title: Trends and patterns of playground injuries in United States children and adolescents.
abstract: OBJECTIVE
  To determine the prevalence, trends, and severity of injuries attributable to playground falls relative to other common unintentional mechanisms that resulted in an emergency department (ED) visit in the United States.
  
  
  METHODS
  Data from the emergency subset of the National Hospital Ambulatory Medical Care Survey collected from 1992 to 1997 for children <20 years.
  
  
  METHODS
  Injury rates and 95% confidence intervals (CIs) were estimated and injury severity scores were computed.
  
  
  RESULTS
  There were 920551 (95% CI: 540803 to 1300299) ED visits over the 6-year study period by children and adolescents that were attributable to falls from playground equipment. The annual incidence of visits for playground injuries did not significantly decrease over the course of the study (187000 to 98000, P =.053). Injury visits for playground falls were twice as prevalent as pedestrian mechanisms, but they were less prevalent than visits for motor vehicle-- and bicycle-related injuries. A larger proportion of playground falls resulted in "moderate-to-severe" injury than did bicycle or motor vehicle injuries. Children aged 5 to 9 years had the highest number of playground falls (P =.0014). Playground falls were most likely to occur at school compared to home, public, and other locations (P =.0016).
  
  
  CONCLUSIONS
  Playground injury emergency visits have not significantly declined and remain a common unintentional mechanism of injury. Injury visits for playground falls were proportionally more severe than injury visits attributable to other common unintentional mechanisms. Interventions targeting schools and 5- to 9-year-old children may have the greatest impact in reducing emergency visits for playground injuries.
authors.affiliation: Department of Pediatrics, Children's Hospital Medical Center, Cincinnati, OH 45229, USA. kj.phelan@chmcc.org
authors.forename: K J
authors.initials: KJ
authors.lastname: Phelan
authors.forename: J
authors.initials: J
authors.lastname: Khoury
authors.forename: H J
authors.initials: HJ
authors.lastname: Kalkwarf
authors.forename: B P
authors.initials: BP
authors.lastname: Lanphear
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010988:Play and Playthings; D015995:Prevalence; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000517:prevention & control