Monkeying Around: Children and Playground Injuries

Armen Hareyan's picture

15 million children are treated in hospital emergency rooms every year, and many of their injuries are playground equipment related. According to Mary Christine Bailey, MD, "The Consumer Product Safety Commission estimates that 200,000 injuries a year are the result of playground equipment." In her research, Dr. Bailey, Medical Director of the Pediatric Emergency Department at Newton-Wellesley Hospital, found that "88% of playground injuries specifically involved the use of climbers", which includes monkey bars, jungle gyms, swings and slides. The majority of these injuries occur from June through August.

Child's play is serious business. Playground equipment manufactured for home use is a multi-million dollar industry. New play systems include specific features that can be attached to a basic module. Slides, monkey bars, simulated rock-climbing units; playhouses and forts are among the options available.

Child's play is also a serious business within emergency medicine. Costs are not measured in dollars and cents, but rather in the risk of injury posed by many types of playground equipment. Many cuts and bruises are treated at home. But all too frequently, a bandage and Mom's kiss isn't enough. Data collected in the research in which Dr. Bailey participated, reports that 25% of playground injuries are serious enough to require hospitalization. The majority of those children hospitalized required orthopedic surgery.

Dr. Bailey is both a pediatrician and pediatric emergency medicine physician. Through the Harvard School of Medicine and Boston Children's Hospital, she conducted research in 1999 in conjunction with two other physicians and two nurses, with the goal to "gain an understanding of the specific injuries that occur as a result of child's play on monkey bars and jungle gyms." The results of this research illuminate the severity of children's injuries from use of this equipment. Study results also call into question much of the consumer product safety information that parents rely upon to evaluate safety and to purchase certain types of equipment.

Is it safe to assume?

Manufacturers, parents and the federal government scrutinize products used by children for safety. Prior to 1999, there were several laboratory studies of playground equipment that resulted in safety suggestions for consumers. Both the Centers for Disease Control, and the United States Consumer Product Safety Commission, for example, have recommended that impact-absorbing materials will provide a protective surface underneath playground equipment. While implying that these surfaces may diminish the severity of injuries, the researchers also offer the caveat that these alone will not prevent equipment related injuries.

The results of Dr. Bailey's research were published in the article titled "Monkeybar Injuries: Complications of Play" and appear in the May 1999 issue of the journal Pediatrics. Study results "indicate that injury pattern is independent of the surface below the equipment." It is also common to assume that children will be more susceptible to injuries when playing without adult supervision. This research did not confirm the validity of this assumption. "Adult supervision, while always recommended, also did not seem to influence the occurrence of the most common injury, long-bone fractures," the authors state.


Severity Potential

The majority of playground equipment injuries are minor cuts and bruises. Unless one has had personal experience to the contrary, these are usually what come to mind when thinking about playground injuries. But, there is a rather high potential for severe injuries such as ruptured spleens, genital and urinary trauma from straddle injury, injury to the eyes, and head injuries resulting in neurological complications. Bone fractures are the most common injuries related to playground equipment.

Be Aware

Should monkey bars, jungle gyms and other climbing equipment be banned from playgrounds? Dr. Bailey and her colleagues answer this question in their Pediatrics article by suggesting that more study of the efficacy of soft surfaces is needed before taking such drastic action. For now, parents must be aware of the fact that child's play of this type may not be as safe as it seems. Awareness that injuries related to playground equipment are quite common and frequently severe should be used to inform this decision.

Newton-Wellesley is one of only 10% of the nation's hospitals to have an emergency department dedicated to the special emergency medicine needs of children. The Vinik Pediatric Emergency Department at Newton-Wellesley Hospital is open daily, noon to midnight.


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