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Published on: January 20, 2023
Nonfatal Playground-Related Traumatic Brain Injuries Among Children, 2001-2013
Tabitha A Cheng1, Jeneita M Bell2, Tadesse Haileyesus3
1Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, The CDC Experience Applied Epidemiology Fellowship, Division of Scientific Education and Professional Development, and tacheng@mednet.ucla.edu.
Insights
Playground injuries cause thousands of emergency department visits for traumatic brain injuries (TBIs) in children annually. Rates increased from 2005-2013, highlighting the need for improved playground safety measures.
Area of Science:
- Pediatric emergency medicine
- Injury prevention science
- Public health surveillance
Background:
- Playgrounds are common recreational areas for children.
- Traumatic brain injuries (TBIs) are a significant public health concern in pediatric populations.
- Understanding playground-related injuries is crucial for developing targeted prevention strategies.
Purpose of the Study:
- To analyze the trends and characteristics of emergency department (ED) visits for nonfatal, playground-related traumatic brain injuries (TBIs) in children aged 14 years and younger.
- To identify specific playground equipment and locations associated with these injuries.
- To describe the demographic patterns of pediatric TBI from playground incidents.
Main Methods:
- Utilized data from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) spanning January 1, 2001, to December 31, 2013.
- Calculated injury rates per 100,000 population using US Census bridged-race population estimates.
- Employed Joinpoint linear regression analysis to identify trends and significant changes in annual TBI visit rates.
Main Results:
- An average of 21,101 children aged ≤14 years were treated annually in EDs for playground-related TBIs.
- The highest ED visit rates were observed in boys (39.7/100,000) and children aged 5-9 years (53.5/100,000).
- Monkey bars/playground gyms and swings were the most common equipment involved; injuries frequently occurred at recreational facilities and schools. The annual rate of TBI ED visits significantly increased from 2005 to 2013.
Conclusions:
- Playgrounds continue to pose a substantial risk for pediatric traumatic brain injuries.
- There is an urgent need for enhanced safety interventions, including improved supervision, risk-reducing behaviors, equipment maintenance, and safer playground surfaces.
- Effective strategies are required to mitigate the incidence and severity of playground-related TBIs in children.
Objective:
To describe the circumstances, characteristics, and trends of emergency department (ED) visits for nonfatal, playground-related traumatic brain injury (TBI) among persons aged ≤14 years.
Methods:
The National Electronic Injury Surveillance System-All Injury Program from January 1, 2001, through December 31, 2013, was examined. US Census bridged-race population estimates were used as the denominator to compute rates per 100 000 population. SAS and Joinpoint linear weighted regression analyses were used to analyze the best-fitting join-point and the annual modeled rate change. These models were used to indicate the magnitude and direction of rate trends for each segment or period.
Results:
During the study period, an annual average of 21 101 persons aged ≤14 years were treated in EDs for playground-related TBI. The ED visit rate for boys was 39.7 per 100 000 and 53.5 for persons aged 5-9 years. Overall, 95.6% were treated and released, 33.5% occurred at places of recreation or sports, and 32.5% occurred at school. Monkey bars or playground gyms (28.3%) and swings (28.1%) were the most frequently associated with TBI, but equipment involvement varied by age group. The annual rate of TBI ED visits increased significantly from 2005 to 2013 (P < .05).
Conclusions:
Playgrounds remain an important location of injury risk to children. Strategies to reduce the incidence and severity of playground-related TBIs are needed. These may include improved adult supervision, methods to reduce child risk behavior, regular equipment maintenance, and improvements in playground surfaces and environments.
