Danger may be lurking at the playground

Orthopaedic surgeons remind people to inspect and supervise playgrounds

ROSEMONT, Ill.—With fall approaching, children will be returning to school and the schoolyard playgrounds, where remarkable numbers of injuries are occurring.

Though not all injuries occur on schoolyard playgrounds, the U.S. Product Safety Commission, in the year 2003, reported there were more than 465,000 playground-related injuries among people younger than age 18 treated in hospitals, doctors’ offices, clinics, ambulatory surgery centers and emergency rooms. Not only are children sustaining injuries that, in many cases, can be prevented, it costs the U.S. ,pre than $10 billion in medical costs to treat injuries, plus costs from work loss, pain, suffering and legal liability.

Most injuries occur when children fall from the equipment onto the ground. Often they are hurt not only by the fall, but by being struck by the equipment as they fall.

“The type of surface on the playground is the most important factor in reducing the severity of injuries due to falls,” explained Stuart L. Weinstein, M.D., a pediatric orthopaedic surgeon, and first vice president of American Academy of Orthopaedic Surgeons.

“Look for softer surfaces such as engineered wood mulch, or cushioned rubber safety surfacing. Asphalt, concrete, soil, packed dirt, grass and turf are not recommended,” added Weinstein. “And the greater the height of the equipment, the deeper the surfacing material depth must be to provide enough impact absorption in a fall.”

Adult supervision is a key component in safe play. Other important factors that can help reduce the incidence of injury are playground design, and equipment installation and maintenance.

A well-designed playground includes separate areas for active play such as swinging, and quiet play, such as digging in sandboxes. Spaces for preschoolers should be located away from areas where older, more active children play. Playground equipment should be made of weather-resistant materials with railings, steps and handholds scaled for children. Manufacturers’ instructions for proper installation and spacing should be followed carefully, including recommendations for maintenance.

The American Academy of Orthopaedic Surgeons offers the following lists of items to look for when inspecting your school playground:

Loose, damaged, or missing supports, anchors, footings, nuts, bolts or other connectors;

Broken or missing rails, steps, rungs, or seats;

Bending, warping, rusting, or breakage of any component, or sharp edges due to wear or breakage;

Protective end caps missing from bolts or tubes;

Deformed hooks, shackles, rings, links, etc.;

Worn swing hangers, chains or bearings;

Lack of lubrication on moving parts;

Exposed mechanisms such as joints or springs that could result in a “pinch” or “crush injury”;

Splintered and deteriorated wood, or cracks or holes in surfacing materials; and

Trash in area (particularly glass or cans), or environment hazards such as roots, rocks, or poor drainage areas.

Adults supervising children on the playground should remember the following important tips to prevent injury:

Slide one person at a time, sitting down and facing forward, and move away from the slide as soon as they reach the ground;

Swing sitting down, one person per swing and wait until the swing stops before getting off;

Be careful crossing in front of moving swings;

Remove drawstrings and hoods that could catch on equipment;

Play on dry equipment only; and

Wear proper footwear—no bare feet.

For additional Information on playground safety, call toll-free at 1-800-824-BONES (2663) or send a self-addressed (business sized) envelope to Playgrounds, American Academy of Orthopaedic Surgeons, P.O. Box 1998, Des Plaines, IL 60017. Internet users can download the Academy’s playground safety brochure and fact sheets from the Prevent Injuries America!* section of the Academy’s web site: www.orthoinfo.org.

An orthopaedic surgeon is a physician with extensive training in the diagnosis and non-surgical as well as surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles and nerves.

With more than 27,000 members, the American Academy of Orthopaedic Surgeons is a not-for-profit organization that provides education programs for orthopaedic surgeons, allied health professionals and the public. An advocate for improved patient care, the Academy is participating in the Bone and Joint Decade (www.usbjd.org), the global initiative in the years 2002-2011 to raise awareness of musculoskeletal health to stimulate research and improve people’s quality of life. President Bush has declared the years 2002-2011 National Bone and Joint Decade in support of these objectives.

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