PLAYGROUND INJURIES IN CHILDREN

Childhood injuries are a major source of morbidity and mortality in in dustrialized countries, and many injuries occur on playgrounds, Our pu rpose was to examine childhood playground injuries in a metropolitan c enter in Canada, All children injured on playground equipment who were seen in the emergency department (ED) at The Hospital for Sick Childr en between March 1990 and July 1991 and were entered in the Children's Hospital Injury Research and Prevention Project (CHIRPP) database wer e included, The type, body part, and mechanism of injury mere determin ed as well as the type of equipment, location, and surface. Among the 289 children injured on playground equipment, the mean age was 5.9 yea rs with 39% <5 years (range: 1 to 18 years), The most common injuries included fractures (28%), lacerations (24%), and hematomas (14%), The head and neck were injured 43% of the time, the upper extremity 41%, l ower extremity 10%, and the trunk 6%. Climbing apparatus injuries occu rred in 29% of children <5 years compared with 47% of those injured wh o were greater than or equal to 5 years (P = 0.002), Injuries related to slides occurred in 40% of children <5 years compared to 26% of chil dren greater than or equal to 5 years (P = 0.033), Of children <5 year s, 58% had head and neck injuries compared to 32% of children greater than or equal to 5 years (P = 0.0006), Of children <5 years, 28% had u pper extremity injuries compared to 49% of children greater than or eq ual to 5 years (P = 0.0005), There were no fatalities and the overall hospitalization rate was 18%. Of those children hospitalized, 77% had fractures, compared to 16% of those not hospitalized (P = 0.00001). Of all children hospitalized, 62% were injured on climbing apparatus, co mpared to 37% of those not hospitalized (P = 0.0004). There were no si gnificant differences between nonprotective and natural protective sur faces with respect to hospitalization. We conclude that: 1) upper extr emity injuries, especially fractures, accounted for the majority of ho spitalizations resulting from injuries on playground equipment; 2) cli mbing apparatus-related injuries accounted for nearly two thirds of ho spitalizations; 3) older children sustained more injuries on climbing apparatus, where younger children sustained more injuries on slides; a nd 4) younger children sustained more head injuries on playground equi pment than older children, but most of these were minor.