A systematic review of the risk factors and interventions for the prevention of playground injuries

Richmond, Sarah; Clemens, Tessa; Pike, Ian; Macpherson, Alison

doi:10.17269/s41997-018-0035-8

Cited by 21 publications

(17 citation statements)

References 46 publications

(219 reference statements)

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“…There are relatively few studies that have evaluated specific playground factors associated with extremity fractures (Richmond et al 2018 ). In one case-control study regarding playground related-extremity fractures, investigators found that equipment height exceeding 1.5 m (4.92 ft) and fall height exceeding 1 m (3.28 ft) were risk factors for extremity fractures (Sherker and Ozanne-Smith, 2004 ).…”

Section: Discussionmentioning

confidence: 99%

Playground equipment-related extremity fractures in children presenting to US emergency departments, 2006–2016

Blanchard

Hamilton

et al. 2020

Inj. Epidemiol.

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Background Despite updated playground equipment and improved industry standards, playgrounds remain a common source of childhood injury. Fractures account for 35% of all playground injuries presenting to emergency departments (EDs). We aimed to examine the time trends and epidemiologic patterns of playground equipment-related extremity fractures in children in the United States. Methods We analyzed data from the National Electronic Injury Surveillance System. Children ≤14 years presenting to US emergency departments from 2006 to 2016 with playground equipment-related injuries were included. We used weighted complex survey analysis to describe the epidemiologic patterns and severity of playground equipment-related extremity fractures and Joinpoint linear weighted regression analysis to determine trends in extremity fractures. Results An annual average of 72,889 children were treated in US EDs for playground equipment-related extremity fractures, yielding a national annual incidence rate of 119.2 per 100,000 children. Playground equipment-related extremity fractures accounted for 33.9% of ED presentations and 78.7% of hospitalizations for playground equipment-related injuries. Of patients with playground equipment-related extremity fractures, 11.2% had severe fractures requiring hospitalization. The annual rate of ED visits due to playground equipment-related extremity fractures remained stable (annual rate of change = 0.74, p = 0.14) from 2006 to 2016. Adjusted for age, injuries on monkey bars or climbing gyms were associated with significantly increased odds of extremity fractures in comparison to injuries from other playground equipment (adjusted odds ratio [aOR]: 2.0; 95% CI: 1.9–2.1). Overall, 49.8% of extremity fractures and 54.7% of severe extremity fractures (i.e. those requiring hospitalization) occurred on monkey bars or climbing gyms. Conclusions Despite enhanced playground safety standards, national rates of playground equipment-related extremity fractures have remained stable in the US. Extremity fractures remain the most common type of playground injury presenting to EDs and most commonly occur on monkey bars and climbing gyms.

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Section: Discussionmentioning

confidence: 99%

Playground equipment-related extremity fractures in children presenting to US emergency departments, 2006–2016

Blanchard

Hamilton

et al. 2020

Inj. Epidemiol.

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“…Epidemiological studies on playground injuries, and more specifically, injuries associated with playground equipment, primarily are conducted with injury data from the United States and Canada. [10] The NEISS is used to collecting ED admission data associated with injuries due to products in the United States. [3–6] Likewise, Canada also collects hospital data associated with injuries through the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP).…”

Section: Discussionmentioning

confidence: 99%

“…However, the majority of such epidemiological studies have been conducted using data limited to the United States and Canada. [10] Furthermore, the data solely analyzed patients particularly injured by playground equipment. [2–8] As such, the aforementioned studies did not include the myriad types of injuries that can occur within the playground, apart from the use of playground equipment.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of playground equipment related/unrelated injuries to children

et al. 2018

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The aim of study was to understand the epidemiology of playground injury and to find the factors related to the clinically significant injuries. This retrospective observational study enrolled children (age 0–18 years old) who visited the emergency departments (ED) of 6 hospitals in Korea.We obtained and analyzed the data from the ED injury surveillance system, which was supported by the Korea Centers for Disease Control. Clinically significant injury (Cs injury) was defined as the injuries that caused hospital admission for more than one day. The factors associated with injury and clinical outcome were compared between admitted and discharged patient groups. Multivariable logistic regression and the population attributable fraction were used to identify significant factors for hospitalization.A total of 1458 patients were enrolled. The proportion of patients who visited ED due to injuries unrelated to the playground equipment use was 57.8%. The majority of Cs injury was upper extremity fractures (68.1%). The risk factors for admission were the 6- to 11-year old age group (OR 5.7, 95% CI 1.3–25.0) and public playground (OR 2.4, 95% CI 1.1–5.3); the population attributable factor of these factors was 51.3% and 36.0%, respectively.This study shows that approximately 60% of the patients visited ED due to injury unrelated to the playground equipment use. The risk factors of Cs injuries were ages 6 to 11 and public playgrounds. The results of the study can be helpful to formulate the prevention policy against playground injury.

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“…This may be explained by the increase in adventurous behaviours that occur during middle childhood despite incomplete development of neuromuscular coordination 15 . The potential for risky behaviour and equipment misuse are also important etiological considerations for playground injuries across all age groups 1,16 . For these reasons, in addition to safety standard compliance, targeted education to care‐givers and school staff regarding conscious supervision and appropriate playground behaviours remains imperative.…”

Section: Discussionmentioning

confidence: 99%

Paediatric playground and tree‐related injuries: Hospital admissions in the Midland region of New Zealand

Bentley

Amey

Smith

et al. 2021

J Paediatrics Child Health

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To examine the incidence and outcomes of paediatric playground and tree-related injuries in the Midland region of New Zealand. Methods: A retrospective review of Midland Trauma Registry hospitalisation data between January 2012 and December 2018 was undertaken. Cases included children aged 0-14 years hospitalised for playground and tree-related injuries. Demographic and event information, injury severity and hospital-related outcomes were examined. Results: Playground and tree-related hospitalisations (n = 1941) occurred with an age-standardised rate of 144.3/100 000 (confidence interval (CI) 127.3-161.3) and increased 1.4% (CI 1.3-4.2%) annually. The highest incidence was observed in 5-9-year olds (248.8/100 000) with 0-4 and 10-14-year olds at 86.0 and 89.2/100 000, respectively. Injuries most commonly occurred at home, school or pre-school (77.1%), 93.7% were due to falls and, the upper extremity was the most frequently injured body region (69.9%), particularly due to forearm (55.6%) and upper arm (34.7%) fractures. Tree-related incidents comprised 11.6% of all injuries and explained 57.1% of injuries classified as major severity. Fifty-eight percent of children were hospitalised for 1 day and 97.0% for less than 5 days. Estimated hospital costs were NZ$1.2 million annually with a median of NZ $3898 per incident. Injuries classified as minor severity accounted for 86.5% of the total estimated cost. Conclusion: Children aged 5-9 years' experience high rates of costly hospitalisation for playground and tree-related injuries. Targeted injury prevention initiatives, particularly in the home and school environments, are imperative to reduce the incidence and burden of playground and tree-related injuries to affected children, their families and hospital resources.

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A systematic review of the risk factors and interventions for the prevention of playground injuries

Cited by 21 publications

References 46 publications

Playground equipment-related extremity fractures in children presenting to US emergency departments, 2006–2016

Playground equipment-related extremity fractures in children presenting to US emergency departments, 2006–2016

Epidemiology of playground equipment related/unrelated injuries to children

Paediatric playground and tree‐related injuries: Hospital admissions in the Midland region of New Zealand

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