Table 5

Case series after 1985

Title and authorPopulationMethod of data collectionConclusions
Ball D. Playground injuries: a scientific appraisal of popular concerns. 19912213 A&E units in England & Wales.A&E data LASS.Total of 1812 cases recorded. Fractures accounted for 16.5% injuries, concussion for 1.4%. Playground injuries are relatively uncommon and certain safety measures may not be justifiable on cost terms.
Edwards D. Tarzan swings. A dangerous new epidemic. 1991.23A&E attendance Sheffield.Questionnaire.29 children with fractures, 90% to the upper limb. Homemade rope swings are associated with serious fractures.
Bond M. The risk of childhood injury on Boston’s playground equipment and surfaces. 199324Playgrounds in Boston.Single observer site visit/checklist.Boston’s playgrounds are not adequately maintained or designed to reduce clear hazards.
47 in final sample.
Mott A et al. Patterns of injuries to children on public playgrounds. 1994.25A&E attendances, 0–14 years, Cardiff UK.Questionnaire.Fewer injuries overall than predicted on modern surfaces (not statistically significant). The profile of injury differed between surfaces.
Playground survey.
Playground inspectors recorded utilisation.
Briss P et al. Injuries from falls on playgrounds. Effects of day care centre regulation and enforcement. 1994.26Day care centres across USA. Under 5s.Probability sample. Telephone survey.Injury rates lower on optimal but not on potentially resilient surfaces. The benefit of optimal surfaces increases with increasing height.
Lillis K. Playground injuries in children. 1997.27CHIRRP data.CHIRRP data extraction.289 injuries, fractures accounted for 28% and concussion for 3%. Climbing frame injuries accounted for 2/3 hospital admissions, most with UL fracture. Numbers were insufficient to comment on effect of surface (and no height data).
Sample A&E units
Mack M. A descriptive analysis of children’s playground injuries in the USA. 1990–9428Neiss data.Neiss database samples 90 A&E units and produces estimates.Neiss playground injury statistics can identify how and where children are injured, increase understanding and guide attempts to decrease injuries.
90 emergency units in USA.
Mayr J. Playground accidents. 1995.291–15 years attending Dept Paediatric Surgery.Postal questionnaire (28% replied = 103).Low response rate but 31% injuries were fractures or concussions, most on non-IAS.
Chalmers D, Playground injury: the kids are still falling for it. 199930Hospital admissions in NZ.School surveys 1997.Trend for increased reporting of minor injuries. Fewer serious injuries seen on modern surfaces.
NZ health information service statistical data.
Waltzman M et al. Monkey Bar injuries. Complications of play. 1999.31Paed admission related to monkey bar falls to Boston trauma centre. Range 20 mth to 12 years.Retrospective chart review.High percentage of fractures (61%) reported. The majority were upper limb with supracondylar fractures accounting for 40% total. Fracture type was age dependent.
Telephone survey.
Children under 4 more likely to sustain long bone fracture.
Surface did not influence injury type but no data on height.
Bernardo LM. Playground injuries in children. A review and Pennsylvania trauma centre experience. 200132Admissions to Pennsylvania trauma centres.Proforma.Nurses can advocate for playground safety.
CPSC Playground Injuries treated in US hospital emergency rooms. 200133Admissions to emergency rooms.Information direct from emergency rooms.Typical example of a yearly publication.
Ball D. Playgrounds: risks, benefits and choices. Contract research report. 426/2002. Health and safety Executive 2002Presentations to LASS from a selection of Accident Departments.From LASS Data Department of Trade and Industry.Information 1988–98.