Stairway to heaven

“Stairway to Heaven,” a song by the British rock band Led Zeppelin and composed by guitarist Jimmy Page and vocalist Robert Plant, was released in 1971 and became one of the most popular rock songs of all time. The lyrics describe a mythical “lady” buying a stairway to heaven to ascend on a spiritual quest. In the last two decades, this fascination with heavenly stairways has spilled over to the real world. The world’s highest escalators are 39 stories tall (one takes passengers up and the other takes them down) and are located in Osaka, Japan, in a glass-enclosed structure at the Floating Garden Observatory in the Umeda Sky Building.1

An escalating problem

The concept of the escalator dates back to 1859, when Nathan Ames of Massachusetts patented his idea of a moving staircase; however, Mr. Ames did not successfully build a working model. At the end of the 19th century, several other inventors patented similar ideas but never actually built a working model. In 1899, Otis Elevator Company introduced the first working escalator.

The word escalator is derived from the Latin word “scala,” meaning steps, and the word elevator, coined by Otis for the name of their moving lift. A Frenchman in 1898 invented a “step-less” escalator for the Harrods department store in London, England, using a continuous leather belt. Customers that were shaken by the experience were revived with free smelling salts and cognac.2

Today, escalators are ubiquitous. It would be difficult to go to any urban area, shopping mall, transportation facility, airport, or large convention center and not find moving stairs that will take you from one floor to the next. The U.S. has an estimated 35,000 escalators that serve an average of 12,000 people per escalator, amounting to 105 billion passenger trips annually.3

However, use of this conveyance convenience carries with it potential harm. According to the U.S. Consumer Product Safety Commission’s (CPSC) National Electronic Injury Surveillance System (NEISS), a system designed to collect data on all injuries seen in emergency departments, an estimated 12,774 patients were injured using escalators in 2014.4

To examine the occurrence of escalator injuries contained in the National Trauma Data Bank® (NTDB®) research dataset for admission year 2014, medical records were searched using the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Specifically searched were records that included the diagnosis code E880.0 (Accidental Fall on or from Escalator). A total of 431 records were found, of which 363 contained a discharge status, including 234 patients discharged to home, 56 to acute care/rehab, and 57 sent to skilled nursing facilities; 16 died. Half of these patients (50 percent) were women, on average 63.9 years of age, had an average hospital length of stay of 5.8 days, an intensive care unit length of stay of 4.1 days, an average injury severity score of 9.5, and were on the ventilator for an average of 4.7 days. Of those tested for alcohol, almost one-third (56 out of 180) tested positive (see Figure 1).

Figure 1. hospital discharge status

Figure 1. hospital discharge status

Watch your step

Escalator injuries can be averted by taking a few simple steps. Avoid carrying heavy packages, hold the handrail, stay away from the lines at the edge of each step that identify an entrapment risk, do not take strollers or wheelchairs onto the steps, and be aware of other riders in case someone ahead of you falls. Next time you get on an escalator and think that it is a stairway to heaven, make sure you heed these safety measures—or it just may be.

Throughout the year, we will highlight these data through brief monthly reports found in the Bulletin. The NTDB Annual Report 2015 is available on the ACS website as a PDF file. In addition, information is available on our website about how to obtain NTDB data for more detailed study. If you are interested in submitting your trauma center’s data, contact Melanie L. Neal, Manager, NTDB, at


Statistical support for this article was provided by Chrystal Caden-Price, Data Analyst, NTDB.


  1. Wilson M. World’s tallest escalator, another day at the mall. August 17, 2007. Available at: Accessed August 29, 2016.
  2. The history of the escalator. Elevator design info. Available at: Accessed August 1, 2016.
  3. Escalators. Available at: Accessed August 1, 2016.
  4. U.S. Consumer Product Safety Commission. National Electronic Injury Surveillance System query builder. Available at: Accessed September 2, 2016.

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