Playgrounds have come a long way from the asphalt jungle gyms of the 1960s and 1970s.
Monkey bars and hot metal slides have virtually disappeared. They've been replaced by colorful plastic castles with guardrails and ramps and rounded edges. And instead of blacktop and concrete, many new playgrounds are covered with soft wood mulch or springy rubber chips made from recycled tires.
Yet in spite of these improvements, many playgrounds still fall short on safety, experts say.
About 200,000 children go to the emergency room every year because of playground injuries, says Chrissy Cianflone of Safe Kids USA. About 90,000 of those injuries are serious, such as fractures, concussions and amputations. About 15 kids die from playground injuries every year.
Falls are most treacherous
Most injuries occur when children fall from equipment, the Consumer Product Safety Commission says. And though many parents try to be vigilant, even those with eagle eyes and sharp reflexes can't always rush to the rescue in time.
That's why playgrounds need to be built properly and maintained in top shape, says Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio.
Although many playgrounds start out well, many communities neglect to rake or refill the loose materials designed to cushion falls, leaving little more than bare earth underneath swings and climbing structures, Smith says. Kids also tend to kick away mulch.
"If you show me a playground, I can show you a playground that isn't being maintained," Smith says.
In a 2007 report on the safety of rubber playground chips, for example, California officials found that nearly 70% of rubber surfaces weren't shock-absorbent enough to actually cushion falls.
Swings and climbing structures should be cushioned by at least 9 inches of loose-fill material, such as wood mulch, underneath play structures, Cianflone says. Because chips and mulch compress 25% over time, the playground may need to be initially filled with 12 inches of loose fill, she says.
Play structures should never be built over concrete, asphalt, dirt or grass, the safety commission says. Shredded rubber, wood chips or wood mulch are better at preventing injuries, it says.
"The top three things to pay attention to at a playground are surfacing, surfacing and surfacing," says Smith, a pediatric emergency medicine physician. "It's everything."
How to reduce the risk
In recent years, a number of playgrounds have switched to rubber chips, partly because of a 1997 Lancet study. Researchers found that rubber playgrounds had the lowest rate of injury: half the risk of bark mulch and one-fifth the risk of concrete.
Some environmental groups, however, are concerned about the safety of rubber mulch, which can contain lead.
Lead is toxic at any level, and its damage is cumulative, says Mary Jean Brown of the Centers for Disease Control and Prevention. Kids can accumulate lead exposure through lots of sources -- playgrounds, old lead paint in their homes or even some toys. About 250,000 children have a blood lead level the CDC considers high, which puts them at increased risk for brain damage.
Children can reduce their exposure to playground lead by washing their hands after playing, Brown says. To avoid ingesting lead, children shouldn't snack while on the playground. And children shouldn't use the rubber chips in a sandbox, Brown says.
Playgrounds can contain other toxins as well.
Wood play structures built before 2004 may contain arsenic, the safety commission says. Staining or sealing the wood at least once a year can help contain the arsenic and reduce the risk to children. The agency recommends that people fill playgrounds only with wood mulch that's not treated with arsenic.
Despite the potential risks, children don't need to avoid the playground, says Maida Galvez of New York's Mount Sinai School of Medicine. Given the spread of childhood obesity, Galvez says children can benefit from playing outside. But a little homework by parents, schools and community leaders can make playgrounds a lot safer.
"It's important we encourage our kids to be active," Galvez says. "Parents should choose materials that are the least toxic. That's not always easy to do."
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