People losing their balance is costing Marlborough $5.7 million with nearly 44,000 days of productivity lost due to falls, ACC figures reveal.
Falls continued to be a major cause of injury, with people tripping over leads or falling off ladders.
Most injuries were in the home, where people felt more secure.
Pete Halligan from Blenheim fell off a ladder two years ago and was lucky to walk away unscathed.
He was cleaning out the guttering on one of his rental properties and was stretching to clear out debris when he fell. "The ladder slipped away because it wasn't secure. I was pushing the limit for how far I could extend myself. I was really really lucky I didn't do myself more injury."
It prompted him to start a safe gutter cleaning business - Gutter Sucker NZ. His employee uses an industrial vacuum cleaner to get leaves and muck out of gutters - from the ground.
People losing balance was the most common cause of injury, while the most common pre-accident activities were recreation or sport.
ACC general manager of injury prevention Megan McKenna said the data would help the Marlborough community prioritise injury prevention. "These reports give us all a snapshot of what's happening at a community level, and we hope they'll help inspire solutions that ultimately enhance people's wellbeing."
Speaking at a Health and Safety Expo at Marlborough Convention Centre on Friday, World Health Organisation Safe Communities judging panellist Geoff Wilson said a five-year analysis of ACC claims showed a downward trend for work injuries, motor vehicle injuries and assaults in Marlborough.
ACC injury claims for people aged 10-18 years had decreased by 43 per cent, compared with 3.4 per cent nationally.
Programmes like Clued up Kids which taught children how to react and keep safe in an emergency had been instrumental, he said.
Health and safety awareness had risen as a result of road safety campaigns and networks such as Safe and Sound at the Top of the South.
Injuries at industrial and commercial locations totalled more than $5.7m in ACC claims in Marlborough.
The Government wants to reduce New Zealand workplace injury and death by 25 per cent by 2020.
The new Health and Safety at Work Act will come into force from April 1, 2015. Worksafe New Zealand will introduce new regulations and codes of practice.