Epidemiology of child playground equipment‐related injuries in the USA: Emergency department visits, 1995–2019

Abstract

Aim To analyse the most recent trends and characteristics of playground equipment‐related injuries in children. Methods We used the National Electronic Injury Surveillance System database to acquire cases of playground equipment‐related injuries in children ≤17 years old between 1995 and 2019. A total of 184 580 unweighted cases met our study inclusion criteria. Results A total of 5 356 703 (95% confidence interval 4 235 530–6 477 876) emergency department visits for playground‐related injuries in the USA were estimated during the study period which was equal to an average of 29.4 annual injuries per 10 000 US population ≤17 years. The mean age was 6.5 (standard error 0.049) years. School‐aged (42.7%) and pre‐school children (35.3%) accounted for most playground injuries. More than half of the injuries were reported in males (53.6%). Most injuries occurred with climbing apparatuses (36%), followed by swings (25.9%) and slides (20.9%). Overall number of injuries (∆ − 22.3%, P = 0.01) and incidence (∆ − 21.6%, P = 0.01) had a declining trend after 2012. However, reported concussion injuries showed an increasing trend during the study (∆ + 28.3%, P < 0.001). A marked seasonal variation in number of injuries existed with most injuries in May and September. Conclusions Although injuries arising from playground equipment have decreased during the past 8 years, there was an increase in number of reported concussions. The outcomes of this study suggested that further efforts should be directed towards such serious injuries.

A 10-Year Retrospective Review of Playground-Associated Craniofacial Injuries in the Pediatric Patient Population

“…This is consistent with previous research. 9,11,12,18 An explanation for the sex-related difference in injury frequency may be that boys are more prone to engage in risky behavior. 19 Demographic data on neighborhood park visitors suggest that the disproportionate number of injuries in elementary school-age youth may reflect a difference in rates of playground usage rather than the result of direct age-related factors.…”

“…20 This study also confirms that climbing apparatuses, swings, and slides are frequently implicated in playground injury (Table 2), supporting previously reported data from various other NEISS studies. 9,11,12,18 Swings and monkey bars or climbing equipment have previously been associated with pediatric playground falls, 21,22 thus it is suspected that falls were a likely mechanism for these injuries. Increased injury incidence has been associated with increased height of playground equipment, [23][24][25] with falls from playground equipment heights being associated with more severe injury than from standing heights.…”

“…[5][6][7][8] Previous literature has reported that injuries to the head and neck are implicated in a substantial proportion of pediatric playground injury cases, especially in children below 4 years of age. [9][10][11][12] The rate of playground injuries in general has remained relatively constant over time, but, over the past few decades, a marked increase in the number of concussions and closed head injuries has been observed. 9,11 Injuries to the craniofacial region are especially important to note as facial trauma has been associated with functional and aesthetic challenges for children and adolescents.…”

“…[9][10][11][12] The rate of playground injuries in general has remained relatively constant over time, but, over the past few decades, a marked increase in the number of concussions and closed head injuries has been observed. 9,11 Injuries to the craniofacial region are especially important to note as facial trauma has been associated with functional and aesthetic challenges for children and adolescents. 13 Although a large body of work exists on general pediatric playground injuries, there is a void in reporting the unique patterns specific to pediatric craniofacial playground injuries.…”

Epidemiological Characteristics of School Playground Injuries

“…2 Playground injuries are reported to be the leading location of unintentional recreation injuries to children aged 1 to 10 years with over 200 000 children each year treated in EDs for playground injuries. 1,[3][4][5][6][7][8] Playground injury data have been drawn solely from ED and epidemiologic monitoring surveillance systems, such as the National Electronic Injury Surveillance System (NEISS), 1,3,4,6,7,[9][10][11][12][13] Nationwide Emergency Department Sample (NEDS), 2,10 Nationwide Inpatient Sample (NIS), 2,10 Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), 5,8 or National Hospital Ambulatory Medical Care Survey (NHAMCS). 14 Information within NEISS, NEDS, and CHIRPP represents injuries that have warranted medical treatment within the ED, while NIS focuses on hospital inpatient admissions.…”