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Playground injuries file (2)

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Questions to Dr.Mariana Brussoni

from Jutta about playground-related morbidity data, March 15, 2017

I read this comment by you on Tim Gill's blog, dated May 16, 2015:

I was provided stats indicating 1 playground-related fatality in the period 1982-2000. We don’t know when it was or how it occurred, other than it didn’t involve strangulation. In this same time period, there were 17 strangulation-related fatalities.

...the Statistics Canada Cansim database offers the reader a look at national statistics from 2000-2011. The only ICD code that specifies playgrounds is for falls. If one runs the query looking at ages 1-14 years, there was 1 fatality in 2007 to a 5-9-year-old girl.

My questions:

1. do you know of sources for any of the 17 strangulation deaths? As you can see in my link, despite trying for some time, I could find almost none, and the personal information from Dr.Butler-Jones was not helpful. And yet the number is still quoted in many places.

2. your organization is one of the leads in inquiring into childhood injuries. And yet you write that you don't know how the pre-2000 playground detail occurred, in what manner. Does that mean you have no way of finding out? Are such data unavailable even to researchers, on privacy grounds?

I appreciate any help you can give.

response from Dr.Brussoni, March 15, 2017

I’ll do my best to answer your questions:

1. I saw this statistic in a PowerPoint presentation sent to me by Peter Kells. As I recall, it was based on data crunched by Dr. Lynne Warda (IMPACT) who was on the CSA committee for a while. To my knowledge, she never published it....I know that Peter was doing his own surveillance, such as it was, based on newspaper reports and that presentation had that info in it as well.

2. The reason the pre-2000 data are not readily available is due to change in coding from ICD-9 to ICD-10, making comparison of data difficult. As a result, the Statistics Canada Cansim data includes only those post ICD-10. Interestingly, I reran that same query that showed me there was only 1 playground fall related death and those data have been pulled (just show up as *). I imagine the reason is that they weren’t supposed to publish anything with a number below 5 anyway due to privacy considerations, so they must have realized it and changed it.

One detail I would correct from your blog regarding CHIRPP data is that the front of the form – where the event information is captured – is supposed to be filled out by the patient or their guardian. This is not the case in every hospital, but certainly most of them. That means, then that the narrative field of the event description could be quite rich and detailed, depending on what the patient chose to write. If it is too long, it does get truncated to fit the narrative field length, but it does generally have useful data that can be searched to find details that are not available in other datasets. For example, it’s been quite useful in identifying harmful products for which there aren’t particular codes yet – for example, the laundry detergent pods that are proving quite toxic to infants and toddlers these days; or in finding trends for particular kinds of things, such as mountain bike injuries (which would just be coded as cycling in other datasets).

The definition of serious injury is also an interesting one. What’s been typically used in the injury prevention literature is any injury that requires medical attention, because that has cost implications involved. So even if a child went to the emergency department and was treated and released, that would count as a serious injury. [highlight by editor] And typical surveillance reports would only do division by ED visit, hospitalizations, or deaths. However, there’s been work that has tried to deal with the definition of serious injury head-on. The attached article written by some of my colleagues outlines specific ICD codes that would be considered serious according to trauma surgeons. As a result, the scenario you describe in your blog for Janie, or even one where Janie broke her arm, would not necessarily be considered a serious injury.

I do agree with you, however, that people will use and interpret the data in ways that suit them to meet their needs.

[You could look at Parachute Canada's] The economic burden of injury report published in 2015. There’s a chart on page 24 that includes falls from playgrounds. There they report <5 deaths (which is consistent with my observation above that they can’t report numbers under 5). They also have stats for hospitalizations, etc.

Editor's note: See also excerpts from Parachute Canada "The economic burden of injury."


Email to Mariana Brussoni April 3, 2017

Thank you for sending me those very thought-provoking injury links. It took me two weeks instead of the two days I thought I would need, to get the time to organize my follow-up questions, but here they are:

1. the characterization of injury severity:

In the Parachute Cost of Injury report, there are columns on "Permanent partial" and "permanent total disability from injury."

- Would you know where I can find the definitions of these permanent injuries in reference to playground falls?

- are these disability estimates derived from Miller's 1995 U.S. Databook, as the 2010 Parachute report seems to suggest, or is there also a Canadian source you might point me to?

The National Post on Sept 19 2013 reported that of 1599 playground falls resulting in hospitalization in 2010, listed by CIHI, only 12 were categorized as "major." Really?

I note that a Globe editorial's original criticism of the 2005 Sick Kids schoolyard playground injury study pointed out its lack of information about the seriousness of the injuries reported: "All they know is that the injuries required attention, whether from a hospital or simply from a teacher or a parent...").

The confusion shows the usefulness of Dr.Ian Pike's work on defining severe pediatric injury -- is this approach now incorporated in CHIRPP or CIHI reporting?

2. The fluidity of the playground injury numbers:

- For example, there is this 2013 report from BCIRPU: , which says at the beginning "An estimated 2,500 children age 14 and younger are hospitalized every year in Canada for serious playground injuries."

The references in the sentences that follow, re the type of injuries, seem to come from 2001 and 2003.

The number 2500 is very common in other playground reports as well. But the CBC story using CIHI data has a graph showing 1716 "hospitalizations and deaths [sic] due to playground injuries" in 2001, and 1699 in 2003. The BCIRPU report was published in 2013, and if the 2500 number was meant for that year, it still doesn't nearly match: CIHI has 1852 hospitalizations for playground injuries in 2013.

Is the problem that there are different sets of data being used?

- As a follow-up to the CBC playground injury hospitalization chart in the link you sent, I note that the numbers have kept on going up (my updated CIHI excel sheet is attached), and actually have gone up quite sharply. Do you know whether Sick Kids revisited their conclusions, widely reported and also published in the CMAJ, that there was a 49% decrease in schoolyard playground injuries since the CSA standards were applied there?

3. Playground mortality data:

- I see that Dr.Warda quotes the 17 strangulation injuries between 1982 and 2000, in her 2009 power point presentation, plus one head injury, but she provides no reference.

- The Safe Kids Canada Ten-Year Report that you sent gives a narrower number: "between 1992 and 1995 approximately 2 children died every year, each resulting from strangulation or choking." But the footnote only references "Health Canada. Product Safety Bureau, unpublished data, 1992-1995." I have sent Health Canada a freedom of information request asking for details.

- On May 15, 2015, according to Tim Wills, CSA playground committee member Rolf Huber said at a public meeting at Metro Hall that 20 Canadian children had died on playgrounds as a result of falls over the past 20 years. Mr.Wills said that there had been no deaths, quoting you, and then corrected that on his blog, saying that you had clarified "there were two such fatalities between 1982 and 2011." CSA playground committee member Peter Kells commented on Mr.Wills' blog: "I had personal knowledge of deaths on playgrounds in Canada. I am not a statistician but when I have personal knowledge of events then I must speak up. As Mariana Brussoni has pointed out, there have been a number of deaths from strangulation the details of which we are not entirely sure."

- What is the case here? (I am confused!)

- Since CIHI suppresses injury or death numbers when less than 5, how do researchers like you find out the incidence and actual causes of playground deaths? And which researchers have access to the "narrative field of the event description" on the CHIRPP forms that you describe? Have these researchers published descriptive reports? Such details would help with the confusion about what kinds of playground injuries occur and why.


Response from M.Brussoni:

CHIRPP has its own way of coding injuries. That is not likely to change anytime soon. They don’t use ICD codes so it is not compatible with Ian Pike’s methods unless you pay a coder to recode everything and generate them. I seriously doubt CIHI will ever include something like this, though you could theoretically get CIHI data and do it yourself.

2. I suspect the reference in the BCIRPU report came from a previously published article or report – likely from Safe Kids Canada (pre Parachute). The CIHI data that I sent you landed in my inbox later than this report, so they wouldn’t have had access to it. One of the challenges has been getting timely access to data. We have had huge difficulties getting access to data through CIHI and have had to rely on other sources.

The Sick Kids article took advantage of a natural experiment, so they would not have updated the report as the research itself was completed and published.

3. The challenge re: playground deaths comes from the lack of specificity in the codes. We can easily look up how many kids died from playground falls, but there is no specific code for strangulations happening on a playground. As a result, Peter Kells was using newspaper articles to get a sense of the problem. Others may have had other sources. I tend to be very skeptical of some of the playground companies' statistics as I have seen issues with them before.

I saw the death data of playground falls (I suspect) before Statistics Canada realized that they were publishing a number smaller than 5. Last time I checked, it was fixed so you couldn’t see the precise number anymore (though I haven’t checked recently).

Anyone can access CHIRPP data and the narrative field. You need to make a request through PHAC, but you will likely need some sort of ethics certification to do so. You could also contact them directly to see if they have any new reports planned.

It is very difficult to get epidemiological reports published, so academics tend not to do them.


November 9, 2016 Establishing an injury indicator for severe paediatric injury

Ian Pike, Mina Khalil, Natalie L Yanchar, Hala Tamim, Avery B Nathens, Alison K Macpherson

Research in adults has demonstrated that while injury hospitalizations in general are decreasing severe injuries are not. This suggests that changes in clinical practice may be driving the downward trend rather than a real reduction in injuries. Development and specification of an indicator of severe paediatric injury allowed for a similar comparison for children. This can be used for population-based injury surveillance to examine trends over time.

Many of the severe injuries sound awful – but this short list has some exceptions – the only broken bones listed besides what’s below are “fracture of neck of femur” and spinal injuries.

Fracture of rib(s), sternum and thoracic spine

Open wound of abdomen, lower back and pelvis

Fracture of clavicle

Fracture of scapula

Injury of muscle and tendon at lower leg level


Strangulation on playgrounds

Safe Kids Canada: 10 years in review, 1994 - 2003

between 1992 and 1995 approximately 2 children died every year, each resulting from strangulation or choking.

Footnote 162: Health Canada. Product Safety Bureau, unpublished data, 1992-1995. As cited in "For the Safety of Canadian Children and Youth: From Injury Data to Preventive Measures." Ottawa: Health Canada, 1997, pg 200.

Note: FOI request submitted for details to Health Canada April 4 2017


CIHI site injury research data: They say they won't give details on injuries of less than 5 people. This is called “suppression of data in accordance with our privacy policy.”


Comment by Peter Kells May 18,2015 (from Tim Gills' blog)

I was as at the talk given by Tim in Toronto and was quite puzzled when he said that there had been zero deaths on Canadian playgrounds (note: there was no qualification to that statement as in deaths from falls etc.). The reason I was puzzled was because I had personal knowledge of deaths on playgrounds in Canada. I am not a statistician but when I have personal knowledge of events then I must speak up. As Mariana Brussoni has pointed out, there have been a number of deaths from strangulation the details of which we are not entirely sure.

Strangulation can occur due to foreign objects entering the playground (such as skipping ropes etc.) or it can be the result of the geometry of the play equipment (as in head and neck entrapment or clothing entanglement in cracks, crevices and protrusions etc.). So some of the strangulation can be deemed a result of foreign objects entering the playspace or it can be a result of the inherent geometry of the device in question which in my opinion is equipment related and is why playground standards have criteria to address head and neck entrapment as well as entanglement. There was a death in Northern Ontario related to a head entrapment gap on playground equipment that I know happened some years ago.

I have had some experience discussing playground data with the people at Health Canada who are responsible for the CHIRPP database and they indicated to me the challenge in mining the data for relevant information relating specifically to playground incidents – it is not easy as the coding system is not specific to playground incidents and in a world of limited resources the mining may or may not get done. Consequently, we have to be somewhat careful in what we draw from statistical data in that it may or may not be telling the entire story.


This BC injury “research” section link no longer works. In 2010 it said

Most fatal playground injuries are strangulation, and for the past 20 years one child each year has died in this way.


2005 Story of Edmonton girl strangled on slide: CanWest News Service, see link

The media account says that this was yet another instance of strangulation risk on playground equipment: “Strangulation is the most common cause of playground death, and more that 15 children have died from strangulation on playgrounds in Canada since 1882 according to the Children’s Health centre. On average, one Canadian child dies each year on playgrounds, and most of those deaths are caused by strangulation.” Note that the story is on a home slide but the report seamlessly moves to the generalized ending.

Follow-up from the Canadian Playground Practitioners website:

Dear Members, I have finally received the details of the strangulation death of the young girl in Edmonton in early June. It was not a case of clothing or drawstring entanglement.

Several children were playing in the backyard of the house. The mother was in the house. The children were playing "cats" with two scarves obtained from the back hall of the home. The scarves were used as cat tails. No one has any idea why the child tied the scarf to the upright and then attempted to go on the slide with the other end tied to her neck, but it is clear that this was not a case of the scarf becoming entangled on a component of the slide. The scarf was a typical long knitted winter type.

For your information. Christine Simpson, Consumer Product Safety Officer, Health Canada


Tracking the mortality stats

The quote: cited in a "Safe Kids Canada 10-year review 1994 to 2003" footnote 162. That footnote referred to 10 deaths in Canada resulting from playground equipment in the five years between 1992 and 1995.


FOI request A-2017-000011

It seems like the source of all playground mortality information came from the consumer product safety bureau.

What the CD showed:

All deaths listed by Consumer Product Safety

All reports attributed to the same person: Sandra Wright

1. #501568: [Ontario] Drawstring of fleece-lined pullover snagged at top of slide. Report from a newspaper article. Report “updated” 1998-11-23.

2. #503413: [Location: redacted] a rope had been attached to the monkey bars. Child slipped while climbing and was found hanging from the money bars: strangulation. Report “updated” 1999-01-29

3. #503415: [Pacific region] found unconscious at the bottom of the slide at a daycare centre. It is believed that a drawstring on her coat caught at the top of the slide and choked her. Report “updated” 1998-11-20.

4. #503416: [Location: redacted] a tied drawstring on the hood of her jacket became snagged at the top of the slide. The steel screws showed 1” protrusions. Asphyxia. Report “updated” 1999-01-29

5. #503417: [Ontario] boy died with a nylon skipping rope tangled around his neck as he hung face down on the slide. Report “updated” 1998-11-20.

6. #503418: [Location: redacted] drawstring of fleece-lined pullover snagged at top of slide: asphyxia. Report “modified” 1998-11-20.

7. #503420: [Quebec] victim’s coat got caught in the swing. The metal bar at the top on which the coat got caught is about 7 feet off the ground. Strangulation. Report “updated” 1998-11-20.

8. #503423: [Location: redacted] From a newspaper article. A large nylon sack had been tied to a rope that ran across the top of the slide. The child had apparently climbed into the bag and begun swinging back and forth: strangulation. Report “updated” 1999-01-29

9. #503425: [Prairies] wooden play structure. The child became caught on a protruding bolt on the play structure. The child’s jacket because caught in the back of the neck and child strangled as she hung suspended from play structure. Report “updated” 1999-01-29. Victim UNK

10. #500174: [City: unk] child was climbing a wooden fence when the drawstring of his parka became entangled between the top rail and the 4x4 beam: strangulation. Report “updated” 2005-2-25

The data I received may span from 1992 to 2005 – impossible to tell. The year of the death is either redacted or (my contact said) it happened too long ago for checking.

Summary:

5 drawstring strangulations (two may be the same, but there’s not enough information to check). One death was on a wooden fence, presumably not on a playground.

2 were strangulation by a rope and one by a nylon sack, all tied to equipment

2 were because a coat was caught and tightened around the child’s neck. One is anatomically impossible to imagine as described.

Two cited a protruding bolt; there were no other details that point specifically to equipment. There’s not a sufficient basis for deciding anything except to ban drawstrings, ropes, and sacks.

Request for FOI clarification:

I asked for the data cited in a "Safe Kids Canada 10-year review 1994 to 2003" footnote 162. That footnote referred to deaths resulting from playground equipment between 1992 and 1995. But the material on the CD had 10 cases of which 5 were dated 1998, 4 were dated 1999, and one was dated 2005. Can you clarify?

2. The redactions were inconsistent. Why is "city" blacked out in some reports and not in others? Why is part of each case number blacked out? Could you let me know which of the cases were obtained from newspaper articles rather than from first-hand reports to Health Canada?

Email response May 15 2017

from Christina David, ATIP Analyst / Corporate Services Branch Access to Information and Privacy, Health Canada and Public Health Agency of Canada / Government of Canada, christina.david@canada.ca / Tel: (343) 998-1894

1. The dates listed were not the dates when the event occurred.

2. For privacy reasons, we redacted the name and age of the child, the date the event took place, as well as the city (under a population of 50,000). The records were provided to the ATIP office in that format. I don’t know which ones were obtained from articles rather than first hand reports. It’s possible the program would know, but due to the date of the records, it isn’t likely. I could go back and ask, but I wouldn’t expect that they would be able to distinguish between the two.


Follow-up: I made a complaint to the federal Office of the Information Commissioner. It turns out that a mistake was made in redacting the material, since all the deaths were over 20 years ago. 20 years is the cut-off for the privacy shield. So the unredacted version was sent to me.

What I found: two of the cases, even though they were sent as separate occurrences with different case numbers, listed identical descriptions in the same year in the same small northern Ontario town. Most of the other reports had either the name unknown, the age unknown, or the place unknown -- or all three unknown. During the 20 years that this information could not be verified, playgrounds across the country were torn down using the fatality count based on these reports and reported by Health Canada.


In early May I also submitted another FOI request:

"Please send me the records of for “all playground-related serious injuries including deaths reported to or know to Health Canada, i.e. the Consumer Product Bureau as well as any other section of Health Canada from 1996 up to the present.”

I asked for year, cause, gender and age of child, and the source, e.g. media, manufacturer’s report etc. A worker has been assigned, and if whatever they find has the same heavy redactions, that can be attached to my other appeal.

Response:

From kyla.wainberg@hc-sc.gc.ca. She said I could contact Raju Gorinta raju.gorinta@canada.ca /Tel: 416-973-1739, from Consumer Product Safety Program (Health Canada). On June 22 2017 we spoke on the phone (his preference). He said that they would only get occasional random information about injury incidents on equipment bought by institutions. Sometimes they would note a news item.

My summary:

1. the consumer product safety program does NOT collect reports of incidents related to playground equipment bought by schools or parks;

2. the PSP's most recent publication that references playground accidents is from 2012;

3. The Canadian Paediatric Society paper [Gorinta] recommended does not appear to be aware of the steady rise in playground injury hospitalizations since 2006 (information attached, from CIHI);

4. the program does not receive reports of playground deaths because of reason #1.


My query to Public Health Canada in 2006

From Jutta Mason:

I e-mailed the general information link at Health Canada to ask how they had arrived at their number of 17. To my surprise, I got a letter back by regular mail, from the head of Canada’s Public Health Agency, Dr. David Butler-Jones: “the number of strangulations did not come from…coded data, but was based on cumulative information gleaned from coroners’ reports, incidents reported to the Product Safety Program at Health Canada and the Canadian Standards Association, and reports from other public health bodies. There is no single source that may be used to reference this information.” Dr.Butler-Jones said he had no more details.

I spent an afternoon looking up journal references at the university medical library. All but two, maybe three, cases making up the playground strangulation number turned out to be free-floating, unconnected to either a story or a source in the medical journals that dealt with child injuries and accidents.


Health Canada is always cited as the primary source of the “17 playground deaths” figure or its variants. From my FOI request we find out that over a period of possibly 18 years, there were 10 children who were said to have died by strangulation, 9 in playgrounds. But it appears that those Health Canada numbers can’t be verified [and never have been, see above] and so should not be quoted in any report, including by Safe Kids Canada.

On May 19 2017, appeal to the Federal Commissioner of Information

...asking for her to have Health Canada’s redactions of year of death, age of child, and place of occurrence removed. This is now being considered, but my contact at Health Canada suggests that further information may not exist – even to discover which reports were first-hand and which were merely taken from newspaper stories.

June 27, 2017: Email to Eric Murphy, Registrar, federal information commissioner

This is to acknowledge your letter referencing my complaint (3217-00398) and asking about email correspondence. That way of communicating suits me well, and I will be glad to send "any representations or additional information" electronically.

Once this file has been assigned, I look forward to finding out more about the process and about the format for information that is acceptable for your commission.

Nov.10, 2017

No response yet.


Research

Rolf Huber (CSA committee member)

The following quote was taken from Rolf Huber’s Everplay newsletter, at this link. Huber was debunking the idea that rubber surfacing may make people sick:

A problem with a raw material as specific as tire rubber is that studies are expensive and sometimes the only funder is a manufacturer or group of manufactures or their trade association with a true interest in knowing the properties of the raw materials meet the requirements of the customer. Unfortunately this has sometimes caused readers and organizations to view the report with skepticism and question whether the study is comprehensive enough. There are also those in the study business, who will always find fault with someone else’s work, or raise obscure questions that promote their business and add nothing to the science or add positively to knowledge or advance the state of the art.


The inspectors come to Dufferin Grove, May 12 2005

Two city inspectors came to Dufferin Grove playground to walk around with five of us. The rec staff had dug up the sand with a couple of community-service-order youth, and we wanted to know if a simple digging, which could be a daily staff task, would pass the CSA playground surface test. So the men set up their shiny high-tech accelerometer (a metal ball on a wire). The dug-up sand passed at every spot that had been dug, with honours. No need for a pricey sand replacement.

After the “drop tests” were done, we went through the list of the playground parts condemned in the 1998 Canadian Standards Association inspection. One of the inspectors said he might have done the original report, but he couldn't remember now because they inspected so many.

With the carnage of playground destruction all over the city, it must be hard to keep it all straight.

In the inspection report, at Dufferin Grove playground, half the swings on the big swing frame are slated to be removed. The climber has to go. All the baby swings on the centre structure are supposed to come off, and the little slide there too, and the broad slide nearby. All horizontal railings have to be replaced by tight vertical pickets engineered so they are impossible to climb. As the inspectors walked around with us, they described in each case what injuries could happen. Kids on swings could go sideways and smash into other kids on swings. Kids could climb on a railing, fall and break their necks. The conversation was full of dreadful images, smashed heads with permanent brain damage, strangling on monkey bars, complex fractures with permanent impairment from falling off the side of the slide. The only thing that would let the inspectors sleep well at night, as far as we could tell, would be ripping out the whole playground and starting over with a new structure.

We said, “we don't want a new structure. We like this one.” They said, “why wouldn't you want something brand new instead?” “We said, would you like to throw out all your living room furniture, your favourite comfortable chair, the couch, the table you got from your grandfather, and replace it all with new stuff from the store?”

They said “.....hm.”

These inspector-fellows are urged to imagine the worst thing, the one-in-a-million disaster that could happen in this world where gravity exists. They are not trained in math, so in their minds an event that happened once in a million times – on a playground, on the street, in the bedroom – is almost a sure thing to happen again, right here. Their mantra is: if even one child is saved from a terrible accident, all of the changes made in playgrounds will have been worth it. When we told them that the playground accidents in Toronto had gone UP since the great playground destruction that began here in 2000, they said that was not possible. It might be that emergency room visits had increased because parents are so neurotic that they'll take their kids to the hospital for nothing. But “no,” we said, “the number of at-least-one-night hospital stays has gone up. In other words, real injuries have increased since you guys put in what you hoped was "safe" equipment.”

They were stumped. But only for a little while. When there's a new statistic that makes no sense in this CSA-safety-world, it can't find a toehold, so it just fades away. The inspectors left the playground with a promise to come back and fix all the dangers as soon as they could get the time.

I sent my account of the walkabout to Maya, and her answering e-mail was a passionate rant. “A boring playground is a dangerous playground. All those measures put into place by CSA to prevent falls by the use of pickets, and changing all surfaces so kids can’t balance—making them pointy. They are telling children that these spaces are not part of the playground, not for climbing on! But they don’t provide anywhere to climb and healthy, active, normal kids will always climb so, at the playground……kids are naturally climbing more dangerously than ever before! So, kids are FALLING and getting injured more than ever before! Nobody told the kids that playgrounds are just for walking, standing and kicking at the dirt. So they still behave like normal, active kids and they still try to climb! Dumb kids! Playgrounds are dangerous. Stop climbing!”


Many people are under the impression that "research has shown" specific cases of injuries in playgrounds of the kind that get inspectors so worried. The surprising thing is, very few details are known to researchers when they try to find out how playground accidents happen. Injury counts often lump injuries merely requiring a bandaid and a cookie with injuries resulting in a broken leg or worse. This recent article from Norway shows how scant the data can be:

NORDIC EARLY CHILDHOOD EDUCATION RESEARCH JOURNAL

Injuries in Norwegian Early Childhood and Care (ECEC) Institutions Sando, O.J., Sandseter, E.B., Pareliussen, I., Egset, C.K. VOL. 14 (1), p. 1-15, PUBLISHED 7th OF FEBRUARY 2017

Norwegian injury statistics show that Norwegian children have never been as safe as they are now, there has been a marked decline in the number of injuries and deaths among Norwegian children during the last 50 years (Ellingsen, 2008). Data on injuries show that each year, approximately 6,500 Norwegian children are brought in for medical care because of injuries on playgrounds (BFD, 2000), but this excludes data on details about where and when the injuries happen to children. In addition, they do not distinguish between serious or minor injuries. Therefore, it is difficult to make conclusions about the number and severity of Norwegian playground injuries. The numbers from Norwegian Statistics (2012)show that the occurrence of death injuries on playgrounds and ECECs from 1996 through 2009, was 7 incidents. This also includes injuries that happened on public playgrounds and on the ECEC playgrounds after hours when people independently visited the playground.....

....How the number of severe injuries in the present study relates to comparable numbers in ECECs has not yet been possible to evaluate since no other studies in ECECs — to our knowledge — show detailed numbers and descriptions of these severe injuries. Since the rest of the injuries (19) in level 4 in this study are not described by the respondents and since two ECECs have, exclusively, reported 11 of the injuries without any descriptions, it is very difficult to interpret the results in more detail. Nevertheless, the results indicate that severe injuries are very rare in Norwegian ECECs...


May 27, 2017, request to see CHIRRP data

Declined. Correspondence.


How to do science the right way: from a SAFE KIDS CANADA Powerpoint

-- by Pamela Fuselli. Note: this link no longer works.

The National Injury Prevention Program of the Hospital for Sick Children

Knowledge – Credibility Guidelines

Judging the credibility of injury prevention information can be challenging. Who do you trust as a source of information and why?

Internet has significantly increased the amount and variety of information that communities and individuals can access. Some of the information available is incorrect, out of date, or of questionable origin.

• A credible information resource tells you who is responsible for the information it provides.

• If the resource names an individual as its author, the credentials of this author should be identifiable and these credentials should be solid (e.g. academic designation(s) from a reputable institution and/or experience).

• If the resource names an organization as its author, both awareness of the organization and experience with it contribute to the credibility of an information resource

Currency

• A credible information resource clearly identifies its date of production (or date last modified) as well as provides information on the currency of the information used in the resource.

• The more “dated” the information presented in the resource, the more its credibility is weakened

Accuracy

• Thoroughly references the sources used to provide the information, including statistics and images.

• If this is not possible within the resource itself, the resource should provide the means e.g. contact information, by which one can obtain the list of sources used to develop the resource.

Accuracy

• Demonstrates evidence that the sources used for the development of the resource are current and reputable.

• Examples of reputable sources include

•articles from peer-reviewed journals

•government reports

•position statements by authoritative organizations

•consultations with experts or organizations in the topic area

•“best practices”

•results of vigorous evaluation studies/protocols

If these criteria were actually applied to the 2005 Sick Kids-sponsored article about playground injuries, that paper would not fare well. Instead it's quoted over and over again, like some persistent gossip.


An odd finding about injury-prone safety researchers.

Study led by Mariana Brussoni

….The researchers sent out surveys to organizations and online forums for such professionals, who include academics, employees of safety agencies, civil servants and insurance-company officials.

Just over 400 responded to questions about whether they had suffered medically treated injuries in the previous 12 months. The results were compared to data on the general population from the federally run Community Health Survey.

Almost 84% of professionals said they thought that working in the field made them more careful. Yet 86 reported having a total of 112 injuries that required medical attention in the preceding year.

Sports injuries (33%) and falls (19%) were the most common mishaps. The per-capita rate of injury was 70% higher than that for the overall population, the study concluded.

Thinking the professionals were perhaps more likely to be physically active than the average Canadian — and so more prone to harm from sports and other exercise — they compared their findings to the most-active sub-group in the national survey. The injury professionals were still 50% more likely to get hurt than those active Canadians, the study said.

Mr. Smith of the Safety Council said actual injury-prevention practitioners, like the safety inspectors who visit factories and other workplaces, are likely to be more careful than academic researchers, a difference that seemed to be borne out by the study. National Post tblackwell@nationalpost.com


Content last modified on February 07, 2018, at 02:15 AM EST