Researchers at The Hospital for Sick Children (SickKids) and York University have found that using granite sand as playground surfacing reduces the risk of arm fractures in children. The researchers compared the sand surfacing to frequently used wood-chip surfaces. The study is published this week in the open-access journal PLoS Medicine.

Falls on a playground may go with the territory, but many children’s spills and tumbles off playground equipment can lead to emergency room visits and hospital stays. And just how badly a child is hurt not only depends on how far they fall, but also on the type of surface they land on.

The study shows the risk of an arm fracture from a fall off playground equipment is 4.9 times higher on a wood-chip surface compared to sand. Risks of other types of injuries are also higher on wood-chip surfaces.

Above: Researchers at SickKids and York University found that sand surfacing in playgrounds reduces the risk of arm fractures in children from falls off the equipment. Photo: Wikimedia Commons.

“Broken arms from playground equipment falls are common and can be severe. A simple sand surface, properly maintained, can prevent many of these injuries,” says Dr. Andrew Howard, the study’s lead author and SickKids orthopedic surgeon, scientist and associate professor in the Departments of Surgery and Health Policy, Management & Evaluation, at the University of Toronto. “We hope these findings will help update standards to reduce the most common injuries without limiting children’s access to healthy outdoor play.”

Alison Macpherson (right), professor in York University's School of Kinesiology & Health Science, acted as senior author on the study.

“We found fewer injuries overall than we expected on playgrounds, which shows that the Canadian Standards Association requirement for playground surfaces is protecting children,” says Macpherson. “This study suggests schools could reduce the number of broken arms even further by choosing sand.”

In 2003, the researchers took advantage of a unique opportunity to conduct a real-life randomized trial. The Toronto District School Board was resurfacing a number of school playgrounds and partnered with SickKids in the research. Over a two-and-a-half-year period, 28 schools joined the study and reported on the types of injuries and how they occurred.

There were fewer fractures on sand because it has a lower friction surface and allows the hand to slide or sink, limiting bending and preventing a fracture, says Howard.

The study was funded by the Canadian Institutes of Health Research and the SickKids Foundation. Funding for the playground installations was provided by the Toronto District School Board.

For more information about playground safety, visit the Safe Kids Canada Web site.