A model of community pediatrics: improving access to safe play environments.

The importance of play for the healthy development of children is clear. Safe and accessible playgrounds give children the opportunity to challenge themselves and develop physically, mentally, and socially. In the article by Allen et al in the current issue of Pediatrics, the authors assessed more than 450 playgrounds in Chicago to identify hazards and compare the number and safety of the playgrounds based on neighborhood and population characteristics. This study reveals promising results. Over the 3-year study period, safety scores increased significantly among the playgrounds surveyed. The authors attribute this improvement to the collaborative efforts of the study team and community partners. An important finding of Allen et al was the lack of adequate safety surfacing on many of the playgrounds they studied, especially on those that relied on wood chips for energy absorption. The authors found that among playgrounds utilizing wood chips for safety surfacing, up to 99% failed to meet minimum safety recommendations for chip depth. The two determinants of energy transfer in a fall are (1) fall height and (2) the impact attenuating capacity of the surface. Adequate safety surfacing is critically important for the prevention of playground-related injuries. Given that 75% of playground injuries are due to falls, this is one of the most significant factors in determining the occurrence and severity of playground-related injuries. Adequate surfacing can make the difference between a scrape or contusion and a fracture, concussion, or worse.