The US Consumer Product Safety Commission estimates that 65,000 people in one year visit the emergency room due to ladder accidents. If you don't want to be one of those accident victims, follow these tips.

Inspect for damage

Wooden ladder: check for rot, cracks, slivers, loose side rails, broken rungs. Make sure there are no loose nails, joints or bolts. Check that the hardware is not rusted, cracked, bent, or otherwise damaged.

Aluminum or steel ladder: check for burrs, sharp edges, loose joints or bolts, cracks. The slip-resistant feet on the ends of the side rails should be in good shape.

Stepladder: check for loose hardware, missing or broken stop on spreader, loose or bent hinges or spreader. Check for broken, bent, or worn steps.

Extension ladder: check for broken or loose steps, frayed rope, broken lock.

Set up the ladder

Extension or straight ladder:

• 3-foot Rule: If a straight or extension ladder is set up for access to a roof, landing, or other level, it should extend three feet above the point at which it contacts that landing or roof. (Proper Ladder Setup Angle). Make sure it's securely positioned so that you can mount and dismount the ladder safely.
  
• 1:4 Rule: The straight or extension ladder should be set up so that for every four feet from the ground to where the ladder is resting, the ladder bottom extends out one foot. In other words, if the ladder is resting on the edge of a root 16 feet above the ground, the bottom of the ladder should be four feet out from that edge. (Proper Ladder Setup Angle).
  
• Have someone available to hold the ladder while you're on it, if at all possible.
  
• Lash or otherwise attach the ladder at the top, especially on windy days.
  

Extension ladder: make sure that both the locks engage.

Stepladder:

• Make sure it's all the way open. Don't use a stepladder while folded.
• Watch that you don't pinch your fingers in the spreader hinge as you open or close the ladder.
• Make sure it's the right height for the job.
  

All ladders:

• Make sure the ladder is level.
• Use a large flat wooden board under a ladder if the ground is soft or uneven.
• On a hard, smooth surface, non-skid feet on the ladder are helpful, or the ladder could slip.
• Don't leave a ladder set up and unattended, especially outside. A ladder is attractive to young children, who love to climb and don't understand the risk. A ladder could also fall and injure someone.
• If you're setting up the ladder in front of a door, make sure the door is locked or barred. If you cannot do that, prop the door open so anyone coming through can see the ladder clearly.