How many Canadian children die in playground accidents? An open question to Rolf Huber

How many children in Canada die each year as a result of equipment-related injuries on school and public playgrounds? The question is blunt, but important. As I have noted before, the safety standards body ASTM is right now voting on a proposal to make one of its key play equipment standards – for safety surfacing – more stringent, arguing that the risk of serious injuries and fatalities from falls in playgrounds is too high.

When such a serious proposal – which could cost hundreds of millions of dollars to comply with – is on the table, everyone deserves to know the facts. Hence this question.

Rolf Huber

Rolf Huber

I am openly addressing the question to Rolf Huber, for two reasons. First, because he is a longstanding member of the relevant ASTM committee, is well-known in the playground industry for his leading role in the standards-setting process, and has made public statements in favour of the ASTM change. Second, because he came along to my talk last night at Metro Hall in Toronto, and disputed my answer to this question.

What is my answer to this question? My answer is zero. That is right. Zero. According to Dr Mariana Brussoni of the BC Injury Prevention and Research Unit, who I met in Vancouver a couple of weeks ago, there have been no such fatalities for at least the last 20 years. [Update 16 May 2015: it looks like the answer is that there were two such fatalities over the 30-year period 1982-2011 – see Mariana’s second comment below.] (Readers who have been following the safety surfacing debate may recognise Mariana as one of the authors of an article I shared here that was highly critical of ASTM’s proposal.)

What is Rolf Huber’s answer to this question? At last night’s Toronto meeting, Rolf claimed that 20 children in Canada had died on playgrounds as a result of equipment-related injuries over the last 20 years.

The gulf between his answer and mine (via Mariana) is huge: I must say I was very surprised to hear his figure. I know that some people are wary of statistics, especially on such an emotive and distressing topic. But statistics are vital in gaining a sense of the scale of the problem. And while statistics can be collected, interpreted, debated and abused, they cannot and should not be ignored. Figures on playground fatalities go to the heart of the question of whether or not playgrounds are too dangerous, and hence whether more stringent playground standards – such as those proposed by ASTM – are justified.

The gulf between Rolf’s answer and mine is also puzzling. One gruesome, tragic but – in this context – valuable fact about fatalities is there should be little dispute about them. They are not difficult to define, nor difficult to count. It is easy to monitor and study them – and to share references and sources. This is unlike serious injuries, where what counts as a serious injury is open to debate (is a long-bone fracture a serious injury or not?) and injury rates are harder to count.

This is why I am so keen to get an answer to the question. And why I hereby invite Rolf Huber to back up the statement he made last night in Toronto with references and sources.

Let me give one final clarification to my question. I am asking for statistics on fatalities from equipment-related injuries, which have happened in school and public playgrounds in Canada. I am not asking about fatalities in homes and private gardens. (CDC statistics show that in the USA, the majority of playground fatalities arise from home equipment – but there are different safety standards for these. The public policy implications are different too: with public and school playgrounds, the cost of compliance falls on taxpayers.) And I am not asking about fatalities that are unrelated to playground equipment, such as those from strangulation due to clothing, or due to ropes or similar that have been attached to equipment by users after installation. (The CDC statistics referenced above show that strangulations make up more than half of all American playground fatalities.)

Rolf – I will close by addressing you directly. I am sure that you recognise the need for transparent, open and public debate on this issue. Share the source of your claim with the Toronto audience who heard you make it last night – and with the growing numbers around the world who are following the playground safety debate. I look forward to reading your response.

13 responses to “How many Canadian children die in playground accidents? An open question to Rolf Huber

  1. Mariana Brussoni

    As an injury prevention researcher and member of the BC Injury Research & Prevention Unit, I deal with data all the time. This is one of the best mechanisms we have to determine where to place our limited resources in helping prevent injuries. We know, for example, that motor vehicle crashes are the leading cause of injury death for children, and thus spend a lot of time developing prevention mechanisms.
    I can unequivocally say that there have been no playground fatalities in Canada for several decades. I invite readers to go to Safe Kids Canada’s report on children’s unintentional injuries to see the playground injury statistics (page 25) for themselves: http://www.mhp.gov.on.ca/en/prevention/injury-prevention/skc_injuries.pdf
    Anyone can access injury data from British Columbia at any time using the iDot tool at http://www.injuryresearch.bc.ca.
    It is these statistics and the latest research on child health and development that have convinced me that we need to change our approach to children’s play.

    • Thanks for those links Mariana. For anyone in a hurry, there are 2 key quotes in that Safe Kids Canada report. The first is at p.26, at the start of the section on playgrounds: “Deaths are rare and almost always caused by strangulation.” The second is at p.27: “Although deaths at playgrounds are rare, between 1992 and 1995 approximately 2 children died every year, each resulting from strangulation or choking.”

  2. Any change in the requirements for rubber safety surfacing by the ASTM, is all about “money” and the overall poor performance by this type of surfacing to meet and sustain effective protection. If not for the ADA, these types of poor performing, short lived and extreme installation and replacement costs safety surfacing would have been dismissed years ago.

  3. Mariana Brussoni

    I wanted to follow-up my earlier post to clarify and add details on data that have come to my attention since my earlier post. First, my comments do not relate to strangulations.
    Second, I was provided stats indicating 1 playground-related fatality in the period 1982-2000. We don’t know when it was or how it occurred, other than it didn’t involve strangulation. In this same time period, there were 17 strangulation-related fatalities.
    Third, the Statistics Canada Cansim database offers the reader a look at national statistics from 2000-2011: http://www5.statcan.gc.ca/cansim/a26?lang=eng&id=1020540. The only ICD code that specifies playgrounds is for falls. If one runs the query looking at ages 1-14 years, there was 1 fatality in 2007 to a 5-9-year-old girl.
    My sincere apologies that I did not catch this one fatality earlier.
    The core issues are not altered at all. Serious injuries and deaths resulting from falls from playgrounds are extremely rare.
    Note that there are no fatalities from falls from trees during the same 12 year time period.

  4. Hi Tim et al,

    Well here we are again! You will of course remember the debate here in the UK many years ago when it was claimed that Playground equipment killed one child every year, until David Ball did his research into every death that was claimed to be play equipment related. He found that three out of instances were unrelated (one was a bee sting, another a child was run over by maintenance staff) and of the remaining deaths, as I recall, evry three or four years, the causes could not have been prevented by any amount of standardisation as all were so diverse, creating no statistical pattern that could be responded to. I believe that this is why the attitude to standards and surfacing has eased in Europe, Foe example Turf now being accepted to have a fall height safety of 1.5m. I don’t know if this helps, but you certainly are in the thick of it! Good luck!

  5. Oh dear, I should have read it through before posting,
    it should of course be three out of four deaths were unrelated and further down it should be one every three or four years
    and a Freudian slip? Foe instead of for?
    Sorry about that!

  6. Thanks Mariana for the links. It is very helpful to have access to the data. My contribution to this discussion must be anecdotal – yet several people I respect have stated that “story is everything”.

    Here is another death that seems to have resulted from a fall from a tree.

    http://www.cbc.ca/news/canada/not-just-a-video-game-the-obsessive-world-of-gaming-and-its-young-stars-1.809580

    For those of you who don’t want to cut and paste the link – a 15 year old boy in Barrie Ontario died in 2008, when he ran away from home after his parents took away his gaming console. His body was found in a forest close to his home, beneath a tree. There was evidence of a chest injury.

    What was the real cause of Brandon’s tragic death? Was it lack of protective surfacing – because the tree was in the forest? Was it lack of tree-climbing skill – because the boy was gaming day and night and never used his body? Was it uninformed consumption – because he got into a game that was rated for 17+ and he was younger? Or was it caused by the desperate parents – who pulled the console away without realizing its impact on the boy’s game, causing him to run away? (Some of us have living relatives who survived in the forest for months during WW II or walked across a desert to escape a civil war.) Was it the hockey coach who excluded the smaller players in the approved “outcome-based”, possibly foundation funded “healthy active recreation” program, because winning was more important than playing. This boy died within days – we are not sure exactly how – and almost within shouting distance of his home. What is the significance of this debate about number of deaths in the real world of parks and playgrounds? I don’t think the exact number matters. What matters is that the children’s social lives have been disembodied – the physical plane is a foreign place to too many of them and therefore, we need parks and playgrounds that entice them and make it attractive for them to be outside and socializing in an embodied healthy way.

    Do these rubberized surfaces contribute to that goal?

  7. I was at the talk given by Tim in Toronto and was quite puzzled when he said that there had been zero deaths on Canadian playgrounds (note: there was no qualification to that statement as in deaths from falls etc.). The reason I was puzzled was because I had personal knowledge of deaths on playgrounds in Canada. I am not a statistician but when I have personal knowledge of events then I must speak up. As Mariana Brussoni has pointed out, there have been a number of deaths from strangulation the details of which we are not entirely sure.
    Strangulation can occur due to foreign objects entering the playground (such as skipping ropes etc.) or it can be the result of the geometry of the play equipment (as in head and neck entrapment or clothing entanglement in cracks, crevices and protrusions etc.). So some of the strangulation can be deemed a result of foreign objects entering the playspace or it can be a result of the inherent geometry of the device in question which in my opinion is equipment related and is why playground standards have criteria to address head and neck entrapment as well as entanglement. There was a death in Northern Ontario related to a head entrapment gap on playground equipment that I know happened some years ago.
    I have had some experience discussing playground data with the people at Health Canada who are responsible for the CHIRPP database and they indicated to me the challenge in mining the data for relevant information relating specifically to playground incidents – it is not easy as the coding system is not specific to playground incidents and in a world of limited resources the mining may or may not get done. Consequently, we have to be somewhat careful in what we draw from statistical data in that it may or may not be telling the entire story.

  8. Getting to the bottom of deaths stats is surely the crux of the debate about play safey standards and risk benefit analysis. I often fear that ‘child death’ figures may be bandied around in a cavalier fashion for commercial gain or to frighten us rather than inform. It is like being subjected to a crude but pervasive emotional blackmail.

  9. Peter – thanks for your comments. I am pretty sure that at the event, I said ‘equipment-related’ fatalities. For some time, I have been aware of the predominance of strangulations in the fatality statistics.
    Be that as it may – and we may have to agree to disagree on what I said at the meeting – my post above is an opportunity to clarify the facts around equipment-related fatalities. And I do not see anything in your comment that changes the basic picture that these are vanishingly rare. You mention a single fatality relating to a head entrapment, which I accept may be equipment-related (though it would be good to have a link or reference, for transparency).
    Let’s put these statistics into perspective: between 2000 and 2011 on average, 60 Canadian children a year under 19 years old have died after being run over, and 450 per year have died in transport accidents overall. This implies a total of some 1,800 child pedestrian fatalities, and 13,500 child transport fatalities overall, over the 30-year period we are considering here. (Figures extracted from Stats Canada. The figures are probably higher, as transport fatalities have been falling in the last decade). As I have argued before, this comparison is yet another reason to question ASTM’s recent proposal on safety surfacing, which may well divert taxpayer dollars away from issues such as road safety.
    As a colleague of Rolf’s on various safety standards committees, perhaps you could ask him to comment here as well. I would also welcome a clarifying comment on this recent quote from him: “Falls are the leading cause of playground injuries, greater than all other causes combined and is one of the leading causes of death.” This sentence – the second sentence in this report of his [pdf link] is – I have to say – at best unclear, and at worst extremely misleading.

  10. Jerry and Brenda – thanks for your comments. I agree Brenda that the stories we tell matter. But numbers tell stories too.

  11. Of course, Tim, I do not want to minimize the importance of these numbers. I was moved by Mariana’s stat about the one death resulting from a fall. It reminded me of the other tragic fall which would not necessarily have appeared on anyone’s radar as a playground issue – yet, I would argue that it was a play-related death – resulting from the child’s lack of any developed capacity to manage risk.

    Without wanting to sound callous, it seems to me that Rolf’s number – 20 deaths over 20 years – does not support his argument. It is still an astonishingly low number – over what must be millions of playground visits by millions of children.

    Another question raised for me about your zero (now 1) stat is that it may be the outcome of fewer playground visits overall. There is a story behind every number – to be sure.

  12. Pingback: Playground safety: troubling new move from ASTM | Rethinking Childhood

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