By TONI L. KAMINS - The New York Times - 01/18/04

When Aimee Fitzgerald, a corporate communications executive from Colorado, stepped out of the shower at the Ritz-Carlton Hotel in Phoenix in March 2002, she didn't notice that a little water had accumulated on the floor.

The shiny white marble floor, combined with the bathroom's bright lights, made the water almost impossible to see. Fitzgerald slipped, fell and broke her sacrum. But the water was only partly to blame, she says: The shower curtain didn't extend below the rim of the bathtub, and the rubber backing on the bath rug was worn.

Last June, Genna Goldberg, a California publicist, did an unintentional split while she stepped from the bathtub onto the marble floor at Le Merigot, a JW Marriott hotel in Santa Monica, Calif. She was lucky to get away with a few aches and pains.

According to hotel industry statistics, slips and falls have consistently accounted for about 42 percent of guest accidents; bathrooms are among the top five places they occur.

Marble bathrooms polished to a glossy, reflective finish are popular with hotel designers and guests alike. And although the all-marble trend started at luxury hotels, the look is so popular that it is filtering down to midprice hotels, too. But marble's smoothness makes it a dangerous material for bathroom floors.

Hotel-industry experts speculate that the proliferation of marble and other smooth, easy-to-clean materials along with the absence of federal standards for hotel bathtub and shower safety means the accident rate is likely to increase, as baby boomers age. But travelers of all ages need to be cautious.

The accident rate doesn't surprise Bruce Goff, a San Francisco-based hotel room designer. Goff, who specializes in bathrooms, said that he has walked into some hotel rooms and thought, ‘‘Gee, I hope their insurance is paid up.''

Three factors determine the kind of material that goes into a hotel bathroom, he said: initial cost, aesthetics and cleaning time. ‘‘Luxury is the be-all and end-all,'' he added, ‘‘and the marketplace competition is what drives the aesthetics.'' In other words, bathrooms sell rooms.

The increased presence of the supersize bathtub, with high sides and wide interiors, is another hazard. Stepping in from a slippery floor surface onto a slippery tub surface magnifies the problem.

Russ Kendzior of the National Floor Safety Institute, a trade organization that promotes the use of high-traction materials, says that hotels don't like to use the available materials or rubber mats because they believe they detract from the look of the bathroom and also because nonskid surfaces require constant upkeep. Stepping into a wet bathtub without some kind of high-traction surface or one that has been worn away by improper cleaningis an accident waiting to happen, he said.

John P.S. Salmen, a Maryland architect who consults on code and materials issues for the hotel industry, says that slip-resistant floors are possible and most cost effective if installed when the hotel is built.

But according to Ken Giles, a spokesman for the Consumer Product Safety Commission, safety standards (which are voluntary) don't apply to bathroom floors, only to the interior of the tub or shower.

Representatives of Hilton — which also owns the Hampton Inn, Doubletree, Embassy Suites, and Homewood Suites brands — and Hyatt refused a number of requests to be interviewed for this article.

In a response to questions sent in an e-mail message, a representative for Marriott (whose brands include JW Hotels, Courtyard, Renaissance, Residence Inn, TownePlace Suites, Fairfield Inn, SpringHill Suites, Ramada and Ritz-Carlton), said that new hotels managed by Marriott ‘‘have grab bars in tubs/showers'' that ceramic floor tile in bathrooms must have a ‘‘slip resistance coefficient'' that meets the flooring industry's specifications, and that bathtubs must have factory installed slip-resistant etching. Regular cleaning, he said, is the best way to maintain that etching.

In their quest for more exquisite bathrooms, some hotels, especially upscale ones, have taken steps to reduce some of the safety problems, although safety was not the driving force. One example is installing separate shower stalls and soaking tubs. Experts say that this is safer because the floors of stall showers are usually made up of small ceramic tiles, which are less slippery. But the soaking tub remains a concern because of the marble floor and the interior surface of the tub.

The Ritz-Carlton chain, which favors marble floors in its hotel bathrooms, has made separate shower stalls with far less slippery small ceramic tile floors standard since the mid-1990s, according to Derek Flint, senior corporate director of rooms, though older properties have the combined bathtub-shower and thus have rubber bath mats.

‘‘We want the bathroom to make a statement,'' Flint said, adding that the marble bathroom floors are not slip resistant. But cotton bath rugs are provided at tubs and shower stalls and rubber-backed mats at sinks to reduce slips, he added. Treatment with a slip-resistant coating, he said, affects the look of the floor.

In Aimee Fitzgerald's case her medical expenses, which were paid by Ritz-Carlton after she filed some forms and nudged them a little, came to about $2,000. Barry Knopf, a New Jersey personal-injury lawyer, said that he had seen laments for injury-related medical expenses ranging from $1,800 into six figures. In June 2000 a Wisconsin jury awarded $189,000 to a plaintiff who slipped and fell in the bathtub at the Hyatt Regency in Milwaukee.

Some luxury hotels, like the Hotel Teatro in Denver, use surfaces such as Indonesian sandstone that look rich, but are not slippery when wet. Grab bars are one safety feature that can be easily added to a bathroom, and they have become more commonplace, even in upscale hotels such as newer Ritz-Carltons.

Goff said that as a designer one of his jobs was to educate the client about materials used in bathrooms. But design is only the beginning; safety features must be properly installed and maintained. In November 2001, a jury awarded a plaintiff $1.75 million for an injury sustained when the safety grab bars in the tub at a Holiday Inn in Chattanooga, Tenn., detached from the wall.

What injuries can occur with the hard surfaces in the confines of a bathroom? According to Dr. Edward AToriello, director of orthopedics at Wyckoff Heights Medical Center in Brooklyn, injuries can include strains and sprains, broken hips, and back, shoulder and wrist injuries. Dr. Munsey Wheby, president of the American College of Physicians, cautions that there can also be less obvious injuries. Effects of some serious injuries, such as rib fractures and blood clots on the brain, can take three to five days, even weeks, to become obvious.