National Study Evaluates Playground Equipment-Related Injuries

October 6, 2008

Schools have opened their doors this fall and the sounds of children echo from surrounding playgrounds. While children’s activities on playgrounds can benefit their psychosocial and physical development as well as combat problems such as childhood obesity, these activities are not risk-free.

A new study from researchers at the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio found that more than 213,000 children under 18 years of age are treated each year in hospital emergency departments in the United States for playground-related injuries. The number of injuries remained consistent across the 10-year study period. The study is now available in the electronic issue of Clinical Pediatrics.

“Although playground guidelines and standards exist, the consistently high numbers of injuries we are seeing in our emergency departments show that unsafe playground conditions remain and pose risk for severe injury,” said study co-author Gary Smith, MD, DrPH, director of the Center for Injury Research and Policy at Nationwide Children’s Hospital, and an associate professor of pediatrics at The Ohio State University College of Medicine. “Our study findings underscore the importance of strengthening current standards and increasing our efforts to prevent these injuries.”

Other key findings in the study include:
• Injuries occurred most frequently on climbers (36 percent), followed by swings (30 percent) and slides (20 percent). 

• The majority of injuries occurred to children between 5 and 12 years of age and injuries occurred equally among boys and girls.

• The most commonly injured body parts were the upper extremities – which included the upper and lower arm, shoulder, elbow, wrist, hand and fingers (45 percent), followed by the head (15 percent) and face (13 percent).

• The most common types of injuries included fractures (35 percent), bruises (20 percent), cuts (20 percent) and sprains and strains (11 percent) with more than three-fourths of these injuries occurring as the result of a fall. 

• Compared with other mechanisms of injury, falls were significantly associated with fractures, and fractures accounted for over 90 percent of the injuries among children who needed to be admitted to the hospital as the result of a playground equipment-related injury.

The Center for Injury Research and Policy is CDC’s newest Injury Control Research Center (ICRC) and it is working to better understand pediatric and adolescent injuries.  

“When science and the community come together, we can help our children play safely whether they are at school or in sports areas or around the home,” said Dr. Ileana Arias, director of CDC's Injury Center. “We want our children to exercise to stay healthy, and it’s a good idea if parents check the play area for safety hazards before their children start to play.”

The Center for Injury Research and Policy recommends the following:
• Make sure there is a shock-absorbing surface under and around the play equipment.
• Remove or close open “S” hooks that could cause an injury.
• Check for spaces where children can get their head caught.
• Make sure platforms and ramps have guardrails for barriers.
• Remove any trip hazards.
• Never attach ropes, jump ropes, clotheslines, or pet leashes to playground equipment.
• Have children remove their bike helmets before entering the playground. Strangulation can occur if either the straps or the helmet gets caught on playground equipment while the child is wearing the helmet.

The Center for Injury Research and Policy (CIRP) of The Research Institute at Nationwide Children’s Hospital works globally to reduce injury-related pediatric death and disabilities. With innovative research as its core, CIRP works to continually improve the scientific understanding of the epidemiology, biomechanics, prevention, acute treatment and rehabilitation of injuries. CIRP serves as a pioneer by translating cutting edge injury research into education, policy and advances in clinical care. Learn more about CIRP at

CDC’s Injury Control Research Centers are located at 13 research institutions throughout the United States. The research centers bring together scientists with different areas of expertise in an effort to find new and more effective ways to prevent, reduce and respond to injuries.  The work of the research centers includes identifying important research questions, conducting studies that help answer important research questions or that address gaps in current knowledge, and providing injury-related assistance and recommendations. For more information about the CDC’s Injury Prevention work, visit Full descriptions of current research and education projects conducted by the CDC Injury Control Research Centers may be accessed at

EDITOR NOTE:  This study was conducted prior to CDC funding being awarded to this ICRC.

About Nationwide Children's Hospital

Named to the Top 10 Honor Roll on U.S. News & World Report’s 2021-22 list of “Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit free-standing pediatric health care systems providing unique expertise in pediatric population health, behavioral health, genomics and health equity as the next frontiers in pediatric medicine, leading to best outcomes for the health of the whole child. Integrated clinical and research programs, as well as prioritizing quality and safety, are part of what allows Nationwide Children’s to advance its unique model of care. Nationwide Children’s has a staff of more than 13,000 that provides state-of-the-art wellness, preventive and rehabilitative care and diagnostic treatment during more than 1.6 million patient visits annually. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s physicians train the next generation of pediatricians and pediatric specialists. The Abigail Wexner Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Health-funded free-standing pediatric research facilities. More information is available at