Playground injuries hit kids hard

Broken arms, wrists or elbows represent the majority of injuries presented by children during visits to the emergency room in the summer months and these injuries most often are the result of a playground accident. Second only to cycling mishaps, playground injuries made up 8,698 of the emergency room visits in Ontario in 2002-2003.

These insights were part of a report released by the Canadian Institute for Health Information Aug. 11. Alison Macpherson, an epidemiologist with York’s School of Kinesiology and Health Science who specializes in childhood injury research and prevention, says the study confirms the need to find new ways of preventing injuries and decrease the number of serious incidents requiring hospital stays.

Right: Alison Macpherson

Although the figures show no significant increase in the number of injuries since 1998, Macpherson is still concerned about accidents that require a stay in hospital, usually those requiring surgery for a severe fracture or head injury. “In 590 cases, the injury was severe enough to require at least one night in hospital,” said Macpherson. “That’s about seven per cent of injuries – a significant number.”

The study found:

  • 8,698 emergency room visits resulted from playground injuries in 2002-2003;
  • 4,833 of those injured (56 per cent) were children aged 5-9 years old;
  • 3461 of the injuries (44 per cent) occurred during June, July and August;
  • The majority of injuries (3,461) were broken arms, wrists or elbows;
  • Children 10-14 were the next largest group to experience summer sports injuries.

No stranger to these kind of statistics, Macpherson is currently working on a comprehensive atlas of injuries in Ontario with the Institute for Clinical Evaluative Sciences, where she trained as a postdoctoral fellow. She also works with the Canadian Institute for Health Information as a spokesperson, and as a scientific consultant to child safety groups. She recently co-authored a report on a study on playground equipment for the Toronto District School Board and earned her doctorate studying bicycle helmets and efforts to legislate their use.

Copies of the study’s executive summary are available at

Some common playground hazards include inadequate fall zones under playground structures; the absence of guard rails; dangerous protrusions including screws, nails, bolts, pipe ends and sharp or pointed hardware; dangerous swing seats; openings between posts, ladder rungs, deck levels or entryways that are too large; and age-inappropriate equipment.

Safe playgrounds have a deep, soft surface of mulch or a rubber surface beneath the climbing equipment. Dirt or grass can become compacted forming a hard surface. Soft rubber mats or lots of sand under and around structures are better surfaces than pea gravel or wood chips. Parents and caregivers should check the depth of the surface with their heel to make sure it is at least 15 cm deep.

Spacing is important as ladder rungs can trap a child’s head. Safe spaces are smaller than 9 cm or larger than 22.5 cm. Guardrails and handrails are important for equipment that is above the ground.

Sharp edges and exposed nuts and bolts on playground structures can cause pinches or cuts. Swing seats should be made of soft material. 

Macpherson suggests that making the playground safer is a more effective strategy than asking parents to supervise their children. “Parents can’t be everywhere and children play at school and daycare as well,” says Macpherson. “Equipment height and surfacing are the most important factors to consider in playground safety.” The Canadian standards for playgrounds, if followed, lead to safer playgrounds.