There is always risk when working in a data center. Yes you will most likely require ladders and other equipment like that. As for increasing the risk possibly. While working under a floor you could always hurt yourself on something you can't see like an exposed power cable, or a sharp edge. You could also think you have the right cable in your hand when you do not.
I feel the biggest difference is with underfloor cabling you can't always see what your working on/around. With above rack cabling you can now fall off of ladders and such. As a general rule I trust peoples balance over their inability to see.
And lastly in my datacenter I have me and one other person that performs work, so I feel confident that we are being safe while doing our jobs.
OBXandos
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