title: Homemade zipline and playground track ride injuries in children.
abstract: OBJECTIVE
  Playground track ride and homemade zipline-related injuries are increasingly common in the emergency department, with serious injuries and even deaths reported.
  
  
  METHODS
  Retrospective review of the National Electronic Injury Surveillance System (NEISS) database (2009-2015), followed by review of our academic pediatric trauma center's prospectively-maintained database (2005-2013). We included children ages 0-17years of age with zipline-related injuries. We recorded annual incidence of zipline-related injury, zipline type (homemade or playground), injuries and mechanism.
  
  
  RESULTS
  In the NEISS database, 9397 (95%CI 6728-12,065) total zipline-related injuries were reported (45.9% homemade, 54.1% playground). Homemade but not playground injuries increased over time. Common injuries were fracture (49.8%), contusion/laceration (21.2%) and head injury (12.7%). Fall was predominant mechanism (83%). Age 5-9 was most frequently affected (59%). Our center database (n=35, 40% homemade, 1 fatality) revealed characteristics concordant with NEISS data. Head injury was related to fall height>5ft and impact with another structure.
  
  
  CONCLUSIONS
  Homemade zipline injuries are increasing. Children ages 5-9 are at particular risk and should be carefully supervised. Despite protective surfaces, playground ziplines cause significant head injury, extremity fracture and high rates of hospital admission. Playground surface standards should be reviewed and revised as needed.
  
  
  METHODS
  Prognosis Study, Level III.
authors.affiliation: Division of General Surgery and Trauma, Department of Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA, 15213, USA; Children's Hospital of Pittsburgh of UPMC, 7th Floor, Faculty Pavilion, One Children's Hospital Drive, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA. Electronic address: leepercm@upmc.edu.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Leeper
authors.affiliation: Children's Hospital of Pittsburgh of UPMC, 7th Floor, Faculty Pavilion, One Children's Hospital Drive, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA. Electronic address: Christine.McKenna@chp.edu.
authors.forename: Christine
authors.initials: C
authors.lastname: McKenna
authors.affiliation: Children's Hospital of Pittsburgh of UPMC, 7th Floor, Faculty Pavilion, One Children's Hospital Drive, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA. Electronic address: Barbara.Gaines@chp.edu.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Gaines
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003288:Contusions / Q000453:epidemiology; D006259:Craniocerebral Trauma / Q000453:epidemiology; D004864:Equipment and Supplies / Q000706:statistics & numerical data; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology; D006801:Humans; D022125:Lacerations / Q000453:epidemiology; D008297:Male; D010988:Play and Playthings / Q000293:injuries*; D012189:Retrospective Studies; D012449:Safety / Q000706:statistics & numerical data*; D000072264:Sports and Recreational Facilities; D014947:Wounds and Injuries / Q000453:epidemiology*
keywords: Injury; Playground; Zipline