title: Nonfatal Playground-Related Traumatic Brain Injuries Among Children, 2001-2013.
abstract: To describe the circumstances, characteristics, and trends of emergency department (ED) visits for nonfatal, playground-related traumatic brain injury (TBI) among persons aged ≤14 years.
  
  
  
  The National Electronic Injury Surveillance System-All Injury Program from January 1, 2001, through December 31, 2013, was examined. US Census bridged-race population estimates were used as the denominator to compute rates per 100 000 population. SAS and Joinpoint linear weighted regression analyses were used to analyze the best-fitting join-point and the annual modeled rate change. These models were used to indicate the magnitude and direction of rate trends for each segment or period.
  
  
  
  During the study period, an annual average of 21 101 persons aged ≤14 years were treated in EDs for playground-related TBI. The ED visit rate for boys was 39.7 per 100 000 and 53.5 for persons aged 5-9 years. Overall, 95.6% were treated and released, 33.5% occurred at places of recreation or sports, and 32.5% occurred at school. Monkey bars or playground gyms (28.3%) and swings (28.1%) were the most frequently associated with TBI, but equipment involvement varied by age group. The annual rate of TBI ED visits increased significantly from 2005 to 2013 (P < .05).
  
  
  
  Playgrounds remain an important location of injury risk to children. Strategies to reduce the incidence and severity of playground-related TBIs are needed. These may include improved adult supervision, methods to reduce child risk behavior, regular equipment maintenance, and improvements in playground surfaces and environments.
authors.affiliation: Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, The CDC Experience Applied Epidemiology Fellowship, Division of Scientific Education and Professional Development, and tacheng@mednet.ucla.edu.
authors.forename: Tabitha A
authors.initials: TA
authors.lastname: Cheng
authors.affiliation: Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control.
authors.forename: Jeneita M
authors.initials: JM
authors.lastname: Bell
authors.affiliation: Division of Analysis, Research, and Practice Integration, National Center for Injury Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Tadesse
authors.initials: T
authors.lastname: Haileyesus
authors.affiliation: Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control.
authors.forename: Julie
authors.initials: J
authors.lastname: Gilchrist
authors.affiliation: Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control.
authors.forename: David E
authors.initials: DE
authors.lastname: Sugerman
authors.affiliation: Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control.
authors.forename: Victor G
authors.initials: VG
authors.lastname: Coronado
mesh_terms: D000293:Adolescent; D000070642:Brain Injuries, Traumatic / Q000453:epidemiology* / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D016014:Linear Models; D008297:Male; D010988:Play and Playthings / Q000293:injuries*; D011159:Population Surveillance; D014481:United States / Q000453:epidemiology