Warm weather draws children to the playground like lady bugs to roses. But the laughter will be, at some point, punctuated with shrieks.
Each year, about 940 Utah schoolchildren are injured seriously enough to require a doctor's care — and that's just on elementary school playgrounds. It doesn't count those in public parks or the family back yard.
Consider these incidents cited by the Utah Department of Health injury prevention program's latest report on school playground injuries:
A fifth-grader sliding down the fire pole slips and fractures his arm.
A second-grader playing at recess tries a back flip out of the swing, breaking both arms. He's out of school for more than a month.
A fifth-grade girl hangs upside down by her knees on a bar and tries to flip and land on her feet. Instead, she fractures a leg and misses nine days of school.
A third-grader is swinging at recess when it breaks. He lands on his head and is hospitalized for two days with a brain injury.
A first-grader playing before school jumps out of the swing, but his backpack catches. He needs five stitches in his elbow.
A kindergartner jumping from one piece of equipment to another falls and fractures his wrist, is hospitalized for 10 days and needs several surgeries.
The most common school-related injuries to children K-6 occur on the playground, according to the Violence and Injury Prevention Program report, which examined injuries for the five school years from 1999-2000 to 2003-2004.
In that time, 4,703 elementary school students were hurt, wracking up 5,043 missed school days, 270 calls to 911 and 74 hospitalizations. And those were just the injuries reported to the state, so it's very likely an undercount — perhaps as little as half, according to Carol Peterson, health department student injury specialist.
The school playground injury report included only injuries that required medical attention of at least half a day of missed school. There's no official count of injuries that occur on nonschool playground equipment.
Three-fourths of injuries on playgrounds are from falls. The most common injuries are possible fracture/broken bone (54 percent), cuts (17 percent), and bumps/bruises/contusions (9 percent), according to the school report.
At Primary Children's Medical Center, between 2002 and 2005, physicians admitted 177 children who suffered playground equipment injuries, says Bonnie Midget, hospital spokeswoman. About half of them were head injuries and half orthopedic injuries, with a few "assorted others such as abdominal trauma."
Five children with head injuries and one with a hurt belly required a stay in the intensive care unit. The good news, she says, is there were no deaths from playground injuries in that time frame.
Experts say the numbers don't indict playgrounds, which are an important tool to keep children active, but rather should remind adult supervisors to make sure equipment is safe and well maintained, surfaces beneath are soft and children know the rules for playing safely.
For instance, children need to wear their helmets when they ride bikes but take them off before getting on any playground equipment, because they can get caught or choke, says Peterson. Cords, belts and ties such as those in a windbreaker can also get caught and hang children.
Janet Brooks, child advocacy manager at Primary Children's, says strangulation is the most common cause of fatalities related to equipment. Children playing in loose-fitting clothing, ponchos or clothes with drawstrings, or wearing helmets, place themselves in serious danger.
More than half the playground deaths nationally are strangulation, she says. Falls account for about 20 percent.
Children should also be taught how equipment works and should never use it in other ways, which is inherently risky.
In his previous job, David Gneiting, Nebo School District's risk manager, worked for the school board associations inspecting all the school playgrounds in the state, looking for dangers and recommending changes. He was there when many school districts replaced or modified their equipment and improved the surfaces below it.
"Everybody did a really good job with that," Gneiting says. "That's not to say there are not structures or pieces of equipment that shouldn't still be looked at for replacement, but the districts spent a lot of money and time upgrading playgrounds. I'm really impressed with what they did."
Safety issues include adequate spacing between components, eliminating protrusions a child could hang up on or be cut on and fixing openings where a head could be entrapped, among others.
Still, the biggest safety issue is not something that can be inspected away, he says. "It's how the children use the equipment. Take, for example, an overhead ladder. They like to have a little bit of challenge, so they try to skip one rung and sometimes they skip two, but they don't have the arm length or the hand strength and fall. Since there's a swinging motion when they fall, they come down in an awkward position."
It's important to set up equipment so children don't walk or cut through where it's not safe.
No surface is going to provide adequate protection for limbs in a fall. The good ones —gravel, wood bark, rubberized material, sand — are designed to prevent head injury. "You can break your arm jumping on a trampoline if you come down wrong. It's designed to make sure there's surfacing material under and around that will prevent serious head injury," says Gneiting.
He says parents should always inspect the equipment their children are going to play on, teach them what they are allowed to do and what's forbidden, and see that the activity and equipment are age appropriate.
He says he'd never let kids do "cherry drops" off overhead ladders or climb on the outside of tube slides or atop canopies. Children shouldn't play tag in and around playground equipment. And they should be taught not to jump from one section of a structure to another or stand on guardrails.
Among the most dangerous activities — and, alas, the most popular — are "chicken fights," where kids hang on ladders or hand rings and try to knock each other off. "It's all common sense. Use the activities the way they were intended," he says.
"There's just absolutely nothing that can take the place of supervision," Brooks says.
The Consumer Product Safety Commission has guidelines for playgrounds, from protective surfacing to proper equipment use. It emphasizes that grass is one of the most dangerous because it is "not forgiving and has no shock-absorbing features," Brooks says. The commission also warns about the dangers of lead-based paints on metal or wood surfaces.
Brooks says people installing their own playgrounds need to make sure that children — especially young children, who react more slowly — won't burn their hands, legs and bottoms on metal surfaces that bake in the sun. Slippery slides should be placed facing north, if possible. And all equipment should be regularly inspected to make sure there are no splinters, cracks or decayed wood.
"Please, enforce the rules consistently," she counsels parents. "Praise children for using the equipment appropriately and explain that if they misbehave, it can be very hurtful to them or someone else."
The Consumer Product Safety Commission guidelines for safe playgrounds can be found online at www.cpsc.gov. For the state's report, visit the health department's Web site at health.utah.gov.
E-mail: lois@desnews.com