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Playground injuries are a major public health problem.1-3 Laboratory studies have recommended sand, pearock, synthetic materials, or wood chips as protective surfaces beneath equipment,2 and epidemiological studies have confirmed that hard surfaces are dangerous. However, some questions remain about grass.1-3 To compare the protection offered by grass and sand, public and residential playgrounds need to be considered. Most sand surfaces are in public playgrounds, while grass is used mostly at home where up to 25% of accidents occur.2 4 This study aimed at comparing the risk of severe injuries after a fall on sand or on grass.
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 …
Funding: this study was funded by the National Health Research and Development Program (Canada) and by the Régie Régionale de la santé et des services sociaux de Montréal-Centre.
Conflicts of interest : none.