any roof that is wet, frosty or icy. Panhandle mornings often frost over even after a warm day.
- Do not work up high in strong or gusty wind. Wind can push a ladder and catch a strand of lights like a sail.
- Metal and steep roofs can be slick even when dry. If you would not walk it in July, do not walk it in December.
- Older adults face the highest rate of hospital admission in this data. Consider leaving the ladder work to someone else.
Methodology
- Source. CPSC NEISS public annual case files for 2016 through 2025 (10 full years, 3,565,774 total sample cases). NEISS collects emergency department records from a probability sample of about 100 U.S. hospitals.
- Case selection. A case was counted when its narrative or product codes showed decorating (holiday words such as Christmas or holiday together with lights, decorations, ornaments, wreaths or garland; any mention of decorating; hanging or taking down lights; or the NEISS Christmas lights and Christmas decorations product codes) and also involved a ladder (narrative or the ladder and stepladder product codes) or a roof (narrative). 932 sample cases matched.
- Estimates. National estimates sum the NEISS statistical weight for each case. They are estimates with sampling error, and we round headline figures. CPSC treats estimates based on fewer than 20 cases or under 1,200 visits as potentially unstable; monthly figures outside October through January fall below that bar.
- Definitions. Ages are at treatment. "Admitted" includes patients admitted or transferred to another hospital. NEISS often codes closed head injuries as "internal organ injury," which explains that diagnosis's high rank. Thanksgiving weekend is Thanksgiving Thursday through Sunday each year.
- Caveats. NEISS has no state, county or city data, so no Texas figure is possible. Narratives are short and written by hospital coders, so some decorating falls are missed and a few cases involve non-Christmas decorating (such as Halloween). Because some product codes in common use for ladders and holiday items did not match their expected categories in the public files, we relied on the codes verified against narratives plus keyword matching. Results cover ER visits only, not deaths at the scene, urgent care or doctor visits.
Free to Use
Free to use with credit and a link to CRS Roofing & Construction. Please cite "CRS Roofing & Construction analysis of CPSC NEISS data" and link to https://crsroofer.com/holiday-ladder-roof-fall-study.
Holiday Ladder and Roof Fall Study FAQ
How many people go to the ER after falling while hanging Christmas lights?
Based on CPSC NEISS data for 2016 through 2025, CRS Roofing estimates about 4,600 emergency department visits per year nationwide for injuries involving a ladder or roof while decorating or hanging lights. That is about 46,400 over the 10 years. These are national estimates built from a sample of hospitals, not exact counts.
When do holiday decorating ladder falls happen most?
74% of the estimated visits came in November and December, and another 14.9% came in January, when decorations come down. The busiest half month was December 1 to 15. The four days of Thanksgiving weekend held 13.1% of November and December visits, about double their share of the calendar.
Are older adults more at risk?
Adults 65 and older made up 31.8% of the estimated visits. They were also more likely to be admitted or transferred: 33.4% of their visits, compared with 19.3% for patients under 65.
What injuries are most common?
Fractures were the most common diagnosis at 36.3% of estimated visits. The head was the most often injured body part (18.5%), followed by the lower trunk, which includes the lower back and hips (17.2%).
Is there data for Texas, Amarillo or Lubbock?
No. NEISS does not publish state, city or hospital location, so this study is national only. The safety advice applies to Panhandle and South Plains homes, where wind, ice and steep or metal roofs add risk.
Can I use this data in a story?
Yes. Free to use with credit and a link to CRS Roofing & Construction at https://crsroofer.com/holiday-ladder-roof-fall-study.
Media kit: download graphics
Maps, charts and square stat cards sized for TV (1920x1080) and social (1080x1080), in PNG and SVG. Free to use with credit to CRS Roofing & Construction.
