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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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The true reality

Posted by Rogerwill on 24 Jan 2010 at 12:50 GMT

The study’s conclusion states, “Granitic sand playground surfaces reduce the risk of arm fractures from playground falls when compared with engineered wood fiber surfaces. Upgrading playground surfacing standards to reflect this information will prevent arm fractures”. Now that the author has been shown the realities of the playground industry, he is quoted as saying, “We appreciate that a single study is insufficient to redefine a guideline but hope that high quality injury information is incorporated into the guideline process.”

The author can rest assured that high quality injury information is incorporated into the standard development process. The CSA Z614 standard is reviewed and updated at five year intervals. Currently, we are working towards the 2012 edition. However, the measure of quality information is not determined by those who produce it but by those who dissect its foundation and methodologies and verify its worth in a real world application.

Unfortunately, granitic sand and sand in general, has a fatal shortcoming in terms of its use as a mainstream protective playground surface. It cannot provide accessibility for persons with disabilities. Neither can it be used in conjunction with adjacent accessible surfaces due to its propensity to destroy the impact absorbing qualities of those surfaces. As we move forward, accessibility will be a priority and an absolute requirement in Ontario and Canada. Currently, protective playground surfaces comprised of sand make up less than 1% of playground surfacing in the United States due to their inability to comply with the Americans with Disabilities Act. There are hundreds of thousands of EWF playground surfaces in use in the US, in part, because of their ability to provide accessibility. Proactive municipalities, school boards and other public entities in Canada are already adjusting to this reality as sand, as a protective playground surface is rendered inappropriate. It simply is not compatible to an inclusive environment. EWF incorporates accessibility into its injury reduction characteristics and is widely available across Canada.

This then brings into question the value of this study, notwithstanding its procedural anomalies. Was it useful and wise to expend our precious resources on the study of a product whose prognosis is glum? Based on a logical assessment, the information generated by this study will likely never be utilized by the industry or incorporated into protective playground surfacing standards. Like sand as a protective playground surface, it will quickly fall by the wayside.

Competing interests declared: I am the owner of a company that manufactures EWF and Granitic sand