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Playgrounds are an important part of healthy development for children that help them learn things like how to share, and how to communicate with others. Unfortunately, that fun can sometimes take a turn for the worse. Every year in the United States over 200,000 children visit emergency rooms with playground-related injuries [1].  In Canada in 2008, 28,500 children visited hospitals with injuries related to playground use [2].

The US Centers for Disease Control and Prevention (CDC) found that around 75% of nonfatal injuries occurred on equipment in public playgrounds, including schools and daycare centers. Severe fractures, internal injuries, concussions, dislocations, and amputations make up about 45% of playground injuries or injury complications [3]. The Canadian Paediatric Society notes that when it comes to Canadian emergency room visits, approximately 75% of injuries were caused by falling. Others were caused by impact with an obstacle (11%), body part pinches, cuts, and crushes (8%), and entrapments (1%). The most common form of injury are fractures, usually of an upper limb caused by falls from a climbing structure. Playground head injuries account for 15% of emergency room visits with the most common cause being falling from a swing [4].

The nature and extent of injuries are shown to be influenced by fall height and impact. Falling from higher than 4 feet 11 inches (1.5 meters) quadrupled the risk of injury [5]. The higher the height, the more serious the injury. The risk of injury is reduced 1.7 times when playgrounds are surfaced in impact-absorbing materials such as sand or pea gravel, rather than a material such as grass. The Canadian Standards Association (CSA) published a guide in 1990 titled “Children’s Playspaces and Equipment” which was revised in 1998 and accepted as a voluntary national standard by the Standards Council of Canada. The most recent revision was in 2007. The guide outlines detailed specifications for layout, access, surfacing materials, equipment strength, and performance requirements. It also included installation, inspection, maintenance, and design specifications for each piece of play equipment. Recommendations laid out by the voluntary standards include [5]:

Reducing the maximum fall height of the equipment. Strategies include:

• Innovative designs for new equipment at lower heights
• Using age-appropriate equipment

Reducing the risk of falling from equipment. Examples include:

• Protective barriers and guardrails
• Using vertical rather than horizontal bars (to discourage climbing)
• Using peaked or curved surfaces for guardrails (to discourage their use as play surfaces).

Improving protective surfacing under and around play equipment. Possible surfaces include:

• Loose-fill, such as coarse sand or pea gravel (smooth, round, pea-sized stones), wood chips, and synthetic surfaces, to depths of at least 6 inches (15 centimeters) for preschool equipment and 12 inches (30 centimeters) for full-sized equipment.

Deaths on playgrounds are extremely rare but they do occur. In the United States there are approximately 17 deaths per year attributed to playground equipment, 67% of which occur on home playground equipment [6]. Strangulation is the most common cause of playground death. Clothing drawstrings, scarves, and skipping ropes can get caught on equipment, causing death. Another potential cause of death is when a child’s head gets entrapped in an opening on playground equipment [7].

The Canada Safety Council has an easy rule for parents to follow before allowing their children to play on new playground equipment called ‘The 5 Ss of Playground Safety’. They are Surface, Structures, Site, Supervision, and Safety [8].

• Surface: Like that stated above, the surface around the equipment should be a soft surface such as wood chips, shredded rubber, or sand and it should be close to 12 inches deep and surround the equipment on all sides at least out to a distance of 6 feet. Also, check the temperature of the surface of metal slides to prevent burns on exposed arms and legs.
• Structure: Check wooden structures for splinters or weak spots. All steps should have good traction, swing seats should be made of soft material at least 2 feet apart and should be in a separate area to lessen the chance of someone getting too close to a child swinging.
• Site: Check for objects such as broken glass, nails, bolts, broken parts, or any other objects that could cause harm.
• Supervision: Ensure you are always able to see your children while on the equipment.
• Safety: Read posted playground rules and ensure your children understand them. Do not allow toddlers to play on regular-sized equipment.

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[1] https://www.brainline.org/article/playground-safety

[2] https://activesafe.ca/wp-content/uploads/2018/04/Playgrounds.pdf

[3] https://www.cdc.gov/homeandrecreationalsafety/playground-injuries/playgroundinjuries-factsheet.htm           

[4] Preventing playground injuries, Paediatrics & Child Health, Volume 17, Issue 6, June 2012. P. Fuselli, NL Yanchar, Canadian Paediatric Society, Injury Prevention Committee

[5] Preventing playground injuries, Paediatrics & Child Health, Volume 17, Issue 6, June 2012. P. Fuselli, NL Yanchar, Canadian Paediatric Society, Injury Prevention Committee

[6] https://www.cpha.ca/playground-injuries

[7] Preventing playground injuries, Paediatrics & Child Health, Volume 17, Issue 6, June 2012. P. Fuselli, NL Yanchar, Canadian Paediatric Society, Injury Prevention Committee

[8] https://canadasafetycouncil.org/playground-safety/