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Canadian Journal of Public Health

, Volume 109, Issue 1, pp 134–149 | Cite as

A systematic review of the risk factors and interventions for the prevention of playground injuries

  • Sarah A. Richmond
  • Tessa Clemens
  • Ian Pike
  • Alison Macpherson
Systematic Review

Abstract

Objectives

The primary objectives of this work were to (1) identify the risk and/or protective factors associated with playground injuries among children less than 18 years of age and (2) identify interventions/programs/policies aimed at preventing playground-related injuries among children less than 18 years of age. Secondary objectives include a summary of the data that reflect alignment with current playground standards.

Methods

For the primary outcome, 4 databases and 12 online resources were systematically searched to include observational and experimental studies examining risk and/or protective factors or interventions associated with playground injury or outcomes related to playground injury (e.g., risky playground behaviour). Data extraction included study design, participants, outcome, exposure or intervention, data analysis, and effect estimates. The quality of evidence for all studies was assessed using the Downs and Black criteria.

Results

This review included studies of moderate quality, revealing a number of risk factors and effective interventions for playground injury. Risk factors included absence of handrails and guardrails on playground equipment, non-impact-absorbing surfacing, and critical fall heights. Effective interventions included modifying playground surfacing and reducing equipment height to less than 1.5 m.

Conclusion

Equipment- and structure-based playgrounds should adhere to and maintain playground standards in order to reduce the risk of serious injury. Organizations responsible for installing and maintaining playgrounds should consider alternative play spaces that allow children to play outdoors, in a natural environment that supports healthy child development and promotes physical activity.

Keywords

Interventions Playgrounds Systematic review Play and playthings Wounds and injuries Risk factors 

Résumé

Objectifs

Les principaux objectifs de l’étude consistaient : 1) à dresser la liste des facteurs de risque et/ou de protection associés aux blessures sur les terrains de jeux chez les enfants de moins de 18 ans et 2) à dresser la liste des interventions, des programmes ou des politiques visant à prévenir les blessures sur les terrains de jeux chez les enfants de moins de 18 ans. Le résumé des données en phase avec les normes en vigueur pour les terrains de jeux était un objectif secondaire.

Méthode

Pour les objectifs principaux, nous avons systématiquement interrogé 4 bases de données et 12 ressources en ligne pour repérer les études observationnelles et expérimentales portant sur les facteurs de risque et/ou de protection associés aux blessures sur les terrains de jeux (p. ex., les comportements dangereux sur les terrains de jeux), sur les interventions ou sur les résultats des blessures sur les terrains de jeux. Nous avons extrait les données sur le protocole d’étude, les participants, le résultat, l’exposition ou l’intervention, l’analyse de données et les estimations des effets. La qualité des données probantes de chaque étude a été évaluée selon les critères de Downs et Black.

Résultats

Les études de cette revue étaient de qualité moyenne; elles ont mis au jour des facteurs de risque de blessures sur les terrains de jeux et des interventions efficaces. Les facteurs de risque étaient l’absence de mains courantes et de garde-corps sur les équipements de jeu, les surfaces n’absorbant pas les impacts, ainsi que les hauteurs de chute critiques. Les interventions efficaces consistaient à modifier la surface des terrains de jeux et de réduire la hauteur des équipements à moins de 1,5 m.

Conclusion

Les terrains de jeux qui comportent des équipements et des structures devraient être conformes aux normes pour les terrains de jeux afin de réduire les risques de blessures graves. Les organismes chargés de l’installation et de l’entretien des terrains de jeux devraient envisager des aires de jeu différentes qui permettent aux enfants de jouer à l’extérieur, dans un milieu naturel propice à leur développement sain et à l’activité physique.

Mots-clés

Interventions Terrains de jeux Revue systématique Jeu et accessoires de jeu Plaies et blessures Facteurs de risque 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

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Copyright information

© The Canadian Public Health Association 2018

Authors and Affiliations

  • Sarah A. Richmond
    • 1
  • Tessa Clemens
    • 1
  • Ian Pike
    • 2
  • Alison Macpherson
    • 1
  1. 1.Faculty of Health, Kinesiology and Health ScienceYork UniversityTorontoCanada
  2. 2.BC Injury Research and Prevention UnitBC Children’s HospitalVancouverCanada

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