There are many rules and regulations governing playground safety, and as with any context in which there are rules, some rules will be violated by some of the people, some of the time. But which is the most often-violated playground safety regulation?
From my own field experience as a safety analyst, I'd say that the most common violation is the maintenance of the proper depth of resilient surfacing. That is, woodchips, wood mulch, rubber mulch, etc. There are supposed to be at least 6 inches of woodchips (or whatever other surfacing material is used) within a 6 foot radius of the equipment, and more if the equipment is above a certain height. I've rarely seen adherence to that, though, and this report by researchers at Monash University, Australia, confirms my suspicion: only 4.7% of the playgrounds they studied had the recommended depth of protective surfacing, given the equipment height. Fewer than 1 in 20!
Marc Miller, of Maryland Materials, offers another opinion: overlapping areas of play. Structures are not meant to be too close together - just picture kids trying to leap from swingset to monkeybars to spring toy. It's a safety nightmare. And, often, playgrounds do have structures that are a bit too close together, because of schools or day care centers wanting to squeeze in more equipment than the allotted area can safely support.
I'll do some reading on the subject, and post if I find anything particularly egregious. Until then, happy playing...
Friday, October 29, 2010
Tuesday, October 26, 2010
A little bit of trivia
When you're at your next cocktail party, break out this little gem to astound and amaze your peers:
Q: When, where, and in what form was the first even public playground in America?
A: "The first public playground in the United States was located in Boston where, in 1885, the Massachusetts Emergency and Hygiene Association procured a heap of sand for the yard of the Parmenter Street Chapel to create opportunities for children’s play."
Source: the Harvard School of Public Health report, from a couple of posts ago.
Q: When, where, and in what form was the first even public playground in America?
A: "The first public playground in the United States was located in Boston where, in 1885, the Massachusetts Emergency and Hygiene Association procured a heap of sand for the yard of the Parmenter Street Chapel to create opportunities for children’s play."
Source: the Harvard School of Public Health report, from a couple of posts ago.
Monday, October 25, 2010
Need for a state-wide database?
The good people of Oklahoma have woken up to the fact that there's no reliable way to track the total number of injuries incurred on playgrounds, and where (which school, park, etc.) these injuries occurred.
This article - which is quite long, but worth the read - goes into the potential costs and benefits of instituting a state-wide tracking system. The issue has been raised because a 9-year-old girl died from a playground injury this past summer, and school officials in that district "discovered" that they had no formal means of spreading that information to the 500 other school districts in the state.
I'm all for a state-wide database. It would create a small amount of bureaucracy for schools, yes, but wouldn't it be worth the cost to know if there are any particular schools that are incurring abnormal amounts of playground injuries, so corrective action could be taken? Good data makes the world go 'round...
This article - which is quite long, but worth the read - goes into the potential costs and benefits of instituting a state-wide tracking system. The issue has been raised because a 9-year-old girl died from a playground injury this past summer, and school officials in that district "discovered" that they had no formal means of spreading that information to the 500 other school districts in the state.
I'm all for a state-wide database. It would create a small amount of bureaucracy for schools, yes, but wouldn't it be worth the cost to know if there are any particular schools that are incurring abnormal amounts of playground injuries, so corrective action could be taken? Good data makes the world go 'round...
Sunday, October 24, 2010
Injury estimates and a question of "should"
We've seen a lot of numbers over the past few posts. Over 200,000 playground injury hospitalizations per year, with who-knows-how-many skinned knees, bumped heads, and twisted ankles NOT taken for emergency room treatment, and therefore absent from the data. It's important to recognize that this 200,000 figure is a lower bound on the actual number of playground-related injuries; these are just the injuries that are taken for emergency room treatment.
What are these non-reported injuries? It stands to reason that there will be two such categories: injuries for which the child COULD or SHOULD be taken to the ER but isn't, and injuries that don't merit hospital treatment. Let's take them one at a time.
What would prevent a parent or educator from taking a child to the hospital for a bad injury? Not much, I'd wager. If a child gets badly cut, or breaks a bone, or is knocked unconscious, then I'm sure that he or she'd be taken to the hospital, health insurance or no health insurance. But what about a bump to the head, or a twisted ankle, or a not-too-bad cut? Here, there's some latitude for parents to opt not to take the kid to the ER and the decision will depend solely on the characteristics of the parent than anything else. Some parents would consider them hospital-worthy, some wouldn't. Call these Type I non-reported injuries.
What about the everyday bumps, bruises, and falls that comprise a childhood? There are not hospital-worthy injuries, and hardly even qualify as injuries. Let's call them Type II non-reported injuries.
So, now we can arrive at an estimate of total playground injuries:
Hospital visits + Type I injuries + Type II injuries
Now, how to estimate Type I and II injury rates? Is there any way of getting a tally on how many on these minor and unreported injuries happen each year? Well... not really. One COULD assign investigators to monitor a random sample of playgrounds all over the country for a certain period (say, 1,000 playgrounds for 2 weeks each), and have the monitors record every fall, bump, and scrape that happens, but I can't imagine the NSF dishing out grant money for that particular project. Alternatively, one could send out questionnaires to a random sample of schools asking that THEY monitor their playgrounds and record everything that happens, but there would be serious issues of selection bias to consider.
So, getting a total figure is probably impossible. Should we even try? I don't worry too much about the Type II injuries - they're unavoidable, and kids learn important lessons in spatial awareness and physical coordination by occasionally tripping over their own two feet. But I DO worry about the Type I injuries, and the differential rates of reportage. Does the NEISS data systematically under- or over-report certain types of injuries for certain groups of children (for example, injuries incurred at day care centers) because of characteristics of the parents (to use that same example, child at day care = parents working = probably have insurance = hospital visits)? And, if so, will that be taken into consideration for any regulations made from NEISS data?
In the same vein, I leave you with a link to an interesting report from the Harvard School of Public Health on the relationship between neighborhood socioeconomic characteristics and access to safe playgrounds in Boston. The authors conclude that "playground safety and access to playgrounds varied according to indicators of small-area socioeconomic and racial/ethnic composition." Not groundbreaking for anyone who has ever spent any time in a city, but still an interesting read.
What are these non-reported injuries? It stands to reason that there will be two such categories: injuries for which the child COULD or SHOULD be taken to the ER but isn't, and injuries that don't merit hospital treatment. Let's take them one at a time.
What would prevent a parent or educator from taking a child to the hospital for a bad injury? Not much, I'd wager. If a child gets badly cut, or breaks a bone, or is knocked unconscious, then I'm sure that he or she'd be taken to the hospital, health insurance or no health insurance. But what about a bump to the head, or a twisted ankle, or a not-too-bad cut? Here, there's some latitude for parents to opt not to take the kid to the ER and the decision will depend solely on the characteristics of the parent than anything else. Some parents would consider them hospital-worthy, some wouldn't. Call these Type I non-reported injuries.
What about the everyday bumps, bruises, and falls that comprise a childhood? There are not hospital-worthy injuries, and hardly even qualify as injuries. Let's call them Type II non-reported injuries.
So, now we can arrive at an estimate of total playground injuries:
Hospital visits + Type I injuries + Type II injuries
Now, how to estimate Type I and II injury rates? Is there any way of getting a tally on how many on these minor and unreported injuries happen each year? Well... not really. One COULD assign investigators to monitor a random sample of playgrounds all over the country for a certain period (say, 1,000 playgrounds for 2 weeks each), and have the monitors record every fall, bump, and scrape that happens, but I can't imagine the NSF dishing out grant money for that particular project. Alternatively, one could send out questionnaires to a random sample of schools asking that THEY monitor their playgrounds and record everything that happens, but there would be serious issues of selection bias to consider.
So, getting a total figure is probably impossible. Should we even try? I don't worry too much about the Type II injuries - they're unavoidable, and kids learn important lessons in spatial awareness and physical coordination by occasionally tripping over their own two feet. But I DO worry about the Type I injuries, and the differential rates of reportage. Does the NEISS data systematically under- or over-report certain types of injuries for certain groups of children (for example, injuries incurred at day care centers) because of characteristics of the parents (to use that same example, child at day care = parents working = probably have insurance = hospital visits)? And, if so, will that be taken into consideration for any regulations made from NEISS data?
In the same vein, I leave you with a link to an interesting report from the Harvard School of Public Health on the relationship between neighborhood socioeconomic characteristics and access to safe playgrounds in Boston. The authors conclude that "playground safety and access to playgrounds varied according to indicators of small-area socioeconomic and racial/ethnic composition." Not groundbreaking for anyone who has ever spent any time in a city, but still an interesting read.
Saturday, October 23, 2010
Parsing a new-ish CPSC report
Update: I just wrote, and lost, an entire post. Blast! Sigh. I'll try to replicate it as best I can.
Last post, I promised regressions and more data-digging. Forgive me, but I won't do that today! Instead, I'll write about a new report from the Consumer Product Safety Commission (CPSC) on playground-related injuries from 2001-2008. The report mostly uses data from an internal CPSC database, in addition to the NEISS data (which we saw last time), and death certificate data. First, kudos to the CPSC for putting out a revised report. There are so many playground injuries each year (over 200,000!) that it's important people - parents, educators, regulators - don't grow complacent. I found the report on the Maryland Materials website, link here.
Still, the report isn't perfect. My main gripe with it is that the CPSC database is not a nationally representative sample; it's a collection of reports culled from newspapers, direct complaints, letters from lawyers, etc. There were 2,691 incidents reported to the CPSC from 2001-2008... meanwhile, there were about 60,000 incidents collected in the NEISS database over the same period! That means that one can extrapolate the NEISS data with a reasonable degree of confidence and make claims based on that data on the state of playground safety in the country as a whole, but one can't do the same with the CPSC data.
A random and interesting foible in the CPSC data is that Wisconsin day care centers comprise 35% of all reports (as opposed to restaurants in New Mexico, homeowners in Vermont, schools in California, and so forth) because all product complaints from Wisconsin are automatically sent to the CPSC database. Bizarre!
There are some striking discrepancies in the CPSC data and NEISS data. For instance, 28% of all accidents in the CPSC data are reported as occurring at home (and that number rises to 44% of you exclude the day care center-heavy Wisconsin data), compared to about 17% in the NEISS data over the same period. Moreover, 4% of all injuries in the CPSC data (without Wisconsin) occur at school (7% with the Wisconsin data), whereas the NEISS data tells us that about 25% of all playground-related accidents occur at school! We'll assume that the NEISS data are "correct", since they are statistically representative (assuming that all sample hospitals submit accurate and timely injury reports... *gulp*). So, why are home accidents over-reported and school accidents under-reported in the CPSC data?
There seem to be three possible reasons. First, the two datasets represent different things. The CPSC data cover for reported accidents, whether hospital-worthy or not, and the NEISS data are strictly confined to hospitalizations. So, maybe parents are just over-anxious, reporting every little incident that happens, and schools are more lackadaisical. Second, it could just be statistical noise - i.e., there are so few observations that it's just coincidental that so many accidents happened at home. Third, and most cynically, and therefore most likely, it could be the case that parents report home accidents in the hopes of building a lawsuit against the equipment manufacturer, while schools DON'T report because they want to open themselves to liability in that particular direction (since the equipment manufacturer could blame the school for poor upkeep, or improper installation, etc.).
Final thoughts: one must be careful when drawing conclusions from data! Even with large samples like NEISS, there are always possible reasons for why the data are skewed in a certain way.
Last post, I promised regressions and more data-digging. Forgive me, but I won't do that today! Instead, I'll write about a new report from the Consumer Product Safety Commission (CPSC) on playground-related injuries from 2001-2008. The report mostly uses data from an internal CPSC database, in addition to the NEISS data (which we saw last time), and death certificate data. First, kudos to the CPSC for putting out a revised report. There are so many playground injuries each year (over 200,000!) that it's important people - parents, educators, regulators - don't grow complacent. I found the report on the Maryland Materials website, link here.
Still, the report isn't perfect. My main gripe with it is that the CPSC database is not a nationally representative sample; it's a collection of reports culled from newspapers, direct complaints, letters from lawyers, etc. There were 2,691 incidents reported to the CPSC from 2001-2008... meanwhile, there were about 60,000 incidents collected in the NEISS database over the same period! That means that one can extrapolate the NEISS data with a reasonable degree of confidence and make claims based on that data on the state of playground safety in the country as a whole, but one can't do the same with the CPSC data.
A random and interesting foible in the CPSC data is that Wisconsin day care centers comprise 35% of all reports (as opposed to restaurants in New Mexico, homeowners in Vermont, schools in California, and so forth) because all product complaints from Wisconsin are automatically sent to the CPSC database. Bizarre!
There are some striking discrepancies in the CPSC data and NEISS data. For instance, 28% of all accidents in the CPSC data are reported as occurring at home (and that number rises to 44% of you exclude the day care center-heavy Wisconsin data), compared to about 17% in the NEISS data over the same period. Moreover, 4% of all injuries in the CPSC data (without Wisconsin) occur at school (7% with the Wisconsin data), whereas the NEISS data tells us that about 25% of all playground-related accidents occur at school! We'll assume that the NEISS data are "correct", since they are statistically representative (assuming that all sample hospitals submit accurate and timely injury reports... *gulp*). So, why are home accidents over-reported and school accidents under-reported in the CPSC data?
There seem to be three possible reasons. First, the two datasets represent different things. The CPSC data cover for reported accidents, whether hospital-worthy or not, and the NEISS data are strictly confined to hospitalizations. So, maybe parents are just over-anxious, reporting every little incident that happens, and schools are more lackadaisical. Second, it could just be statistical noise - i.e., there are so few observations that it's just coincidental that so many accidents happened at home. Third, and most cynically, and therefore most likely, it could be the case that parents report home accidents in the hopes of building a lawsuit against the equipment manufacturer, while schools DON'T report because they want to open themselves to liability in that particular direction (since the equipment manufacturer could blame the school for poor upkeep, or improper installation, etc.).
Final thoughts: one must be careful when drawing conclusions from data! Even with large samples like NEISS, there are always possible reasons for why the data are skewed in a certain way.
Thursday, October 21, 2010
Who gets hurt?
In the last post, I introduced the NEISS data and gave a few general figures. Here, I thought I would go more deeply into the numbers to see if any interesting patterns jump out.
[To be specific, I'm looking at hospital-treated playground injuries reported to NEISS from 2000-2009 for injuries incurred on Monkey Bars, Playground Gyms and other Playground Climbing Apparatus; Seesaws or Teeterboards; Slides or Sliding Boards (excluding swimming pool and ground water slides; Swings or Swing sets (excluding portable baby swings); and Other Playground Equipment]
So, what does the data tell us?
Boys incur more injuries (53-54%) than girls (46-47%). This seems to make sense given that playground-age boys are a rambunctious bunch, but it could just be the case that boys play more on the equipment, and are therefore more likely to be hurt on it.
Ages five and six are the most injury-prone years. A density curve of injury by age reveals a right-tailed bell curve, meaning that while very few 1- and 2-year-olds are hurt, lots of kids aged 3-9 are hurt, and then it tails off into the mid-teens (although about there were about ten 18 year olds hurt each year from 2000-2007, with that figure rising to 20 and 22 in 2008 and 2009, respectively... two questions: why the sudden rise, and what are 18 year olds even doing on a playground?!). Given an age range of 1-18, over half of all injuries each year are incurred by children aged 4-7.
Monkey bars and other climbing apparatuses (apparatii?) account for a consistent 40% of all injuries (with a dip to 38% in 2009), with slides and sliding boards holding steady at about 23%, although with a slight rise over the decade. Interestingly, the share of injuries to due "other playground equipment" fell quite significantly throughout the decade, from about 33% to 27%.
Next up: digging deeper, and fun with regressions.
[To be specific, I'm looking at hospital-treated playground injuries reported to NEISS from 2000-2009 for injuries incurred on Monkey Bars, Playground Gyms and other Playground Climbing Apparatus; Seesaws or Teeterboards; Slides or Sliding Boards (excluding swimming pool and ground water slides; Swings or Swing sets (excluding portable baby swings); and Other Playground Equipment]
So, what does the data tell us?
Boys incur more injuries (53-54%) than girls (46-47%). This seems to make sense given that playground-age boys are a rambunctious bunch, but it could just be the case that boys play more on the equipment, and are therefore more likely to be hurt on it.
Ages five and six are the most injury-prone years. A density curve of injury by age reveals a right-tailed bell curve, meaning that while very few 1- and 2-year-olds are hurt, lots of kids aged 3-9 are hurt, and then it tails off into the mid-teens (although about there were about ten 18 year olds hurt each year from 2000-2007, with that figure rising to 20 and 22 in 2008 and 2009, respectively... two questions: why the sudden rise, and what are 18 year olds even doing on a playground?!). Given an age range of 1-18, over half of all injuries each year are incurred by children aged 4-7.
Monkey bars and other climbing apparatuses (apparatii?) account for a consistent 40% of all injuries (with a dip to 38% in 2009), with slides and sliding boards holding steady at about 23%, although with a slight rise over the decade. Interestingly, the share of injuries to due "other playground equipment" fell quite significantly throughout the decade, from about 33% to 27%.
Next up: digging deeper, and fun with regressions.
Sunday, October 17, 2010
Why should you care?
Greetings from "Safety by the Numbers", a blog dedicated to all manner of playground safety-related issues. Let's start with a few numbers.
The Consumer Products Safety Commission reports an average of about 215,000 playground-related injuries requiring hospital care for each year from 2001-2008. This is from NEISS (National Electronic Injury Surveillance System), a great tool that tracks hospital visits and reports location, injury type, product associated with the injury, etc. Visit NEISS here to search the system to your heart's content (make sure to look up product codes first in the manual, here.)
A quick search reveals that in 2009, there were 96,780-138,236 hospitalizations due to injuries from "monkey bars, playground gyms, or other climbing apparatus", "seesaws or teeterboards", and "Slides or sliding boards (excluding swimming pool and and ground water slides)". This doesn't even include swings, spring toys, sandboxes, or other unspecified playground accidents!
A 2001 CPSC report indicates that 75% of playground accidents occur on playgrounds intended for public use, and that about half of these occurred on school playgrounds. Read the report here for more juicy tidbits.
We must protect the children, of course, but we must also protect our pocketbooks! A quick Google search reveals settlements in playground accident cases in the millions of dollars. These are rare, yes, but they exist. And as health care costs continue to rise, the smart money is on the average settlement size only increasing over time. The school districts that pay out for the settlements are, of course, funded by you and me and our tax dollars.
So, why should you care?
If you're a parent, care about your children's safety.
If you're an educator, care about the safety of your play equipment.
If you're a taxpayer, care about the tax-dollar-funded settlements.
If you are none of the above, then care about the pain and suffering caused by unnecessary accidents! As a playground-accident survivor (broken arm at age 7), I assure you that they're best to be avoided.
The Consumer Products Safety Commission reports an average of about 215,000 playground-related injuries requiring hospital care for each year from 2001-2008. This is from NEISS (National Electronic Injury Surveillance System), a great tool that tracks hospital visits and reports location, injury type, product associated with the injury, etc. Visit NEISS here to search the system to your heart's content (make sure to look up product codes first in the manual, here.)
A quick search reveals that in 2009, there were 96,780-138,236 hospitalizations due to injuries from "monkey bars, playground gyms, or other climbing apparatus", "seesaws or teeterboards", and "Slides or sliding boards (excluding swimming pool and and ground water slides)". This doesn't even include swings, spring toys, sandboxes, or other unspecified playground accidents!
A 2001 CPSC report indicates that 75% of playground accidents occur on playgrounds intended for public use, and that about half of these occurred on school playgrounds. Read the report here for more juicy tidbits.
We must protect the children, of course, but we must also protect our pocketbooks! A quick Google search reveals settlements in playground accident cases in the millions of dollars. These are rare, yes, but they exist. And as health care costs continue to rise, the smart money is on the average settlement size only increasing over time. The school districts that pay out for the settlements are, of course, funded by you and me and our tax dollars.
So, why should you care?
If you're a parent, care about your children's safety.
If you're an educator, care about the safety of your play equipment.
If you're a taxpayer, care about the tax-dollar-funded settlements.
If you are none of the above, then care about the pain and suffering caused by unnecessary accidents! As a playground-accident survivor (broken arm at age 7), I assure you that they're best to be avoided.
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