school playground surfacing and arm fractures in children a cluster randomized trial comparing sand to wood chip surfaces学校操场上堆焊和手臂骨折在儿童集群随机试验比较砂和木屑表面.pdfVIP

School Playground Surfacing and Arm Fractures in Children: A Cluster Randomized Trial Comparing Sand to Wood Chip Surfaces 1,2 3 2 2 4 Andrew W. Howard *, Colin Macarthur , Linda Rothman , Andrew Willan , Alison K. Macpherson 1 Division of Orthopaedic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada, 2 Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada, 3 Bloorview Kids Rehab, Toronto, Ontario, Canada, 4 Department of Kinesiology, York University, Toronto, Canada Abstract Background: The risk of playground injuries, especially fractures, is prevalent in children, and can result in emergency room treatment and hospital admissions. Fall height and surface area are major determinants of playground fall injury risk. The primary objective was to determine if there was a difference in playground upper extremity fracture rates in school playgrounds with wood fibre surfacing versus granite sand surfacing. Secondary objectives were to determine if there were differences in overall playground injury rates or in head injury rates in school playgrounds with wood fibre surfacing compared to school playgrounds with granite sand surfacing. Methods and Findings: The cluster randomized trial comprised 37 elementary schools in the Toronto District School Board in Toronto, Canada with a total of 15,074 students. Each school received qualified funding for installation of new playground equipment and surfacing. The risk of arm fracture from playground falls onto granitic sand versus onto engineered wood fibre surfaces was compared, with an outcome measure of estimated arm fracture rate per 100,000 student-months. Schools were randomly assigned by computer