Playground safety regulations address adult supervision, age-appropriate playground equipment and environment, fall surfacing, and maintenance of playground equipment and materials, often following the National Program for Playground Safety’s S.A.F.E. framework. As of 2016, the US Consumer Product Safety Commission (US CPSC) estimates that 247,075 injuries are associated with playground equipment and treated in emergency departments each year1. Four-fifths of reported playground injuries involve falls from playground structures or equipment failures.
Expected Beneficial Outcomes (Rated)
Reduced injury
Other Potential Beneficial Outcomes
Increased physical activity
Evidence of Effectiveness
There is some evidence that playground safety regulations decrease injury rates among children2, 3, 4. Playground regulations based on the US Consumer Product Safety Commission (CPSC) guidelines are recommended by the National Program for Playground Safety5 and Safe Kids Worldwide6. However, additional evidence is needed to confirm effects.
Safety surfacing on playgrounds has been shown to reduce serious head injuries2. The risk of playground injuries appears to increase in the absence of safety surfacing and with higher playground equipment3. An Ohio-based study suggests that playgrounds with softer surfaces and equipment are associated with higher levels of physical activity among black children than playgrounds without them7.
A North Carolina-based study of improved playground safety regulations suggests such regulations are associated with significant reductions in child care injury rates4. Evaluations of Stamp-in-Safety, an effort to train preschool staff in active supervision, indicate increases in knowledge, perception, and self-efficacy around playground supervision and attentive supervisory behaviors8, 9.
Impact on Disparities
Implementation Examples
Many states have passed legislation addressing playground safety, including: Arkansas, California, Connecticut, Florida, Illinois, Michigan, New Jersey, North Carolina, Oklahoma, Oregon, Rhode Island, Tennessee, Texas, Utah, Virginia, and Wyoming5. In a 2004 evaluation by the National Program for Playground Safety, the average state safety grade was C+10.
Implementation Resources
NPSI - Play and Playground Encyclopedia. National Playground Safety Institute (NPSI).
US CPSC-Playground safety - US Consumer Product Safety Commission (CPSC). Playground safety alerts, guides, and handbooks.
NPPS-SAFE framework - National Program for Playground Safety (NPPS). S.A.F.E: The framework.
AAP-CFOC - American Academy of Pediatrics (AAP), American Public Health Association (APHA), National Resource Center for Health and Safety in Child Care and Early Education (NRC). Caring for Our Children (CFOC): National health and safety performance standards; Guidelines for early care and education programs. 3rd edition. Elk Grove Village, IL: American Academy of Pediatrics; Washington, DC: American Public Health Association; 2011.
KidsHealth-Playground safety - KidsHealth. Playground safety.
Footnotes
* Journal subscription may be required for access.
1 US CPSC-Hanway 2016 - Hanway S. Injuries and investigated deaths associated with playground equipment, 2009-2014. US Consumer Product Safety Commission (US CPSC); 2016.
2 Norton 2004 - Norton C, Nixon J, Sibert JR. Playground injuries to children. Archives of Disease in Childhood. 2004;89(2):103-8.
3 Khambalia 2006 - Khambalia A, Joshi P, Brussoni M, et al. Risk factors for unintentional injuries due to falls in children aged 0-6 years: A systematic review. Injury Prevention. 2006;12(6):378-81.
4 Kotch 2003 - Kotch JB, Hussey JM, Carter A. Evaluation of North Carolina child care safety regulations. Injury Prevention. 2003;9(3):220-5.
5 NPPS-Guidelines - National Program for Playground Safety (NPPS). Guidelines, standards and best Practices.
6 SKW - Safe Kids Worldwide (SKW). Playground safety tips.
7 Nasar 2013 - Nasar JL, Holloman CH. Playground characteristics to encourage children to visit and play. Journal of Physical Activity and Health. 2013;10:1201–8.
8 Schwebel 2015 - Schwebel DC, Pennefather J, Marquez B, Marquez J. Internet-based training to improve preschool playground safety: Evaluation of the Stamp-in-Safety Programme. Health Education Journal. 2015;74(1):37–45.
9 Schwebel 2006 - Schwebel DC, Summerlin AL, Bounds ML, Morrongiello BA. The Stamp-in-Safety Program: A behavioral intervention to reduce behaviors that can lead to unintentional playground injury in a preschool setting. Journal of Pediatric Psychology. 2006;31(2):152–162.
10 NPPS-Report Cards - National Program for Playground Safety (NPPS). State report cards.
Related What Works for Health Strategies
To see citations and implementation resources for this strategy, visit:
countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/strategies/playground-safety-regulations
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countyhealthrankings.org/whatworks