Donna Thompson

A descriptive analysis of children's playground injuries in the United States 1990-4.

OBJECTIVES: To review playground injury statistics over a five year period in order to develop an awareness of how and where children in the United States are being injured. METHODS: All data are based on the United States Consumer Product Safety Commissions National Electronic Injury Surveillance System (NEISS) for playground related injuries during 1990-4. The surveillance data includes injuries recorded in more than 90 hospital emergency departments located throughout the United States. RESULTS: Each year there are roughly 211,000 preschool or elementary school-children in the United States who receive emergency department care for injuries associated with playground equipment. On average, 17 of these cases result in death. 70% of all injuries occur on public playgrounds, with nearly one third classified as severe. Swings, climbers, and slides are the pieces of playground equipment associated with 88% of all NEISS reported injuries. Falls to the surface are responsible for 70%. CONCLUSIONS: NEISS playground injury statistics contribute to our understanding of playground injuries. By identifying where and how children are injured, suggestions can be made in an attempt to make playgrounds safer.

Testing the impact attenuation of loose-fill playground surfaces

Objectives—Our objective was to measure the impact attenuation performance of five types of loose-fill playground surfaces at a variety of drop heights, material depths, and conditions. Methods—In a laboratory setting, an instrumented head form was dropped on varying depths of loose-fill materials at one foot height increments until critical deceleration values were exceeded. The effects of test box size, material temperature, and compression were also studied. Results—Data suggest that a larger test box size influences test results. Uncompressed materials performed quite unexpectedly, that is, resilience did not necessarily increase with increasing depth of material and temperature did not have uniform effects. Compression before testing improved consistency of results. Conclusion—The current standard test procedure (ASTM F1292) appears problematic for loose-fill materials. Our results indicate that (1) shredded rubber was the best performer; (2) there was little difference between sand, wood fibers, and wood chips; and (3) pea gravel had the worst performance, making it a poor choice for playground surfacing.

The prevention of playground injuries

The second in a series of three articles devoted to the development, maintenance, and implementation of the National Association of School Nurses 1998-2001 Strategic Plan and how it relates to the practice of school nurses. Information about the development of a mission/vision statement for the organization is given along with strategies for developing a local school district school health program strategic plan. A previous Nursing Practice Management section article discussed the development of the Associations strategic plan considering the changing health care climate, the shifting needs of school children, and the economic climate for school funding. A future Nursing Practice Management section article will discuss the implementation of the seven goal areas in the National Association of School Nurses 1998-2001 Strategic Plan.: The second in a series of three articles devoted to the development, maintenance, and implementation of the National Association of School Nurses 1998-2001 Strategic Plan and how it relates to the practice of school nurses. Information about the development of a mission/vision statement for the organization is given along with strategies for developing a local school district school health program strategic plan. A previous Nursing Practice Management section article discussed the development of the Associations strategic plan considering the changing health care climate, the shifting needs of school children, and the economic climate for school funding. A future Nursing Practice Management section article will discuss the implementation of the seven goal areas in the National Association of School Nurses 1998-2001 Strategic Plan.

Developing a playground injury prevention plan

Playgrounds are a major source of unintentional injuries in the school environment. In fact, 80% of all injuries on public playground equipment happen at school. Thus, the need for developing a playground injury prevention plan is critical to provide safe educational outdoor environments for children. The S.A.F.E.™ framework for injury prevention is the first step in preventing playground injuries. This article highlights suggestions that school nurses can implement in creating an effective playground injury prevention program at their schools.

An Investigation of School Playground Safety Practices as Reported by School Nurses

The purpose of this study was to investigate school playground safety practices. The study used a purposeful sample of school nurses who attended a playground safety workshop at the 2006 National Association of School Nurses annual conference. Seventy-five questionnaires were distributed, and 64 useable questionnaires were returned. The responses indicated that little attention is being given to providing safe playground environments in schools as measured by best practices of supervision, age-appropriate design, fall surfacing, and equipment maintenance. Participants pointed to the need for better supervision and supervision training, careful selection of age-appropriate equipment, maintaining adequate fall surfaces under the equipment, and ensuring that equipment is properly maintained and repaired. The study also revealed that school nurses believe they could play a role in playground injury prevention through the collection and analysis of injury data, communication to administrators about the need for comprehensive planning of the play environment, and becoming active members of playground safety committees.

Play areas and the ADA: providing access and opportunities for all children.

A ll children deserve the right to play. But, for many children with disabilities, this right has been denied through the way play areas are designed. With the advent of the Americans with Disabilities Act in 1990, the theoretical right ofchildren with disabilities to access play areas became a law.As with many legal mandates; however, it has taken more than mere passage of a law to ensure this right. In October 2000, the official recommendations ofthe United States Architectural and Transportation Barriers Compliance Board (Access Board) with regard to playgrounds were sent to the Justice Department. This article willdescribe those recommendations in relation to play areas, including playgrounds at elementary schools. It will discuss what these recommendations are, who needs to comply, and when compliance begins. In addition, this article will describe specific definitions and requirements found in the recommendations and how these definitions and requirements apply to public playgrounds. This information is intended for all HPER professionals who may be considering the development ofa new playground or updating existing playgrounds.

How SAFE are school and park playgrounds? A progress report.

Abstract A new national survey uncovers good news—safety has improved—and bad news—it still rates only a “C+.”

The impact attenuation performance of materials used under indoor playground equipment at child care centers

Each year, thousands of children receive emergency medical treatment for playground-related fall injuries. In the United States, over 64,000 of these playground injuries involve children under the age of 5, many occurring in child care centers. More specifically, playground injuries were estimated to annually involve 1.64% of children in a child care center, with playground fall-injury rates estimated at 0.25/100,000 child-hours in day care. Thus, selecting an appropriate surface material for use under and around playground equipment is a concern for many child care center professionals. Information concerning a range of acceptable surface materials (such as sand, wood chips, gravel, and rubber products) is readily available. However, the advent and popularity of portable playground equipment has complicated the issue of providing safe undersurfacing, especially when used indoors where loose-fill surfacing is not practical. This equipment is designed to meet public playground equipment standards (ASTM F1487 in the United States, for example), but because it does not require concrete footings, this equipment is often used indoors. We believe that outdoor testing standards and procedures (i.e., ASTM F1487 and ASTM F1292) are most applicable to this equipment even if it is used indoors. Child care center operators frequently ask whether rest mats, exercise mats, tumbling mats, and carpet provide adequate fall protection for the portable plastic equipment used indoors in their centers. It appears that the common practice is to place whatever mats are on hand around the equipment. Because data on the safety of this approach are unavailable, the National Program for Playground Safety, located at the University of Northern Iowa, investigated the impact attenuation of products commonly used by child care centers under and around indoor playground equipment. While certainly not exhaustive, the data in this report are intended to highlight a potential safety concern from this practice.

Strategies for Playground Injury Prevention: An Overview of a Playground Project

Abstract Preventing injuries to children, especially debilitating and life threatening, requires an awareness of where these types of injuries occur during the school days. This review examines falls from playground equipment, events that have been identified as the leading causes of nonfatal unintentional injuries for children. Thus, the issue of playground safety is a topic of concern for health educators. School health educators play an essential role in developing safe and healthy outdoor play environments for children. This paper highlights the importance of injury prevention awareness and outlines different strategies that health educators can take for preventing playground injuries. In addition, this paper examines a project that was conducted in the state of Iowa in relation to what effects playground surfacing materials and staff training may have on injury prevention on school playgrounds. The results of the project concluded that with the addition of proper surfacing material and staff training, playground injuries could be reduced. Health educators need to investigate the types of playground injuries in current programs and develop a strategy to keep children healthy and active.

Playground Safety: Using Research to Guide Community Policy

Abstract Each year over 200,000 children in the United States require emergency medical treatment for playground-related injuries, costing an estimated