An emergency room physician in Iowa wants parents to know that they're not keeping their children safe when they accompany them down a slide at the playground. In fact, they may be setting their children up for a broken bone.
In research presented Sept. 18 at the annual meeting of the American Academy of Pediatrics, Dr. Charles Jennissen said children are more likely to suffer injuries when they go down a slide on an adult's lap. That's because a child slides more slowly on her own; the force is greater when the child is propelled by an adult, and that momentum makes it more likely that a bone will snap if the child's foot or leg is twisted during the descent.
That's what happened to a Minneapolis toddler in May. Erin Roche, the child's mother, told WCCO, a CBS affiliate, that her son had just started to walk when she took him to the park and went down a curving slide with her son on her lap. At first, she didn't realize he was injured; she said, "I felt like we went down a little bit funny."
As it turned out, the 20-month-old had broken his tibia, and had to wear a cast from the middle of his thigh to his toes for three weeks.
Dr. Stephen Sundberg, a pediatric orthopedic surgeon at Gillette Children’s Specialty Healthcare in St. Paul, Minnesota, told Jennifer Mayerle of WCCO that he sees this kind of injury daily, the result of a sharp twist to a soft bone.
“It’s not enough force to break your leg or my leg, but children, their bones are pretty soft so it happens quite easily," Sundberg said.
The Roche family's case is typical of injuries that Jennissen found when he studied data from the National Electronic Injury Surveillance System, which collects information about emergency room visits from a sample of hospitals across the country each year.
His findings are important for any family headed to a public playground — particularly if they have children under the age of 2.
Exercise 'extreme caution'
Jennissen, a professor and pediatric emergency medicine physician at the University of Iowa Carver College of Medicine, analyzed the records of more than 352,000 children who were taken to emergency rooms with slide-related injuries between 2002 and 2015. The children were 5 years old or younger; nearly 6 in 10 were boys.
When looking more closely at 600 cases, Jennissen found that children between 12 and 23 months old had the most injuries, and most involved a fracture of the lower leg, like the child in Minnesota.
Thirty-six percent of injuries were fractures; 19 percent were lacerations, the study said.
“The younger the age group of the child, the higher the percentage of injuries involving the lower extremity and of children noted to be on the lap of another person at the time of the injury,” the authors wrote. When a child was sitting on a person’s lap, the tibia, or lower leg, was injured in 94 percent of cases.
Jennissen's conclusion that young children should not go down a slide on another person’s lap may disappoint not only the child who wants the security of a parent’s arms, but also the fun-loving parent who wants to play, too.
Jennissen confessed that he, too, has enjoyed taking his own children down a slide and acknowledged that parents might not want to give up that small pleasure. But there’s something parents can do to make ride-sharing safer if they persist in the practice: Make sure that the child’s legs are not close to the edge of the slide, where they could get caught. “Extreme caution” is necessary, Jennissen’s report said.
It’s important to note, however, that the study's conclusions are speculative, based as they are on delayed reporting of the event, and where the injuries are on the child.
As Kendra Pierre-Louis wrote for Popular Science, “If a child tumbles while climbing a slide's ladder, she's likely to injure her head or face — or her arms, if she reaches out to break her fall.”
"We think a lot of these lower extremity injuries are because they're on the lap," Jennissen said in Popular Science. "We don't know that for sure, because the narrative doesn't say that. But from my experience, and the data that suggests it, we think almost all of these are kids are on the lap."
Tragically, some children die from slide accidents, most often because of head injuries.
The Consumer Product Safety Commission’s report on playground-related injuries and deaths between 2002 and 2014 says that the agency investigated 34 deaths associated with playground equipment during those years. Five were associated with slides; five were associated with the most dangerous of playground equipment, something not mentioned in Jennissen’s latest report: swings.
Slides, it turns out, are the third most hazardous object at your typical playground. Swings come in second, and most dangerous of all, at least according to CPSC statistics, are see-saws, which accounted for 42 percent of injuries reported. Other equipment that seems equally dangerous, such as monkey bars, zip lines and tire swings, registered only 1 percent each. But that may be, in part, because fewer playgrounds have them because of safety concerns.
The first slide was a plank
Although children, adults and even some animals have been sliding down hills and other inclines for pleasure for thousands of years, the modern playground slide is thought to have been designed and installed by Charles Wicksteed Jr., the son of a Unitarian minister in the United Kingdom.
Photographs of his creation, which opened to the public in 1922, show children sliding slowly down two long wooden planks -- one for boys, one for girls. By 1935, a new model had been devised with a seat made of steel, doubtless a relief to parents who lack the talent (or moxie) to remove splinters from a shrieking child.
Wicksteed, an engineer, said he invented the equipment, in part, because he believed it was important for children to play outside. In 1928, he published a book, “A Plea for Children’s Recreation after School Hours and after School Age.”
“I have direct evidence from mothers how whining, pale-faced children, complaining of any food they get, have come back with healthy faces and rosy complexions, ready to eat the house out after a good play in the playground,” he wrote.
Wicksteed might be surprised to learn that his creation resulted in injuries after decades of improvements. In a 1924 catalogue, The (U.K.) Daily Mail reported, he said of his slides: "It was at first thought that children would hesitate about climbing so high a ladder; this has proved to be quite a mistake, they go up without fear or trembling, and we have never had an accident of any sort, although tens of thousands of sliders use them."
None of the children, however, in the early pictures were toddlers, and the modern accident data suggest that parents should wait until their children are older before introducing them to the joys of sliding.
When it’s time, the American Academy of Pediatrics has three safety suggestions:
When the sun is shining, check the slide’s surface to make sure that it’s not too hot; check the base to make sure that there are no rocks, glass or other dangerous debris; and make sure that the slide has a platform at the top with rails to hold onto and sides that are at least 4 inches high. Then stand back and enjoy watching your child have fun.
As Wicksteed, the inventor of the modern slide said, “Parents enjoy seeing the sport, even when they don’t join in it."