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BACKGROUND. Body checking is the predominant mechanism of youth ice hockey injuries. The Canadian Hockey Association has allowed body checking from ages 12 to 13 (peewee level) and up. One Canadian province (Ontario) introduced body checking at ages 10 to 11 (atom level) in the competitive leagues, whereas in Quebec body checking has only been allowed at ages 14 to 15 (bantam Level). The purpose of this study was to compare body-checking injuries, fractures, and concussions in boys' minor hockey between jurisdictions in which checking is allowed and jurisdictions in which body checking is not allowed. METHODS. Data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) were used to characterize children's ice hockey injuries from September 1995 to the end of August 2002. Children treated at CHIRPP hospitals in areas in which checking was allowed were compared with children in areas in which checking was not allowed. RESULTS. Of the 4736 hockey injuries, 3006 (63%) were in Ontario and 1730 (37%) were in Quebec. Most of the injuries occurred in areas in which checking was allowed (2824 [59.6%]). At ages 10 to 13, players had significantly greater odds of suffering a checking injury where checking was allowed (odds ratio [OR]: 1.86; 95% confidence interval [CI]: 1.6–2.11). Players in this age group were also more likely to suffer a concussion (OR: 1.42; 95% CI: 0.98–2.05) or fracture (OR: 1.25; 95% CI: 1.06–1.47) where checking was allowed. Among older players, when checking was allowed in both provinces, there were higher odds (OR: 1.90; 95% CI: 1.36–2.66) of receiving a checking injury in the province that had introduced checking at a younger age, suggesting that there is no protective effect from learning to check earlier. CONCLUSIONS. Increased injuries attributable to checking were observed where checking was allowed. This study supports policies that disallow body checking to reduce ice hockey injuries in children.

This is the first large observational study examining school travel mode and the environment. Walking proportions were higher than those previously reported in Toronto, with large variability. Associations between population density and several roadway design features and walking were confirmed. School crossing guards may override the influence of roadway features on walking. Results have important implications for policies regarding walking promotion.

The findings emphasise the importance of incorporating safety into the conversation about creating more walkable cities.

Focusing interventions around schools with attention to age, travel times, and crossing location will reduce the burden of injury in children. Future studies that take into account traffic and pedestrian volume surrounding schools would be useful for prevention efforts as well as for promotion of walking. These results will help identify priorities and emphasise the importance of considering spatial and temporal patterns in child pedestrian research.

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ResearchRecherche P laygrounds provide a recreational refuge for children, away from traffic and other outdoor hazards. In addition, playground activities can enhance children's cognitive, physical and psychosocial skills. Playground safety is of concern to physicians, parents and injury prevention advocates. Of all playground injuries that result in a visit to a hospital emergency department, 27%-40% are fractures and 17% require hospital admissiona greater frequency of admission than that associated with any other cause of pediatric injury except traffic.1-4 The results of an observational study in Wales showed that 90% of all playground injuries resulting in a visit to an emergency department were related to the playground equipment.1 As might be expected, playgrounds are the location within elementary schools with the highest injury rates and the most severe injuries. 5 In a study conducted in Kingston, Ont., children were 12 times more likely to be injured in school playgrounds than in municipal playgrounds. 3Standards for playgrounds have been developed both in Canada 6 and internationally. [7][8][9][10][11][12] The Canadian Standards Association (CSA) standards for the design, installation and maintenance of playgrounds and equipment were most recently revised in 1998. 6 No published data exist on the relation between equipment standards and injury rates. If applying standards can identify unsafe playgrounds and, more importantly, reduce the rate of child injury, such standards would be a useful tool for school and municipal authorities responsible for playgrounds.We sought to determine the effect of replacing unsafe playground equipment (as determined using the new CSA standards) on injury rates among school children. MethodsThe Toronto District School Board (TDSB) worked with an independent, qualified playground consultant to develop a methodology for assessing the compliance of all playground equipment in its jurisdiction with the 1998 CSA standards and 1990 CSA guidelines. Details of the methodology are given in the online appendix at www.cmaj.ca/cgi/content/full/172/11 /1443/DC1. In the spring of 2000, the same consultant assessed all playground equipment in TDSB elementary schools (n = 398) for CSA compliance and indicated whether the equipment in each case should be left as is, repaired or retrofitted, or removed and replaced. Two factors were considered in making the decision: the severity of injury that could result from using the equipment and, where equipment was noncompliant, the feasibility of achieving compliance through repair or retrofit.The assessment identified 136 schools with playground equipment that represented a severe hazard (i.e., an imminent risk of serious and permanent injury, usually indicating risk of a fall from more than 1.5 m or a fall onto unsuitable surfacing), did not standards for playground equipment prompted the removal of hazardous equipment from 136 elementary schools in Toronto. We conducted a study to determine whether applying these new standards and replacing u...