Trends and patterns of playground injuries in United States children and adolescents

Objective.-To determine the prevalence, trends, and severity of injuries at tributable to playground falls relative to other common unintentional mecha nisms that resulted in an emergency department (ED) visit in the United Sta tes. Design and Setting.-Data from the emergency subset of the National Hospital Ambulatory Medical Care Survey collected from 1992 to 1997 for children < 20 years. Methods.-Injury rates and 95% confidence intervals (CIs) were estimated and injury severity scores were computed. Results.-There were 920 551 (95% CI: 540 803 to 1 300 299) ED visits over t he 6-year study period by children and adolescents that were attributable t o falls from playground equipment. The annual incidence of visits for playg round injuries did not significantly decrease over the course of the study (187 000 to 98 000, P = .053). Injury visits for playground falls were twic e as prevalent as pedestrian mechanisms, but they were less prevalent than visits for motor vehicle- and bicycle-related injuries. A larger proportion of playground falls resulted in "moderate-to-severe" injury than did bicyc le or motor vehicle injuries. Children aged 5 to 9 years had the highest nu mber of playground falls (P = .0014). Playground falls were most likely to occur at school compared to home, public, and other locations (P = .0016). Conclusions.-Playground injury emergency visits have not significantly decl ined and remain a common unintentional mechanism of injury. Injury visits f or playground falls were proportionally more severe than injury visits attr ibutable to other common unintentional mechanisms. Interventions targeting schools and 5- to 9-year-old children may have the greatest impact in reduc ing emergency visits for playground injuries.