Pediatrics, May 2016: Nonfatal Playground-Related Traumatic Brain Injuries Among Children, 2001–2013

Link

Excerpts:

Quick summary for the busy pediatrician:

What’s Known on This Subject:

Modern playground surfaces reduce the risk of death or serious injury due to falls. However, playgrounds are still important locations of injuries to children; these injuries may be further reduced through the application of injury prevention strategies.

What This Study Adds:

A national sample of emergency department visits for playground-related traumatic brain injuries among persons aged ≤14 years was studied, finding 21 101 persons affected with this condition from 2001 to 2013. This describes the importance of continued efforts to improve playground safety.

From the summary you'd never know that the study shows a steady increase in playground injuries. Also the summary gets the number wrong, see next quote:

"from 2001 to 2009, there were an estimated 16 706 emergency department (ED) visits annually for playground-related traumatic brain injury (TBI) among persons aged ≤19 years.8 Most of these patients were treated and released, suggesting that they would likely be best categorized as mild in severity."

"From 2001 to 2013, an annual average of 214 883 persons aged ≤14 years were treated in EDs for playground-related injuries; of these, 21 101 were treated for TBI (9.8%)"

"From 2001 to 2013, an annual average of 214 883 persons aged ≤14 years were treated in EDs for playground-related injuries; of these, 21 101 were treated for TBI (9.8%) (Table 1). Of the playground-related TBI ED visits, boys accounted for 58.6% and persons aged 5 to 9 years accounted for 50.6%. Overall, 95.6% were treated and released, and 2.6% were hospitalized or transferred for further care."

"From 2001 to 2005, the annual modeled rate change...nominally decreased; whereas in the second segment, from 2005 to 2013, the estimated rate trend increased significantly...For persons aged 0 to 4 years, from 2001 to 2013, the estimated rate trend increased significantly....For persons aged 5 to 9 years, from 2001 to 2006, the estimated rate trend nominally decreased....and then increased significantly from 2006 to 2013....For persons aged 10 to 14 years, from 2001 to 2006, the estimated rate trend nominally decreased....and then increased significantly from 2006 to 2013...."

"....the results of our study do not suggest that injuries sustained on playgrounds have become more severe: >90% of cases (Table1) are treated and released from EDs annually on average....Most cases for other playground injuries were also treated and released annually."

"According to the results of this study, standard ASTM F1292 for playground surfaces appears to be effective, as few deaths from head and neck injuries have occurred in recent years.[Footnotes supplied #5, and #6 are just links to the specifications of the American Society for Testing and Materials ASTM).] However, our study also suggests that standards for playground construction and surfacing need to be continually reviewed and modified to reduce the risk of all TBIs and not just severe head injury and death."

section about "limitations of this study": "the lack of playground equipment exposure data prevented calculation of equipment-related injury rates."

"NEISS-AIP narrative descriptions do not provide detailed information about injury circumstances, such as playground surfacing and risk behaviors. As a result, NEISS-AIP cannot be used to assess the impact of these factors on injury incidence."

"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."