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More Than 200,000 Kids Treated in ERs Each Year for Playground-Related Injuries – May 15, 2017
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More Than 200,000 Kids Treated in ERs Each Year for Playground-Related Injuries
May 15, 2017
WASHINGTON, May 15, 2017 /PRNewswire-USNewswire ( — As temperatures rise, more kids will be on the
playground. The nation’s emergency physicians want all of them to have fun, but also to stay safe.
“Many playground injuries can be avoided if parents are mindful about the risks and teach children to obey safety rules,” said Rebecca Parker, MD,
FACEP, president of the American College of Emergency Physicians. “We encourage children to get outside and play to promote a healthier lifestyle,
but we want to make sure our children are as safe as possible.”
Every year, emergency physicians see more than 200,000 children with
playground-related injuries, according to the Centers for Disease Control
and Prevention (CDC). These injuries are diverse, from head injuries, to
fractures, internal bleeding and others. More than 20,000 of these
children are treated for traumatic brain injury, including concussion.
Facts about Playground Injuries:
More than half of playground-related injuries are fractures,
contusions and/or abrasions.
About 75 percent of nonfatal injuries involving playground
equipment occur on public playgrounds, most of which are at
schools and daycare centers.
The overall rate of emergency visits for playground-related
traumatic brain injury has increased significantly in recent years,
according to the CDC.
Ways to Prevent Playground Injuries:
Closely supervise any young child on a playground. Older children
also need adult supervision.
Make sure the playground facility is properly maintained. Are there
broken pieces of equipment? Is there trash or broken bottles
nearby that can cause injury? Does the playground have adequate
cushioning to prevent injury?
Children should never crowd the playground. If you cannot safely
monitor a child because too many children are using the
equipment, choose another time to play.
Make sure the playground equipment is age appropriate. Younger
children get injured playing on equipment that is meant for older
Older children should stay away from playground equipment
reserved for younger children to avoid injuring those who are
physically smaller. Areas for preschool children should be separate
from the areas of school-age children.
Children should not wear hoods or clothing with strings on a
playground. These can block the child’s peripheral vision and also
create choking hazards.
Teach your child to follow safety rules. Children should not run, push or shove others while on a playground. They also should not walk in the
path of a moving swing or climb a slide instead of using the ladder.
Page 1 of 2
More Than 200,000 Kids Treated in ERs Each Year for Playground-Related Injuries – May 15, 2017
4/2/19, 11(50 PM
ACEP is the national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through
continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as
Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other
government agencies. (
SOURCE American College of Emergency Physicians (ACEP)
For further information: Media Contact: Mike Baldyga, 202-370-9288,
Annals of Emergency Medicine ( | EMAF Website ( | ACEP Policy Statements
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Page 2 of 2
Managing Risk in Recreation Programs, Facilities and Services
Nancy B. White, Ph.D.
Recreation Management Instructor – College of the Canyons – California
Planning Team, PlaySafe, LLC
The management of risk in programs, facilities and services is essential to the
sustainability and viability of recreation agencies. Protecting the safety of participants
and employees should be the top priority in the provision of any recreational activity,
program or service. Proactive management must take place to reduce the risk of injury,
death, damage or liability as a result of participation in recreation offerings. This is not an
easy task given the inherent risks involved in many recreational activities.
The inherent risks of various sport and recreational activities are in large part the reason
individuals enjoy participating. The rush of adrenalin that results from participation in a
challenging basketball game, skiing down a mountain, rappelling from a cliff, swimming
across a pool, or hiking in the wilderness creates a desire for the recreational experience.
If managers sought to eliminate all risk from recreation activities, there would be few
programs or facilities in existence. By providing experiences in which risk is addressed or
controlled, recreation professionals are serving the needs and demands of the public
while protecting their patrons, staff and agencies.
Patrons of recreation programs, facilities and services should be informed of the potential
risks and the level of challenge involved so that they can make informed decisions about
whether to participate. Their acceptance of the inherent risks of participation,
understanding of the safety precautions being taken, role in protecting their own safety
and that of others are important parts of managing risk. It is the responsibility of the
recreation provider to remove or address hazards. Hazards are conditions present that are
unknown or not understood by the user as having the potential to cause injury. Hazards
include an uneven or wet playing surface on a soccer field, presence of chemicals near a
pool, broken glass in a park, or inappropriate use zones in a playground. Operators must
take proactive steps to eliminate hazards immediately or take measures to stop use of the
area. Patrons must be informed and warned about hazards while the situation is being
It is important to understand the legal responsibility of recreation providers. A staff
member of a recreation program hired to provide oversight of programs, facilities or
services has a legal duty to take action to prevent injuries and respond effectively when
an injury occurs. A breach of this duty, either failure to act or taking action that is not
appropriate, that results in actual loss or harm is negligence. Understanding what
negligence is and actively taking measures to act responsibly will reduce the potential for
injury, damages, death and liability for recreation staff and agencies.
To determine appropriate actions that staff members should take, in accordance with the
accepted standard of care, several comparisons should be made. Whether the action was
reasonable under the circumstances and in accordance with what a reasonable and
prudent person would do in a similar situation is one standard for comparison. Another
standard is the generally accepted practice in the field, which can be analyzed using
information from regulatory agencies, professional organizations such as the California
Parks and Recreation Society, and legal decisions. Comparisons can also be made to the
operating procedures and policies of similar recreation agencies. Staff members should be
trained to act in compliance with written policies and procedures of the agency which are
based on the comparisons listed here.
Practical solutions to reduce injury, death, damages and liability in recreation programs
begin with planning and training. Staff members must identify and analyze potential risks
and plan in advance methods for removing hazards and addressing risks. Elements that
could contribute to dangerous situations must be eliminated or mitigated. Staff members
should receive ongoing training on the procedures developed to manage risk. An annual
training session supported by regular in-service training on specific topics reflects a
proactive approach to managing risk. Training topics include procedures for inspection of
facilities and activity areas prior to and after use, routine maintenance and repair, use of
informed consent and waiver forms for participants, and notice of hazards. Document the
date, time and staff in attendance at training sessions. Agencies should consult with legal
counsel and develop protocols for the length of time documents and records should be
retained. Expert review of forms, policies and procedures on a regular basis is another
practical solution to risk management. The risk management plan should be monitored
for effectiveness continually, and changes made as necessary.
Quality maintenance programs play an important role in managing risk. Checklists are
often used to perform daily or weekly inspections of facilities, parks and playgrounds.
Staff should actively seek out and remove hazards, make repairs, and provide warning
when an area is not safe for activity. Records of inspections, maintenance and repairs
should be maintained to demonstrate the agency is diligent in risk management. Retain
records for the period specified in agency protocols. Equipment used for activity must be
inspected regularly and replaced or removed when needed. Annual inspections by a
certified professional of equipment, surfacing, and facilities demonstrate a proactive
approach to safety. An objective third party can identify areas of concern sometimes
overlooked by staff which can then be promptly addressed.
Recreation agencies and staff are responsible for the safe provision of programs, facilities
and services. The public expects and deserves a knowledgeable, professional, and diligent
approach to removal of hazards and management of risk in recreation. Although the task
seems difficult, risk can be addressed and managed proactively. Planning based on
generally accepted practices in the field of recreation is a good place to start managing
risk. Recreation providers should develop a plan of action based on the standard of care
in the industry and train staff to adhere to the risk management policies and procedures of
the agency. This training involves identification of hazards and risks, warning and
informing users, and taking steps to remove, reduce, or address hazards. Routine
maintenance and repair should be performed and documented. Inspections by staff and
audits from outside experts are important components for addressing safety and
compliance to industry standards. The process of risk management requires ongoing
assessment and attention. Changes should be made as needed to provide for the safety of
individuals engaged in recreational activities.
Suggested Resources
Appenzeller, H. (1998). Risk management in sport. Durham, N.C.: Carolina Academic
Peterson, J.A. and Hronek, B.B. (2003). Risk management for park, recreation and
leisure services. Champaign, IL: Sagamore Publishing.
Spengler, J.O., Connaughton, D.P., and Pittman, A.T. (2006). Risk management in sport
and recreation. Champaign, IL: Human Kinetics.
Nancy B. White, Ph.D. is a member of the Planning Team for PlaySafe, LLC and a
professor of Recreation Management. For more information on risk management, contact
Ground Zero — Choosing the Right Playground Safety Surface
4/2/19, 11(51 PM
Ground Zero
Choosing the Right Playground Safety Surface
By Rick Dandes
t’s no secret among safety experts and park managers that the majority of playground injuries
by children result from falls to the surface, often by tripping or by falling from playground
equipment. Fortunately, the severity of these injuries can be minimized with appropriate
protective surfacing material, which should be soft enough and thick enough to lessen the impact
of a child’s fall.
Protective surfacing is one of the most critical safety factors on playgrounds, agreed Caroline
Boland, product manager of a Chattanooga, Tennessee-based surface and installation group.
But, she also cautioned, keep in mind that “there is no perfect surfacing for playgrounds. All
surfacing types have pros and cons. So it’s important to choose the surfacing that meets the
specific needs of your site and playground users. Minimally, all surfacing should be International
Play Equipment Manufacturers Association (IPEMA) certified to AS™ 1951 and 1292, surface
testing standards. This is very important no matter what playground surfacing you choose.”
It wasn’t always that way. In fact, not until 1975, when the Consumer Product Safety Commission
(CPSC) analyzed playground safety hazards and guidelines, did the trend toward installing safer,
shock-attenuating surfaces begin. After that study, woodchips, gravel, rubber and other “softer” materials began to replace harder surfacing materials
like concrete, asphalt, hard-packed earth, grass and sand. And all those surfaces eventually had to meet guidelines first outlined in 1990, when the
Americans with Disabilities Act was passed by Congress.
With all that to keep in mind, there are still basically only two types of playground surfaces, explained Jim Dobmeier, president and founder of a
Buffalo, N.Y.-based surface manufacturer. One is called loose fill, and that ranges from sand and gravel to rubber chips and engineered wood fiber.
The other general kind of playground surfacing is called bound material or unitary surfaces, and there are three general subtypes: poured in place,
which is mixed and applied on site; tiles, made in factories, shipped on palettes and installed in the field; and a turf-type system that can have different
types of underlayment. This surface can be a prefabricated material, a poured material or one covered with some type of synthetic turf.
Due to their features and inherent benefits, there are tradeoffs with every surfacing type, noted Robert Zeager, with a Middletown, Pa.-based
manufacturer. “Because of their ability to move or displace when impacted,” he said, “loose-fill material like engineered wood fiber and rubber mulch
are generally believed to be better at preventing long bone injuries from falls, but they aren’t as easy for children and parents who use wheelchairs to
navigate and they are significantly more limited from a graphic design standpoint. That’s why it’s so important to choose the surfacing that achieves the
primary objectives of your community’s vision.”
Jeff Anderson, parks development specialist, City of Columbus (Ohio) Recreation and Parks
Department, offered some practical advice for parks and recreation departments looking to find
their best, most appropriate surface.
Engineered wood fiber, he said, is “the most cost effective option for playground surfacing, and
for initial installation. It is ideally used in large play areas, high fall heights, swings and natural
play areas. It meets AS™ standards for accessibility and impact attenuation. It’s also true that
natural wood material is an aesthetically appealing fit for a park setting. While EWF works well on
most playgrounds, on certain playgrounds where there is an increased emphasis on universal
accessibility we are more likely to have the entire surface be unitary in order to maximize access
to all parts of the playground.”
Where therapeutic recreation and universal accessibility are of concern, the entire playground
has a unitary surface, Anderson said. If parks and playgrounds are naturalized, there is an
emphasis upon EWF for the surfacing.
Many playground owners believe using a wood chipper to chip downed trees is the same as the
engineered wood fiber sold by playground companies, but that’s just not true, he continued.
Never go with mulch or wood chips that are not certified for playground use. They could contain metals, chemicals or worse, and have no guarantee of
fall cushioning properties. EWF contains a precise formula of fine and larger particles to ensure proper compaction for wheelchair accessibility and fall
Bonded wood fiber is another choice that looks natural, and is pervious and accessible. Using it reduces maintenance of EWF and reduces blowing or
scattering wood fiber. It is ideally used in natural play areas and to increase accessibility. “The one caveat about this surface is it requires a certified
installer,” Anderson said.
Artificial grass looks natural and clean. This surface is ideal for child care centers and nature-themed play areas. Rubber tiles are a wonderful solution
for densely populated urban play areas. Both artificial grass and rubber tiles require certified installers.
A poured-in-place rubberized safety surface is perfect when accessibility is the priority, Anderson said. “It’s attractive and easy to maintain, and
available in a variety of colors. It allows for additional play areas, especially for younger children, and it is least affected by rain events. The surface is
playable sooner.”
Page 1 of 3
Ground Zero — Choosing the Right Playground Safety Surface
4/2/19, 11(51 PM
Playground Courts, Another Story
Basketball courts are treated completely differently than regular playground surfaces, Jim
Dobmeier said. “We pour a lot of them. There are no ADA requirements, no requirements
for surfacing under and around courts.
“I would liken maintenance of the bound surface of a tennis or basketball court to that of
maintaining your driveway,” he said. You really don’t have to do anything. You can choose
to blow it off if there are a lot of leaves or debris on it. You can rake it, you can hose it.
“Most of the times on bonded or acrylic surfaces there is no need for formal maintenance
at all,” he said.
Maintenance and Life Cycles
Different surfacing types have different life cycles. Whatever surface you select, good maintenance and proper care for the material can significantly
extend its life.
“Choosing a company that offers a maintenance program can also help greatly increase the lifespan,” Boland explained, “by performing key treatments
at relevant times in the surface’s life. Roll coating, adding a urethane coat, helps rejuvenate and strengthen the surface. The ability to patch is
important to help repair potential damage from vandals, including holes or cuts that may become trip hazards.”
In these cases, she added, replacement of the entire surface is not usually necessary, as
opposed to being able to address the damaged area exclusively. “Amazingly, you can actually
entirely re-top an existing poured-in-place surface as long as the system is in serviceable
condition. There’s a lot that surfacing experts can do to help playground owners save cost in the
long term.”
Loose-fill materials such as engineered wood fiber and rubber mulch are initially more costeffective, but do require regular maintenance to keep the proper thickness protection under
swings, at the ends of slides and in ot …
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