Taking a tumble from the jungle gym may be a childhood rite of passage, but a new study shows playgrounds are more dangerous than roadways.
Paediatricians at the Children's Hospital & Medical Center in Cincinnati report that a higher proportion of kids under age 20 are seriously injured on playground equipment than in bicycle or motor vehicle crashes.
The findings appear in the July issue of Ambulatory Pediatrics.
Dr. Kieran J. Phelan and his colleagues started the study more than two years ago because of the number of children treated in their emergency room for playground injuries. Nationally, some 200 000 children are treated in emergency rooms for playground injuries every year.
Phelan's team analyzed data from the National Center for Health Statistics on motor-vehicle, playground, bicycle and other types of injuries between 1992 and 1997.
The researchers included only moderate to severe injuries, such as fractures or dislocations.
Falls caused most injuries, leading to 25 percent of emergency room visits, the study found. And about 40 percent of falls occurred on schoolyard equipment; 25 percent happened at home and 9 percent occurred in public parks or recreation areas.
Between 1992 and 1994, playground falls accounted for 44 percent of moderate to severe injuries treated in emergency rooms, compared with 22.5 percent caused by bicycle accidents and 9 percent by motor vehicles accidents.
From 1995 to 1997, tumbles from playground equipment caused 36.2 percent of the more serious injuries, while bicycles accounted for 18.6 percent and motor vehicles for 10.9 percent.
"The proportion of children severely injured is higher for playground falls than any of those other more common mechanisms," says Phelan. "When you actually look at the proportion of severely injured kids (involved in playground accidents), it's almost twice that of motor vehicles or bicycles."
"We were a little bit surprised at the severity of it," says Phelan. "Most people would think that motor vehicles result in more severe injuries. They indeed result in more deaths." Car accidents account for roughly 6 000 to 8 000 deaths per year, says Phelan, while only about 15 to 20 deaths occur in playground accidents annually.
"The implication is that we need to pay attention to the design of these playgrounds, and how they're constructed," says Phelan. He says equipment height could be lowered. "It's been shown that once you get above 1.5 meters, you start seeing more severe injuries when children fall. The surface that they fall on, too, is also key. If they fall onto concrete, that obviously doesn't absorb the impact as well as something like sponge rubber or wood chips."
He says better designs have reduced or eliminated protruding nuts and bolts. "Climbers, swings, slides - those have been reported to be the most common ways that children injure themselves from falls," says Phelan.
Children ages 5 to 9 were at the highest risk.
Those children "are very focused on exploring their environment and challenging themselves from a physical standpoint, and they often aren't good at assessing what the limits of their abilities are," says Phelan.
Donna J. Thompson, director of the National Program for Playground Safety, says the study "points out the need for ongoing education and awareness about playground injuries and injury prevention."
The Consumer Product Safety Commission (CPSC) monitors the risks of injuries or deaths from about 15 000 consumer products, including playground equipment.
Ken Giles, CPSC spokesman, says, "There's been a great deal of work done on the equipment itself, the layout of the playground. And now many cities and states are adopting those guidelines as local code. (Guidelines) call for energy-absorbing material under the playground equipment … and the proper amount of space around each piece of equipment so that you have a 'use zone' or a 'fall zone' in front, back and on the sides. The worst thing to build a playground over is asphalt, concrete or hard-packed dirt."
"Wood chips, sand, gravel or the synthetic material is what should be used, and we do recommend more energy-absorbing material as the height of the platforms rise. The higher the platform from which the child would fall, the more energy-absorbing material you need," he says.