Pediatric Playground-Related Injuries Treated in Hospital Emergency Departments in the United States

This study analyzed pediatric playground-related injuries data from the National Electronic Injury Surveillance System. An estimated 5 025 440 children <18 years were treated in US emergency departments for playground-related injuries during 1990-2012, averaging 218 497 children annually. The average patient age was 6.5 years. The overall annual injury rate declined during 1990-2007 ( P < .001) and then increased during 2007-2012 ( P < .001). The climbing equipment-related injury rate remained constant during 1990-2009 and then increased during 2007-2012 ( P = .014). The concussion/closed head injury rate increased during 1990-2008 ( P < .002) with the rate almost doubling from 2008-2012 ( P < .001). Falls accounted for 76.7% of all injuries and 87.7% of injuries to the upper extremities. Injuries resulted in hospitalization for 4.3% of patients. Despite current playground safety standards and guidelines, a large number of playground-related injuries continue to occur. Revised impact attenuation criteria for playground surfacing materials should be implemented and evaluated to more adequately prevent fall-related upper extremity fractures.

An evaluation of the Cool 2 Be Safe program: an evidence-based community-disseminated program to positively impact children's beliefs about injury risk on playgrounds

Falls from playground equipment during play are a leading cause of injury for elementary school children. Changes to playground design and surfacing materials can reduce injury risk. However, there is also a need for intervention programs to reduce risky play behaviors by children that are associated with falls. The Cool 2 Be Safe program was developed based on past research that identified effective strategies for targeting injury beliefs that predict risk behaviors on playgrounds among individually tested elementary school children. The current study evaluated the effectiveness of delivering these activities as an integrated program and in a group format in after school programs organized by Boys and Girls Clubs of Canada. The clubs were provided all program and extensive training materials, and a webinar training session was conducted for facilitators. Observations of sessions provided data on fidelity of program delivery. Pre- and post-intervention data assessing children's injury beliefs were collected via survey, with children participating in four structured activity sessions in small groups between premeasures and post-measures. The training materials proved to be quite effective; observational data indicated 88 % compliance with the procedures. Comparing children's pre- and post-responses revealed positive changes in injury-risk beliefs that have been shown to predict reduced risk taking on playgrounds. This initial evaluation suggests that the Cool 2 Be Safe community program holds much promise as a means for addressing the issue of fall-risk behaviors by elementary school children on playgrounds.