23 children visit an Ontario ER daily due to playground injuries: CIHI Report

Number of admissions for head injuries declines, though overall number of playground injuries resulting in visits to hospital remains stable

July 18, 2007 — Ontario emergency departments received 8,734 visits due to playground injuries in 2004–2005, up slightly from 8,698 in 2002–2003, according to new data released today by the Canadian Institute for Health Information (CIHI). The vast majority (97%) of these injuries occurred in children aged 19 years and under, representing 23 visits every day to Ontario emergency departments. As expected, summer is the high season for playground injuries, with 44% occurring in June, July or August.

“Over the past few years, we have witnessed a number of initiatives aimed at reducing the number of playground injuries,” says Margaret Keresteci, Manager of Clinical Registries at CIHI. “While we have not seen a decrease in the overall numbers, the good news today is that in general the more debilitating injuries, such as head injuries, are on the decline. This may be due to changes in the design of playgrounds, such as height restrictions on playground equipment, as well as removing hard surfaces beneath the structures to soften the landing for potential falls.”

For those visiting the emergency department after a playground injury in 2004–2005, the largest proportion (51%), were seen for orthopedic injuries, mainly fractures of the upper limbs (such as a broken arm, wrist or elbow), followed by head injuries (22%). Similarly, for admissions to hospital (of at least one night) the most commonly reported injury was an upper arm fracture (80%). Head injuries sustained in Ontario playgrounds that required admission to hospital decreased substantially from 131 in 2002–2003 to 37 in 2004–2005.

Children aged five to nine most at risk

In 2004–2005, children aged five to nine years of age had the highest number of visits to an emergency department due to playground injuries among all age groups, with 4,744 (representing 54% of all visits) and the highest number of hospital stays of at least one night, with 335 (or 61% of overall cases). Children aged 10 to 14 had the second-highest proportion of emergency department visits for playground injuries (2,018 or 23%). Children under the age of five had the third-highest number of visits (1,469 or 17%), and the second-highest number of hospitalizations for playground injuries in Ontario, with 111 hospital stays of at least one night.

“These data show that kids are getting injured every day in Ontario and some of them are ending up in hospital with serious injuries,” says Allyson Hewitt, executive director, Safe Kids Canada. “We definitely want to see kids in playgrounds, exploring and developing their skills and muscles—it is so important for them to be able to do that. But we want their parents and caregivers to be aware of some of the risks and to understand how to prevent them. Safer playgrounds and close supervision are key to preventing injuries, and with it kids can play all summer.”

Hospitalization trends

The number of people admitted to a hospital for at least one night for this type of injury decreased from 590 in 2002–2003 to 553 in 2004–2005 (6%). However, when examining trends over a longer period, the number of hospitalizations for playground injuries remained relatively stable, fluctuating from a low of 420 in 1998 to a high of 644 in 1999.

Regional variations

In 2004–2005, the number of visits to emergency departments because of playground injuries varied considerably from one part of Ontario to another. The southeast region (Kingston and Brockville areas) had the highest rate of playground injuries in Ontario, with 438 ED visits per 100,000 population under 20 years of age, followed by the southwest (London and Windsor areas) with 430 per 100,000, while Mississauga Halton (Mississauga and Oakville) had the lowest rates, with 130 visits per 100, 000 population.

“Our new data tell us that there are regional variations in the number of children requiring care at a hospital after sustaining playground injuries, with visits to emergency or admission to hospital being more common in some areas. Some of the factors that may help explain these differences are availability of playground equipment or tendency for children to use the equipment. Further analysis would be required at the regional level to better understand the specific local issues relating to injuries that occur in playgrounds,” says Keresteci.

The northwest region (including Thunder Bay and Kenora) recorded the highest rate of hospitalizations (at least one night in hospital) with 23 per 100,000, followed by North Simcoe Muskoka (Barrie and Huntsville), with 20 per 100,000. The central region (including North York and Newmarket) had the lowest rate at 12 per 100,000.

Ontario Trauma Registry

Managed by CIHI, the Ontario Trauma Registry (OTR) is funded by the Ontario Ministry of Health and Long-Term Care and provides data on hospitalizations and deaths resulting from injury. The goal of the OTR is to help reduce injury admissions and deaths in the province by identifying, describing and quantifying the nature and scope of injury in Ontario. The information is used by policy-makers, researchers, coroners, trauma-care providers and injury-prevention specialists to develop and monitor injury prevention and treatment programs.

National Ambulatory Care Reporting System

The National Ambulatory Care Reporting System (NACRS) includes data for all hospital-based and community-based ambulatory care, including emergency departments, day surgery and outpatient clinics. The province of Ontario is taking a leadership role in the collection on a province-wide basis of this information, which is used by policy-makers, researchers and ambulatory-care providers to support the study of clinical outcomes and health status of Canadians. The goal of NACRS is to assist with the evaluation of the management of ambulatory care services in Canadian health care facilities and to facilitate provincial and national comparative reporting.

About CIHI

The Canadian Institute for Health Information (CIHI) collects and analyzes information on health and health care in Canada and makes it publicly available. Canada’s federal, provincial and territorial governments created CIHI as a not-for-profit, independent organization dedicated to forging a common approach to Canadian health information. CIHI’s goal: to provide timely, accurate and comparable information. CIHI’s data and reports inform health policies, support the effective delivery of health services and raise awareness among Canadians of the factors that contribute to good health. www.cihi.ca