Briss P A, Sacks J J, Addiss D G, Kresnow M J, O'Neil J
National Center for Injury Prevention and Control, Preventive Medicine Residency Program, Atlanta, Ga., USA.
Arch Pediatr Adolesc Med. 1995 Aug;149(8):906-11. doi: 10.1001/archpedi.1995.02170210080014.
To measure the incidence of playground fall injuries among children attending licensed US day care centers and to evaluate how injury incidence varies with center characteristics and with the regulatory and enforcement climate in which centers operate.
Telephone surveys of directors of day care centers and enforcement agencies and review of written day care regulations.
Probability sample of licensed day care centers in 50 states and the District of Columbia.
Children attending day care centers with playgrounds.
Medically attended playground fall injuries.
Among the 1740 day care centers studied, a weighted total of 89.2 injuries occurred during the 2-month study period (0.25/100,000 child-hours in day care). The most important risk factor for injury was height of the tallest piece of climbing equipment on the playground in both bivariate (P = .01) and multivariate (P = .02) analyses. Neither regulations addressing playground safety or playground surfaces nor enforcement patterns were associated with lower injury rates.
Additional effort is needed to develop and evaluate regulations and enforcement that reduce injury risks for children while minimizing burden on day care centers. In the meantime, limiting climbing equipment heights may reduce playground injury rates.
测定在美国持牌日托中心就读儿童的操场跌倒受伤发生率，并评估受伤发生率如何随中心特征以及中心运营所处的监管和执法环境而变化。
对日托中心主任和执法机构进行电话调查，并审查日托书面规定。
50个州和哥伦比亚特区持牌日托中心的概率样本。
在设有操场的日托中心就读的儿童。
需就医的操场跌倒受伤情况。
在研究的1740所日托中心中，在为期2个月的研究期间，加权后共发生89.2起受伤事件（日托中每100,000儿童小时0.25起）。在双变量分析（P = 0.01）和多变量分析（P = 0.02）中，受伤的最重要风险因素是操场上最高攀爬设备的高度。无论是关于操场安全或操场地面的规定，还是执法模式，均与较低的受伤率无关。
需要做出更多努力来制定和评估相关规定及执法措施，以降低儿童受伤风险，同时尽量减少对日托中心的负担。在此期间，限制攀爬设备高度可能会降低操场受伤率。
