Severity of fall injuries on sand or grass in playgrounds

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Abstract
During the summers of 1991 and 1995, children aged 1 to 14, who attended the emergency department of Montreal's two children's hospitals for a fall related injury involving playground equipment, were identified (n=930). The following information was gathered during a telephone interview with the parents: age, sex, mother tongue, mother's educational level, family size, location (Island of Montreal or not), mechanism of the accident and of the injury, type of playground (home, public, other), supervision (presence of an adult), mean number of playground visits weekly, type of equipment, surface material, nature of injury and body part injured, and number of medical consultations for injuries in the past year. A 91% response rate was achieved. The nature of the injury reported was validated using information from the doctor.5 This variable represents one of our two main outcomes, and it was divided into two categories. The “fracture and head injury” category includes concussions, skull fractures, or head contusions (n=110), fractures and dislocations (n=508). All others types of injuries were grouped into the “other” category. This classification by nature of injury was added to the Abbreviated Injury Scale (AIS) where 1 corresponds to a minor injury and 6 to death,6 because it is more intuitive to most public health professionals involved in injury prevention. Nevertheless, nature of injury categories were compared with the AIS severity score (table 1). As expected, 95% in the “other” category were AIS 1 whereas only 15% of the fractures and head injuries were AIS 1. The analysis was done with both types of outcome, nature and severity. The results with the nature provide information regarding the risk of fracture and head injuries of any type, whereas the analyses with the AIS reflect the risk of having a more severe injury (AIS 2–3).

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