Playground Injuries Research Articles

Decreasing children's risk taking on the playground.

Playground mishaps are some of the most common sources of injury and are the leading killer of children. The present study used a multiple baseline design across three classrooms (N = 379 children). With minimal teaching and rewards, children decreased and maintained decreased risky playground behaviors on slides. Floor effects on climbers prevented the demonstration of similar effects. The decreases seen in risky slide behavior are discussed within the context of preventive safety training for playground injuries.

Trends and Patterns of Playground Injuries in United States Children and Adolescents

To determine the prevalence, trends, and severity of injuries attributable to playground falls relative to other common unintentional mechanisms that resulted in an emergency department (ED) visit in the United States. Data from the emergency subset of the National Hospital Ambulatory Medical Care Survey collected from 1992 to 1997 for children <20 years. Injury rates and 95% confidence intervals (CIs) were estimated and injury severity scores were computed. There were 920551 (95% CI: 540803 to 1300299) ED visits over the 6-year study period by children and adolescents that were attributable to falls from playground equipment. The annual incidence of visits for playground injuries did not significantly decrease over the course of the study (187000 to 98000, P =.053). Injury visits for playground falls were twice as prevalent as pedestrian mechanisms, but they were less prevalent than visits for motor vehicle-- and bicycle-related injuries. A larger proportion of playground falls resulted in "moderate-to-severe" injury than did bicycle or motor vehicle injuries. Children aged 5 to 9 years had the highest number of playground falls (P =.0014). Playground falls were most likely to occur at school compared to home, public, and other locations (P =.0016). Playground injury emergency visits have not significantly declined and remain a common unintentional mechanism of injury. Injury visits for playground falls were proportionally more severe than injury visits attributable to other common unintentional mechanisms. Interventions targeting schools and 5- to 9-year-old children may have the greatest impact in reducing emergency visits for playground injuries.

Evaluation of the Latrobe Valley Better Health Injury Prevention Program

Objective—To evaluate the Latrobe Valley Better Health Injury Prevention Program, a regional community based intervention in south east Victoria, Australia. Method—The evaluation design was quasiexperimental including pre-intervention and post-intervention observations...

Surface characteristics, equipment height, and the occurrence and severity of playground injuries

Objectives—To evaluate whether surface characteristics (absorption level (g-max), material) and the height of play equipment are related to the occurrence and severity of injuries from falls. Setting and methods—During the...

Playground injuries in children: a review and Pennsylvania Trauma Center experience.

To describe patient demographics, injury characteristics, and circumstances of playground injuries in children admitted to Pennsylvania trauma centers and to identify injury prevention strategies. Retrospective, descriptive study of 234 children ages 1 to 18 years sustaining playground-related injuries and whose hospital data were entered into the Pennsylvania Trauma Outcome Study. Most of the injuries occurred between April and September (77%), and noon to 6 P.M. (69%). Falls from playground equipment constituted the highest proportion of incidents (73%). Of 421 injuries (M = 1.8/patient), most were upper extremity (n = 117) and head (n = 110) injuries. Nurses can advocate for playground safety by teaching children to play safely and recommending age-appropriate equipment and protective surfacing.

Risk factors for severe injuries associated with falls from playground equipment

A case control study design was used to determine the risk factors for severe injuries associated with falls from playground equipment. Children presenting to the Hospital for Sick Children in Toronto because of falls from playground equipment (1995–1996) were identified through daily review of admissions and emergency department visits. Cases were defined as children with a severe injury (AIS≥2), whereas, controls were children with a minor injury (AIS<2). Data on age, sex, socioeconomic status, prior experience on the equipment, previous playground injury, type of equipment, height of fall, undersurface, nature of injury, body part involved, and disposition were collected via telephone interview, field trip measurement, and mailed questionnaire. A total of 126 children were studied — 67 cases and 59 controls. There were no differences between the two groups on age, sex, socioeconomic status, prior exposure to the equipment, or previous playground injury. Extremity fractures predominated in the case group, while, facial lacerations predominated in the control group. The median height of fall for cases was 199 cm, compared with 160 cm for controls ( P=0.021). Cases were also more likely to have fallen from a height of >150 cm (73%), compared with controls (54%), P=0.027. The majority of cases (82%) and controls (86%) fell onto an impact absorbing undersurface ( P=0.540). The median depth of impact absorbing undersurface, however, for both case and control injuries was 3 cm — well below the recommended safety standards. Height of fall was an important risk factor for severe injury associated with falls from playground equipment. Above 150 cm, the risk of severe injury was increased 2-fold.

Playground Safety: Using Research to Guide Community Policy

Each year over 200,000 children in the United States require emergency medical treatment for playground-related injuries, costing an estimated $1.2 billion. Thus, the issue of playground safety is a topic of concern for many health care professionals. However, without a reasonable understanding of the scope and magnitude of the problem, any attempts to develop an injury prevention program will be limited. Therefore, this article reviews the data-based playground research so that suggestions can be made concerning the development of a comprehensive playground injury prevention program.

Working in partnership to prevent playground injuries

Working in partnership to prevent playground injuries

Preventing injuries in public playgrounds through partnership between health services and local authority: community intervention study

Public playgrounds are important for children's play and development. Safety is a prime concern not only to prevent injuries but also because families need the assurance that it is safe...

Austrian Committee for Injury Prevention in Childhood

The Austrian Committee for Injury Prevention in Childhood (OKU) is a non-profit organisation with the goal of reducing childhood injuries, especially severe and disabling injuries, and child deaths. Dr Hugo...

A case-control study of risk factors for playground injuries among children in Kingston and area

Objective—To determine the risk for injury associated with environmental hazards in public playgrounds. Setting—One hundred and seventeen playgrounds operated by municipalities or school boards in and around Kingston, Ontario, Canada....

Safety of surfaces and equipment for children in playgrounds

The safety of playgrounds is important to protect children from injury, but studies are mostly done mainly under laboratory conditions without epidemiological data. We investigated the safety of different playground surfaces, and types and heights of equipment in public playgrounds in the City of Cardiff, UK. We did a correlational study of 330 children aged between 0 and 14 years. All children were hurt when playing in playgrounds in Cardiff and presented to the Accident and Emergency Department in Cardiff Royal Infirmary during summer (April to September) 1992 and 1993, and the whole of 1994. We studied the children's hospital records to establish the type of injury and interviewed their parents to find out the playground and type of equipment involved. The main outcome measures were the number of children injured whilst playing, and injury rates per observed number of children on different surfaces, types, and heights of equipment. Children sustained significantly more injuries in playgrounds with concrete surfaces than in those with bark or rubberised surfaces (p < 0.001). Playgrounds with rubber surfaces had the lowest rate of injury, with a risk half that of bark and a fifth of that of concrete. Bark surfaces were not significantly more protective against arm fractures than concrete. Most injuries were equipment related. Injury risk due to falls from monkey bars (suspended parallel bars or rings between which children swing) was twice that for climbing-frames and seven times that for swings or slides. The height of the equipment correlated significantly with the number of fractures (p = 0.005) from falls. Rubber or bark surfacing is associated with a low rate of injuries and we support their use in all public playgrounds. Bark alone is insufficient, however, to prevent all injuries, particularly arm fractures. Rubberised impact-absorbing surfaces are safer than bark. We believe that playing on monkeys bars increases the risk of injury in playgrounds and that they should generally not be installed. Safety standards should be based on physical and epidemiological data. Our data suggest that the proposed raising of the maximum fall height from 2.5 m to 3.0 m in Europe is worrying.

A descriptive analysis of children's playground injuries in the United States 1990-4.

OBJECTIVES: To review playground injury statistics over a five year period in order to develop an awareness of how and where children in the United States are being injured. METHODS:...

Injuries From Falls on Playgrounds

To measure the incidence of playground fall injuries among children attending licensed US day care centers and to evaluate how injury incidence varies with center characteristics and with the regulatory and enforcement climate in which centers operate. Telephone surveys of directors of day care centers and enforcement agencies and review of written day care regulations. Probability sample of licensed day care centers in 50 states and the District of Columbia. Children attending day care centers with playgrounds. Medically attended playground fall injuries. Among the 1740 day care centers studied, a weighted total of 89.2 injuries occurred during the 2-month study period (0.25/100,000 child-hours in day care). The most important risk factor for injury was height of the tallest piece of climbing equipment on the playground in both bivariate (P = .01) and multivariate (P = .02) analyses. Neither regulations addressing playground safety or playground surfaces nor enforcement patterns were associated with lower injury rates. Additional effort is needed to develop and evaluate regulations and enforcement that reduce injury risks for children while minimizing burden on day care centers. In the meantime, limiting climbing equipment heights may reduce playground injury rates.

Patterns of injuries to children on public playgrounds.

The incidence and pattern of injuries to children in public playgrounds presenting to the accident and emergency department were reviewed over two six month summer periods in Cardiff. A total of 178 children (mean age 7.5 years) attended with a playground injury representing 1.1% of all the children attending. One hundred and five children fell from equipment, of which the commonest was the climbing frame; 125 children had playground surface related injuries, 86 on bark and 30 on concrete. The pattern of injuries on the playground surfaces was different: fractures and sprains were more common on bark surfaces and lacerations and abrasions on concrete surfaces. Comparison of total injury rates showed there were fewer injuries on modernised playgrounds than expected but these differences were not significant. Modernised playgrounds are more popular, have new exciting equipment, and offer good play opportunities for children. However, the high fracture rate on modernised bark playgrounds is concerning and requires further research.

Surface-specific fall injury rates on Utah school playgrounds.

The purpose of this study was to estimate surface-specific rates of fall injuries on school playgrounds. Playground injuries related to falls from climbing equipment and the surfaces involved were identified from injury reports for 1988 to 1990 from 157 Utah elementary schools. Enrollment data and playground inspections were used to estimate student-years spent over each surface. The fall injury rates per 10,000 student-years were asphalt, 44; grass, 12; mats, 16; gravel, 15; and sand, 7. These data did not show that impact-absorbing surfaces reduce fall injuries on playgrounds better than grass. Improved field studies are needed to guide policy decisions for playground surfacing.

Injuries sustained during flipping???a new fad activity

This article describes a small series of injuries resulting from a new fad activity among children in Baltimore. "Flipping" involves jumping from an elevated surface and executing an aerial flip, with the intent to land upright. Because this activity takes place frequently on hard surfaces such as concrete, injuries often result. The spectrum of injuries is described and categorized, and injuries are compared with those received during similar activities, such as break dancing or skateboarding, and with playground injuries. Pediatricians and emergency physicians should be aware of the potential for injury in this activity.

Injuries in primary care practices.

A study of injuries among 0-15 year old children attending primary care clinics in a low social class and a middle class neighbourhood was carried out during a period of one year. Data were collected in a structured form by the physicians while the patient was in the clinic. The rate of injuries was 121.3/1000 children per year in the clinic from the lower social class neighbourhood and 70.7/1000 children per year in the clinic from the middle class neighbourhood. Injuries in playgrounds, and on pavements and streets occurred in higher proportions in the low social class than in the middle class neighbourhood clinics. The most frequent causes of injuries were falls and being struck and injured by cutting/piercing instruments; these caused mostly contusions and lacerations. The clinic was the first place of treatment in 65% of the cases in the middle class area and in 45% in the lower social class area; 28% and 10% respectively were referred to the hospital for additional treatment. Data from primary care clinics should be considered when estimating the incidence of injuries in the community, in planning intervention programmes, and future research.

Playground injury manual

SYLACAUGA, Ala. -- A new manual is available that contains guidelines and checklists to help identify, provide and maintain better, safer playgrounds for children. ThePlayground Safety Manual is a 30-page publication with chapters on how to inspect existing equipment for hazards; general safety considerations; specific playground equipment safety considerations; and the school9s responsibility.

The Epidemiology of School-Related Injuries: New Perspectives

Among school-aged children, unintentional injuries are the leading cause of morbidity and mortality. We began this prospective study in a sample of nine schools within the Boulder Valley School District (Colorado) during the 1988-1989 school year in an effort to explore the etiology of school-related injuries and to provide information relevant to their prevention. During the study period, 509 injuries were reported among a population of 5,518 students, yielding an incidence of 9.22 per 100 students. Boys were nearly one and one-half times more likely to have sustained a school-related injury than girls (risk ratio (RR) = 1.41; 95% confidence intervals [CIs] 1.18, 1.68). We found a significant difference among injury rates by school level (P ≺ .001). Middle/junior high students had the highest rate, followed closely by elementary students and distantly by high school students. Sports activities accounted for the largest percentage of school injuries (53%), and the percentage of sports-related injuries increased with increasing grade level. Analysis of injury rates by school location revealed that high school students were most frequently injured in the gym (1.52 per 100), middle/junior high students on the athletic field (4.26 per 100), and elementary students on the playground (6.12 per 100). Using injury location as the focal point, we examined relationships among the variables sport/activity, body site, and nature of injury. We found that a large percentage of injuries sustained on the athletic field or in the gym were similar and affected similar body sites, whereas playground injuries differed in their nature and in body site affected. Additional studies focusing on location will allow school officials to anticipate, and therefore prevent, injuries.