Now is the time when everyone starts thinking about preparing the house and yard for the upcoming holiday season. Whether it is installing the storm windows, placing seasonal decorations, raking leaves, or trimming the tree, one of the first tools that homeowners reach for is a ladder.

Knowing how to properly set up and use a ladder is an important first step in reducing the chance of a fall or other ladder-related accident. Staying safe on a ladder can be made easier if you follow these tips developed by the American Academy of Orthopaedic Surgeons.

*Inspect the ladder. Check the ladder for any loose screws, hinges or rungs that you might not have fixed before you put it away for the winter. Clean off any mud or other liquids that might have accumulated on the ladder.

*Properly set up the ladder. Every ladder should be placed on a firm, level, slip-free surface. If you're working outside, make sure the ladder will not hit electrical wires, tree limbs or any other obstructions when it is extended.

*Remember the 1-to-4 rule: the bottom of the ladder should be 1 foot away from the wall for every 4 feet that the ladder rises. For example, if the ladder touches the wall 16 feet above the ground, the feet of the ladder should be 4 feet from the wall. If you are going to climb onto a roof, the ladder should extend at least 3 feet higher than the roof.

*Do not use a ladder as a seat between tasks. You might want to take a break from your chores, but never use a step ladder's top or pail shelf as a seat.

*Select the right ladder for the job. If you're washing windows inside the home, choose a step stool or utility ladder--they're often used when working at low or medium heights. Extension ladders are ideal for use outdoors to reach high places like cleaning the gutters on the roof of a house.

*Move materials with caution when on the ladder. When you are cleaning out the garage or closet, be careful pushing or pulling anything from shelves while standing on a ladder. You could lose your balance and fall off.

*Always reposition the ladder closer to the work. Over-reaching or leaning far to one side when you're on the ladder could make you lose your balance and fall. Your bellybutton should not go beyond the sides of the ladder!

*Wear proper footwear. Make sure your shoelaces are tied and the soles of your shoes are free of any greasy, oily or wet substances. Do not wear leather-soled shoes -- they are slippery! Pant legs shouldn't be too wide or too long.

*Be careful when climbing and get help if you need it. Ask someone to hold the ladder while you climb. Stay in the center of the ladder as you climb, and always hold the side rails with both hands.

Each year, the Consumer Product Safety Commission reports over 511,000 people are treated in hospital emergency rooms, doctors' offices, clinics and other medical settings because of injuries related to ladder use. Most injuries are cuts, bruises and fractured bones. However, more than 300 people die a year from ladder injuries--almost one death per day.

For physician-reviewed information on ladder safety and more, contact the Academy's public service line at (800) 824-BONES or visit the Prevent Injuries America! website at http://www.orthoinfo.org .

An orthopaedic surgeon is a medical doctor with extensive training in the diagnosis and non-surgical as well as surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles and nerves.

The 26,047-member American Academy of Orthopaedic Surgeons (www.aaos.org) or (http://orthoinfo.aaos.org), is a not-for-profit organization that provides education programs for orthopaedic surgeons, allied health professionals and the public. An advocate for improved patient care, the Academy is participating in the Bone and Joint Decade (http://www.boneandjointdecade.org/us), the global initiative in the years 2002-2011 to raise awareness of musculoskeletal health, stimulate research and improve people's quality of life. President Bush has declared the years 2002-2011 National Bone and Joint Decade in support of these objectives.