Results: There were 22728 emergency department visits owing to playground equipment injuries
recorded by NEISS between 2002 and 2004; 83.9% were owing to monkey bars, swings, and slides, and
the 5 most common diagnoses were fractures (39.3%), contusions/abrasions (20.6%), lacerations
(16.6%), strains/sprains (9.9%), and traumatic brain injuries (TBI) (8.5%). There were 9487 boys
(54.3%) and 7995 girls (45.7%). The average age was 6.5 ± 3.0 years. The injuries occurred at school in
38.9%; at a recreation/sporting facility, in 35.5%; and at home, in 25.6%. Most were treated and released
(94.4%). Amerindian children were 2 times more likely than blacks to be admitted; compared to
contusions, fractures were 9.8 times, and TBIs, 4.7 times more likely to be admitted. Injuries on monkey
bars were 1.2 times more likely to be admitted than those on swings or slides. Fractures were 1.9 times
more likely to occur on a monkey bar compared with swings or slides. Traumatic brain injuries were 1.4
times more likely to occur on a swing compared to slides or monkey bars.
Conclusion: Swings at school are the most common mechanism of injury for TBIs, and the seasonal
data would suggest that increased supervision of children using swings during school hours might
reduce the occurrence of TBIs. Monkey bars are the most common cause of fracture, and fracture is the
most common cause of admission. Prevention strategies to reduce the number of fractures should be
directed at monkey bar equipment and landing surfaces. The trend in playground equipment injury also
indicates that monkey bars are problematic because the number of injuries per year per capita owing to
monkey bars is stable, whereas those from swings and slides is decreasing.
© 2008 Elsevier Inc. All rights reserved.