Ensuring safety in public playgrounds is everybody’s business

Children need outdoor play but safety standards alone will never prevent all injuries; robust data are required to guide risk minimisation strategies

When an injury occurs in a children’s playground, who is responsible? Media headlines1,2 have highlighted risks associated with a recently opened playground in north-western Sydney. The playground’s giant tube slide was closed following a spate of injuries to both adult and child patrons. With injuries described as “horrific”, the media questioned “how the 30 m long, 14 m tall slide passed safety rules”.1 While playground injuries are fairly common,3 there are specific multilevel responsibilities required to balance the importance of play and physical activity with mitigation of injury risk. In this article, we review the role of standards in industry governance and injury prevention.

What are standards?

The “safety rules” referred to in the media1 are set out in the Australian standard for playground safety (AS 4685 series — Playground equipment and surfacing).4 The publisher, Standards Australia, is a not-for-profit organisation that develops voluntary Australian standards through the formation of expert technical committees. Similar to other product standards in Australia (particularly for children’s products), they incorporate applicable design, installation, product conformity, test methods, marking requirements and consumer safety. Of over 15 000 products of all kinds available in Australia,5 most have no voluntary standard and only 41 have mandatory standards, where elements of the voluntary standard have been enforced in legislation. Mandatory standards are regulated by the Competition and Consumer Act 2010 (Cwlth) and enforced by the Australian Competition and Consumer Commission.6 Consumers become aware of some standards (voluntary or mandatory) through manufacturer labelling. There is an incorrect assumption within the community that all products in Australia have some form of mandatory conformity standard. Compliance with AS 4685 is voluntary unless the owner or user enforces compliance under contract law. Playground ownership can be by government (local council, education department, public hospital) or private entities (developers, retail outlets, recreational facilities). Where the playground is associated with a workplace (eg, retail facility, recreational business, school) then the relevant state workplace health and safety body has oversight in the event of an incident. Even if compliance is specified, older playgrounds are assessed to the standard at time of installation, and all playgrounds require maintenance to ensure ongoing compliance.

All product standards set minimum design requirements to facilitate consumer safety, contemplating “reasonably foreseeable use” and potential patterns of “reasonably foreseeable misuse”. They cannot prevent all injuries, instead concentrating on preventing or mitigating serious injuries based on existing evidence of injury patterns. Standards are required to consider all potential product users; not only the targeted end user, particularly where children are at risk. For example, the standard pertaining to child-resistant packaging (AS 1928) is designed to address foreseeable misuse by young children who access medications inappropriately.

Foreseeable misuse is an important concept to consider when designing, developing or regulating products. It includes both inadvertent and deliberate misuse of products. Although the latter is generally out of scope for most standards, innovation can thwart deliberate misuse; for example, changing product composition to reduce risks associated with inhalational use such as with glue and petrol. Inadvertent misuse includes adult consumers not heeding product warnings or using products in unprescribed ways, or child consumers for whom the process is largely experimental; for example, ingesting products not intended for that purpose. Two International Organization for Standardization (ISO) guides inform of specific child injury risks and how to address these risks in standards (ISO/IEC Guide 50 and 51).7,8 The guides can be used to inform designers as well as technical standards committees, some of whom may be unfamiliar with childhood mechanisms of injury. Again, use of the guides is not mandated.

New products or designs can create new hazards, both structural and behavioural. Typically, new designs and product innovations are ahead of product-specific standard development; therefore, new patterns of injury are not necessarily prevented by existing standards, although they may be anticipated by the ISO guides. Timely access to informative hazard and injury data is vital to ensure the assessment of innovations against existing standards and to reveal new hazards.

Applying standards to playground design and development

Playground designers understand that for items such as slides, several factors contribute to injuries, including:

• multiple users (often different anthropometry) who impact on descent;

• children climbing up or jumping from the side;

• footwear or clothing with variable grip such that speed is dramatically increased or decreased;

• for tube slides, children obtaining unintended access to the outside of the tube and climbing higher than the 3 m maximum permissible height;

• hard objects within the free space of the slide;

• metal slides oriented with sun exposure and resultant burns to exposed skin;

• for segmented slides, sharp objects intentionally lodged in the joints resulting in lacerations;

• vandalism of the sides or sliding surface with sharp objects; and

• children riding other objects to increase slide velocity (eg, cardboard sheets or boxes, hessian mats or even skateboards).

All of these issues are foreseeable use or misuse, and although well understood by designers and maintainers of playgrounds, they may not be foreseeable for parents.

Can parental supervision prevent playground injuries?

Risk-aware parenting styles undoubtedly provide greater levels of attention. However, the exact and replicable measure of parental supervision has been difficult to quantify.9 Older siblings may be called upon to supervise younger siblings, and one-on-one parent–child supervision is not always feasible. Even an experienced risk-aware parent cannot possibly anticipate or avoid all of the potentially hazardous things children may attempt. At times, playground design itself limits a parent’s ability to supervise, with elements intentionally designed to engage the child’s inquisitiveness and promote development, such as tunnels and hidden passages.

Should all injuries be prevented?

Most injuries are preventable, but it is neither realistic nor desirable to prevent all injuries. With evidence of steady decline in children’s time spent in outdoor free play over recent generations10 and the rise of screen-based activities and obesity levels, we must continue to encourage active involvement in outdoor free play. This comes with inherent risk, in spite of supervision and standards. Playground standards attempt to prevent serious injuries. Some injury mechanisms must be avoided, regardless of low incidence or severity, where minor injury can represent a near-miss serious or fatal injury. For example, head or neck entrapment, although uncommon, carries a high risk of a serious or fatal outcome. Prevention of all head injuries is desirable but not feasible. In playgrounds, efforts are therefore concentrated on mitigating high impact forces by limiting fall heights and through impact attenuation surfacing.

Has the correct standard been applied?

With regard to the now closed tube slide, we could ask if it is a product that is ahead of AS 4685.4 When the standard was written, it is unclear whether a 30 m long, 14 m tall tube slide was in the minds of the technical committee. Long, totally enclosed tube slides expose the user to psychological effects such as impaired speed perception and dynamic biomechanical movements, creating an out-of-control sensation similar to that of an amusement park ride.

Slide design to separate children of different ages does not necessarily separate the users and decrease the risk. We propose that Australia have a standard for adventure playgrounds that requires “adventure rides” such as giant slides to be supervised with dispatch control. Such a standard could fill the gap between AS 4685 Playground equipment and surfacing (series) and AS 3533 Amusement rides and device (series).

Monitoring efficacy

A standard’s efficacy in mitigating risk can only be inferred by detailed injury surveillance. Determination of precise injury mechanism for this purpose is almost impossible using routinely coded emergency department health data. Data coded for admission are more detailed, including some product and external injury cause codes, but are still deficient, particularly when trying to understand product safety or standards compliance. To better inform product safety and standards development, detailed, nationally consistent injury surveillance data or more specialised data collection (eg, the Australian Paediatric Surveillance Unit) are required. In Australia, level 1 injury surveillance data are only mandated in Victoria as part of the Emergency Minimum Dataset collated by the Victorian Injury Surveillance Unit. This provides a brief textual description as well as coded field options including location type, injury mechanism and activity at the time of injury, and allows more meaningful statewide surveillance of injury trends due to different products or activities. Site-specific information is out of scope.

Conclusion

Children need to engage in outdoor free play, ideally with a low risk to hazard ratio. Everybody shares responsibility for playground safety — supervising carers have a role to play, as do play equipment manufacturers, design engineers, Australian standards developers and compliance assessors. Mandating safety standards with a rigorous process to independently review their application would enhance accountability under the current system.

While we aim to avoid serious injuries, it is impossible to remove all injury risk, which is inherent in play. Monitoring any standard’s efficacy is not possible without precise, detailed incident data to assist in determining whether the standard has been implemented correctly and is preventing injuries as was intended when it was written. Injury surveillance data allow monitoring of the overall pattern of injury but lack specific detail. Ideally, the Victorian model should be replicated nationally, to inform injury researchers of emerging hazards. To better inform public safety strategies, we encourage doctors and parents to report detailed circumstances of avoidable injuries to relevant authorities; the playground owner and, where applicable, the relevant state-based workplace health and safety authority.