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Injuries in public and private playgrounds: the relative contribution of structural, equipment and human factors
E Petridou1, J Sibert, X Dedoukou
1Department of Hygiene and Epidemiology, Athens University Medical School, Greece. epetrid@med.uoa.gr
Insights
Public playgrounds pose a higher risk for child injuries, particularly concussions and open wounds, compared to private ones. Improved supervision and footwear can significantly reduce playground accidents.
Area of Science:
- Pediatric injury prevention
- Public health research
- Child safety
Background:
- Children in developed countries spend increasing time in playgrounds.
- Playground injuries represent a significant public health concern.
Purpose of the Study:
- To identify and quantify risk factors associated with playground injuries.
- To compare injury risks between public and private playgrounds.
Main Methods:
- Case-control study design utilizing data from an Emergency Departments Injury Surveillance System (EDISS).
- Analysis of 777 playground injuries in Greater Athens during 1999.
- Assessment of playground use patterns in a control group of 294 children.
Main Results:
- Annual incidence of playground injuries was approximately 7/1000 for boys and 4/1000 for girls.
- Public playgrounds showed a 2.2 times higher risk of injury compared to private ones.
- Higher odds of concussion (8x) and open wounds (6x) were observed in public playgrounds; swings, slides, and seesaws were common injury sources.
Conclusions:
- Nearly 50% of playground injuries are preventable through structural and equipment modifications.
- Enhanced supervision and promoting appropriate footwear/protective gear can further decrease injury rates.
Unlabelled:
The aim of this case-control study was to identify and quantify risk factors of injuries in playgrounds, where children spend an increasing amount of time in developed countries. The study took place in Greater Athens during 1999. A continuous Emergency Departments Injury Surveillance System (EDISS) of hospitals that cover about 30% of the children's time at risk in Greater Athens identified 777 injuries in public and private playgrounds out of a total of 17 497 injuries. Public playgrounds differ from private ones, because the former generally have more equipment, usually of greater height, with less resilient surfaces, and supervision relies mainly on parents or guardians. Patterns of type of playground use were assessed in a sample of 294 children from the same study base who served as a control group in a hierarchical case-control design. The annual incidence of playground injuries in Greater Athens was about 7 in 1000 among boys and 4 in 1000 among girls, with a 2.2 times higher risk for an injury in public than in private playgrounds (95% confidence interval 1.61-3.07). Children in public vs private playgrounds had a statistically significant eight times higher odds for concussion and six times higher for open wounds, whereas the odds for long bone fractures were four and for other fractures two; swings, slides and seesaws were the types of equipment most frequently associated with injuries. It was further shown that supervision of children was suboptimal (< 60%) in both public and private playgrounds, and children in private playgrounds sustained an unduly high frequency of sprain/ dislocation injuries (odds ratio 1.75) because they were encouraged to play bare-footed.
Conclusion:
Close to 50% of playground injuries could be prevented by structural and equipment changes, while further reduction could be accomplished through simple measures including closer supervision and encouraging children to wear proper shoes and use protective equipment whenever necessary.