title: Height and surfacing as risk factors for injury in falls from playground equipment: a case-control study.
abstract: OBJECTIVE
  Despite the widespread promotion of safety standards no epidemiological studies have adequately evaluated their effectiveness in preventing injury in falls from playground equipment. This study evaluated the effectiveness of the height and surfacing requirements of the New Zealand standard for playgrounds and playground equipment.
  
  
  METHODS
  Early childhood education centres and schools in two major cities in the South Island of New Zealand.
  
  
  METHODS
  Data were collected on 300 children aged 14 years or less who had fallen from playground equipment. Of these, 110 (cases) had sustained injury and received medical attention, while 190 (controls) had not sustained injury requiring medical attention.
  
  
  RESULTS
  Logistic regression models fitted to the data indicated that the risk of injury being sustained in a fall was increased if the equipment failed to comply with the maximum fall height (odds ratio (OR) = 3.0; 95% confidence interval (CI) 0.7 to 13.1), surfacing (OR = 2.3; 95% CI 1.0 to 5.0), or safe fall height (OR = 2.1; 95% CI 1.1 to 4.0) requirements. Falls from heights in excess of 1.5 metres increased the risk of injury 4.1 times that of falls from 1.5 metres or less and it was estimated that a 45% reduction in children attending emergency departments could be achieved if the maximum fall height was lowered to 1.5 metres.
  
  
  CONCLUSIONS
  Although the height and surfacing requirements of the New Zealand standard are effective in preventing injury in falls from playground equipment, consideration should be given to lowering the maximum permissible fall height to 1.5 metres.
authors.affiliation: Department of Preventive and Social Medicine, University of Otago Medical School, Dunedin, New Zealand.
authors.forename: D J
authors.initials: DJ
authors.lastname: Chalmers
authors.forename: S W
authors.initials: SW
authors.lastname: Marshall
authors.forename: J D
authors.initials: JD
authors.lastname: Langley
authors.forename: M J
authors.initials: MJ
authors.lastname: Evans
authors.forename: C R
authors.initials: CR
authors.lastname: Brunton
authors.forename: A M
authors.initials: AM
authors.lastname: Kelly
authors.forename: A F
authors.initials: AF
authors.lastname: Pickering
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003257:Consumer Product Safety; D003627:Data Interpretation, Statistical; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D010988:Play and Playthings; D012307:Risk Factors; D013499:Surface Properties; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control