Are you scared of working at heights?
Falls from height are associated with more fatal and major/specified injuries to workers than any other kind of injury. In the UK in 2013/14 falls from height were the most common cause of fatalities, and the second most common cause of major/specified injuries; accounting for some 567,000 Lost Work Days. 
Most fatalities occurred in construction, agriculture, facilities maintenance, and manufacturing, with older male victims being disproportionally represented. Although not specified by HSE, the opportunities for a fall from height are greater when ladders are used, when people ascend/descend steps and stairways, when sheeting/roping on lorry trailers, climbing out of lorry cabs, and working on structures without leading edge protection. 
Most people are scared of something (spiders, snakes, etc.) with many people being scared of heights, and some being extremely fearful (acrophobic). When someone is fearful, they tend to focus solely on the object or situation that is scaring them, to the exclusion of anything else. As long as the person holds the fear in check, it can lead to continuous risk assessment as they try to ensure their safety. If unchecked, the person’s estimate of the danger increases exponentially, to the point that anxiety and distress can cause them to freeze and/or become a danger to themselves and others. In the workplace, there are many social pressures that lead people to hide their fears. As such, it is highly likely that some fall victims are people who have hidden their fear of heights from their workmates and managers, perhaps because of ‘perceived mickey taking’ or fear of losing their job.
As an ex CITB-trained Advanced Scaffolder, I know that it takes self-confidence to be able to work at a height. These days (as I recently found out while installing a satellite dish on a roof) I do not have that same level of confidence that I used to have, probably because it is not something I do every day. In the workplace, it is also true that many people assigned to work at a height do not do it every day, which could mean their confidence levels are not that high, even if they are not scared of heights: those people who are fearful of heights are very unlikely to feel confident when placed in any height situation at any time.
One way that may help reduce the number of falls from height could be to identify those who are fearful of heights before allocating them to such tasks. This could be done by HR during selection tests, prior to hire, assuming detailed job descriptions are available. At the very least, simply asking people if they are comfortable working at a height should become a recognised part of a risk assessment or permit-to-work process, particularly if they are over 50 years of age. It could also prove useful for incident investigators to explicitly explore the possibility that a fall from height victim was height-fearful.
 HSE (2014). Slips & trips and falls from height in Great Britain, 2014. HMSO:
 Safe Work Australia (2103). Work-related injuries and fatalities involving a fall from height, Australia. October 2013.