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

Abstract

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. Methods-A regional surveillance database was used to identify children presenting to emergency departments who were injured on public playgrounds; each case was individually matched (by sex, age, and month of occurrence) with two controlsone non-playground injury control, and one child seen for non-injury emergency medical care. Exposure data were obtained from an audit of playgrounds conducted using Canadian and US safety guidelines. Exposure variables included the nature of playground hazards, number of hazards, frequency of play, and total family income. No diVerence in odds ratios (ORs) were found using the two sets of controls, which were therefore combined for subsequent analysis. Results-Multivariate analysis showed strong associations between injuries and the use of inappropriate surface materials under and around equipment (OR 21.0, 95% confidence interval (CI) 3.4 to 128.1), appropriate materials with insuYcient depth (OR 18.2, 95% CI 3.3 to 99.9), and inadequate handrails or guardrails (OR 6.7, 95% CI 2.6 to 17.5). Conclusion-This study confirms the validity of guidelines for playground safety relating to the type and depth of surface materials and the provision of handrails and guardrails. Compliance with these guidelines is an important means of preventing injury in childhood. (Injury Prevention 1998;4:39-43)

Keeping children safe: rethinking how we design our surroundings

“…35 The main risk factors for playground-related injury are falls from heights over 1.50 m and inadequate falling surfaces. 36,37 Canadian standards for playground equipment are aimed at limiting potential falling heights and ensuring adequate energy-absorbing surfacing is provided beneath play structures. Evidence from a pre-post study using a control group (equivalent to level 3 evidence) showed that playgrounds that did not comply with standards set by the Canadian Standards Association had about twice the rate of injury of playgrounds that were in compliance.…”

The effect of safer play equipment on playground injury rates among school children

“…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][2][3][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. 3 Standards 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.…”

Expressing urine from a gel disposable diaper for biomonitoring using phthalates as an example

“…In addition to exposures to contaminants present in the natural environment, there are two other risks associated with playgrounds: playground hazards, and materials used in playground equipment or in playground cover. A strong association between childhood injuries and the use of inappropriate surface materials under and around playground equipment has been described (Mowat et al, 1998). Significantly more hazards per play area were identified in playgrounds near lowincome areas compared with those near high-income areas.…”