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Research Article

School Playground Surfacing and Arm Fractures in Children: A Cluster Randomized Trial Comparing Sand to Wood Chip Surfaces

  • Andrew W. Howard mail,

    andrew.howard@sickkids.ca

    Affiliations: Division of Orthopaedic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada, Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada

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  • Colin Macarthur,

    Affiliation: Bloorview Kids Rehab, Toronto, Ontario, Canada

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  • Linda Rothman,

    Affiliation: Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada

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  • Andrew Willan,

    Affiliation: Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada

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  • Alison K. Macpherson

    Affiliation: Department of Kinesiology, York University, Toronto, Canada

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  • Published: December 15, 2009
  • DOI: 10.1371/journal.pmed.1000195

Reader Comments (11)

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3 things to consider before making your decision

Posted by Zeagerbros on 28 Jan 2010 at 15:06 GMT

The title of the news article says "Sand safer for playground falls"
When you look further into the study, "Granite" sand was used which IS NOT INDICTIVE OF ALL SANDS! It is one specific sand that is primarily available in the Toronto / Ottawa areas. The typical consumer is going to generalize this and say that all sands must be better than EWF. This is anecdotal information in that, they should have done a study using several brands of wood fiber, several types of sand and so forth. Here they mention Fibar and granite sand that I believe was supplied by Hutcheson. Sands are significantly more variable than any of the other surfacing types (some offer great resiliency and displacement, others do not --- whereas engineered wood fiber is relatively consistent from product to product). Other locally available sands will likely not provide the same impact and disbursement properties as Hutcheson Granite Sand.
Let’s compare life threatening injuries which admittedly have been drastically reduced since the creation of new playground standards and the introduction of various types of playground surfaces such as engineered wood fiber. According to table D.2 of the CAN/CSA Z614-2007 standard booklet, you can see EWF provides a critical fall height approximately 20 inches (50cm) greater than that of sand in protecting against head injuries. I think it’s unfortunate that this study fails to mention this.
The third issue would be the imminent passing of an accessibility standard in Canada. The Accessible Built Environment Standard is currently out for public comment but will soon be submitted by the standards development committee to the government for law. The doctor in the news clip mentions that the wood chips don't allow the limb to "slide" but rather the limb "plants" into the surface. This is most likely due to the fact that wood fibers tend to "knit" together to form a soft yet firm and stable surface to allow children with disabilities to travel across it. This has always been the balancing act in the U.S as it pertains to playground surfacing. Some products like loose rubber have excellent impact qualities but pale in comparison to poured in place, rubber tiles or EWF when it comes to accessibility. Engineered wood fiber is the closest playground surfacing choice that tends to have both desired characteristics in a playground surfacing – Great impact attenuating qualities yet firm and stable enough to provide wheelchair access. Sand of any kind just doesn’t give you this.

Competing interests declared: I represent an engineered wood fiber manufacturer in the U.S

RE: 3 things to consider before making your decision

plosmedicine replied to Zeagerbros on 04 Feb 2010 at 18:22 GMT

The news article referred to in the above comment can be viewed here: http://www.cbc.ca/health/...

"The Accessible Built Environment Standard" referred to in the above comment can be viewed here: http://www.mcss.gov.on.ca...

No competing interests declared.