Climbing the corporate ladder is usually associated with promotions, salary raises and executive offices. But for many workers, the common metaphor is part of a real-life job description with real-life risks.

Last week, the Centers for Disease Control and Prevention released new data on occupational ladder falls, finding that a fifth — or 20 percent — of all fall injuries among workers involve a ladder. Among construction workers, 81 percent of all fall injuries treated in an emergency department involved a ladder (overall, falls are a leading cause of death in construction). In 2011, CDC researchers found that work-related ladder fall injuries resulted in 113 fatalities and nearly 15,500 nonfatal injuries that were reported by employers and that resulted in more than one day away from work. That same year, work-related ladder falls resulted in about 34,000 nonfatal injuries that ended up in emergency rooms.

To gather the data, CDC’s National Institute for Occupational Safety and Health (NIOSH) analyzed data from multiple surveillance systems, such as the Census of Fatal Occupational Injuries and the Survey of Occupational Injuries and Illnesses.

“Ladder fall injuries represent a substantial public health burden of preventable injuries for workers,” stated the study, which was published in CDC’s Morbidity and Mortality Weekly Report.

The study also found that men and Hispanics experienced higher rates of fatal and nonfatal ladder fall injuries compared to women and whites. Fatality rates were significantly higher among self-employed workers than salary and wage workers, and those businesses with the fewest employees tended to have the biggest fatality rates. Construction and extraction industries were home to the worst rates of fatal and nonfatal ladder fall injuries, followed by installation, maintenance and repair.

Study authors wrote that because the hospital admission rate for emergency department-treated ladder fall injuries was almost three times the rate of other occupational injuries, it suggested that ladder fall injuries are more severe. The authors — Christina Socias, Cammie Chaumont Menendez, James Collins and Peter Simeonov — concluded that ladders contribute “substantially” to the public health burden of fall injuries.

Study authors emphasized that such falls are preventable and called on employers to consider some alternatives, such as using aerial lifts and supported scaffolds. Employers should also select thoroughly inspected ladders, provide safety training, and use creative techniques that reduce the need for ladders as much as possible so that most work can be completed on the ground, the study urged.

“The findings from this study reinforce the need for workplace safety research to prevent falls, including developing and disseminating innovative technologies to prevent (ladder fall injuries),” the authors wrote. “Employers, health care providers and safety professionals should collaborate to ensure availability and training of safe ladder practices.”

Falls are a leading cause of injury among the general population as well as workers, especially among construction workers. NIOSH recently released a mobile app called Ladder Safety that provides guidelines, checklists and helps a worker check that the ladder is angled safely.

To read the full study, visit CDC’s MMWR.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.