Injury Prevention Policy
How big is the problem?
Each year more than 200,000 preschool and elementary school age children in teh United States receive emergency department care for injuries that occurred on playground equipment. On average, 17 of these cases result in death each year. Almost 70% of these injuries occur on public playgrounds (1). Falls, usually to the surface below the equipment, account for approximately 70% of all injuries related to playground equipment (2).
A nationwide survey conducted by the (US) National Program for Playground Safety from 1998-2000 revealed that 78% of the playgrounds had appropriate surfacing materials; however, 53% had insufficient depths of materials to protect from serious head injury. In addition, 33% of the playgrounds surveyed had failed to provide material in adequate use zones around the equipment, and 12% had exposed concrete footings (3).
Policy and Details
Communities shall ensure that playground equipment and surfaces meet the most recent CPSC and ASTM safety standards.
State or local laws should be passed requiring that playgrounds meet nationally recognized safety standards. Two sets of playground safety guidelines provide recommendations for creating safe public playgrounds: the U.S. Consumer Product Safety Commission's (CPSC) Handbook for Public Playground Safety (4) and the American Society for Testing and Materials' (ASTM) F1487 Standard Consumer Safety Performance Specification for Playground Equipment for Public Use (5).
The CPSC handbook contains voluntary safety recommendations for playground equipment and surfacing as well as recommendations for the layout, installation and maintenance of playground equipment.
The ASTM standard is a detailed, technical document intended for use by manufacturers, designers, engineers, etc. and serves as the technical counterpart to the CPSC handbook. It also provides safety recommendations relating to equipment labeling and the accessibility of play areas and play equipment for children with disabilities (6).
These guidelines should be mandated through legislation at either local or state levels to ensure that playgrounds are properly constructed and maintained. Several states have passed legislation that mandates many of the recommendations in these documents (7). As an example, a copy of the California State Playground Regulations is available online (8). The purpose of these laws is to ensure that safe playgrounds are installed, regularly inspected, and maintained by trained personnel.
Parents and caregivers can advocate for compliance with the CPSC and ASTM guidelines at their local school boards, day care centers, and public parks. They can encourage and foster public-private partnerships to fund the improvement and maintenance of local playgrounds (7).
Other injury prevention measures should include the elimination of entanglement and head entrapment hazards on playground equipment that can cause strangulation. The overall layout of a play area should be without visual barriers that could hamper adult supervision of the total play space. Separating the playground into areas suited for different age groups and different types of activity helps prevent injuries caused by conflicting play patterns. Supervision of children on the playground should be conducted by people trained in playground supervision, first aid, and cardiopulmonary resuscitation (7).
Most playground injuries are preventable. Compliance with national playground safety standards can reduce the risk of serious injury and death. The most effective injury prevention measures are those that create a safe environment. A safe playground includes proper design, developmentally appropriate equipment, and proper maintenance.
Protective surfacing is one of the most important safety factors on playgrounds. Shock absorbing surfaces can help disperse the impact of a child's falling body or head, thus reducing the risk of life-threatening injuries. One study found that the odds of being injured in a fall onto a non-impact absorbing surface is 2.3 times greater than falling onto an impact absorbing surface (9). Thus, an important aspect of reducing playground injuries is to provide cushioned surfaces beneath and around equipment at depths appropriate to equipment height. Surfaces such as asphalt, cement, dirt, grass, and rocks are not acceptable surfaces. Protective surfacing must be maintained throughout the fall zone for each piece of equipment.
Limiting the height of playground equipment can also reduce the severity of a fall injury. If the maximum fall height of all playground equipment were reduced to under five feet, the number of children attending emergency departments from playground injuries could be reduced by as much as 45 percent (9).
- Morrison M, Fise ME. Report and Model Law on Public Play Equipment and Areas. Consumer Federation of America, 3rd Edition, 1998.
Donna Thompson, Ph.D.
National Program for Playground Safety
School of Health, Physical Education and Leisure Services
University of Northern Iowa
Cedar Falls, IA 50614-0618
Phone: 800-554-PLAY or 319-273-2416
Susan DeFrancesco, JD, MPH
Johns Hopkins Center for Injury Research and Policy
School of Public Health
624 N. Broadway
Baltimore, MD 21205-1996
1. Mack, MG, Hudson, S, and Thompson, D. A descriptive analysis of children's playground injuries in the United States 1990-4. Injury Prevention, 3, 100-103, 1997.
2. Mack, MG, Thompson, D, and Hudson, S. Playground injuries in the 90's. Parks & Recreation, 33 (4), 88-95, 1998.
3. The National Program for Playground Safety: America's Playgrounds Safety Report Card. Available online: http://www.uni.edu/playground/report.html, May 30, 2000.
4. U.S. Consumer Product Safety Commission. Handbook for Public Playground Safety, Publication Number 325. Washington, DC: U.S. Consumer Product Safety Commission, 1997.
5. American Society for Testing and Materials. F1487-98 Standard Consumer Safety Performance Specification for Playground Equipment for Public Use. West Conshohocken, PA, 2000.
6. DeFrancesco, S. Factsheet on Playground Safety Guidelines and Voluntary Standards. Johns Hopkins Center for Injury Research and Policy.
7. DeFrancesco, S. Advocating for Safe Playgrounds. In "Building on Our Success" Conference Syllabus for the 13th Annual California Conference on Childhood Injury Control and 6th Annual State and Territorial Injury Prevention Directors' Association Conference; October 25-27, 1999: 459-460.
8. California Code of Regulations. Safety Regulations for Playgrounds (Title 22, Division 4, Chapter 22). Available online at: http://www.safetypolicy.org/play-reg/play-reg.htm
9. Chalmers DJ, et al. Height and surfacing as risk factors for injury in falls from playground equipment: a case-control study. Injury Prevention, June 1996; 2(2): 98-104.
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Last modified: 30-August-2000.