TORONTO - Almost one-fifth of childhood injuries occur at school, most often while kids are playing or taking part in informal sports, say researchers, who suggest more adult supervision may be needed to better safeguard children's health.
The one-year study analyzed childhood injury statistics from the Children's Hospital of Eastern Ontario and six other Ottawa-area emergency departments or clinics. It found that 4,287 children were hurt at school in 2002, representing 18 per cent of all children injured.
"I think what's important to remember is these aren't little bumps on the head that they went to the office to get ice and a Band-Aid," said senior author Alison Macpherson, a professor of kinesiology and health science at York University.
"These children actually went to seek medical care at an urgent-care centre or a hospital."
The joint study by York and the University of Ottawa found that 58 per cent of school injuries occurred while children were playing or engaging in informal sports.
"That's a new finding and that's quite important," Macpherson said Wednesday. "So it's not kids who are in gym class or doing something else. They're on the playground, they're playing, they're having fun."
About 10 per cent of the school-based harms that sent kids to hospital emergency departments were head injuries - everything from bad bumps to concussions. Of the 402 head injuries, seven required admission to hospital. More than 1,100 of the injuries, or 26 per cent, involved fractures.
"We're not talking spinal cord injuries, which are the most severe, but we are talking injuries that require treatment," Macpherson said.
"When a mom or a dad sends their child off to school in the morning, they kind of expect them to come home healthy and in one piece. It's a bit of a surprise to have them end up in the emergency department when they're going to school, which is what children do every day."
Data for the study, published in the February issue of the Journal of School Health, was collected by doctors in Ottawa-area hospital emergency departments and urgent-care clinics through the Canadian Hospital Injury Reporting and Prevention Program (CHIRPP).
Boys were hurt more often than girls (about 60 per cent versus 40 per cent) and suffered a significantly higher proportion of head injuries.
"Children between the ages of 10 and 14 are the most frequently injured, which means that programs directed toward preventing injuries at school should be designed largely for elementary schools," noted Macpherson.
She said school boards across the country may want to look at increasing supervision when kids are out in the schoolyard, but another area to consider is the safety of the environment where they play.
"Earlier research has shown that installing safety-conscious playground equipment substantially decreases the rate of injury," said Macpherson.
For instance, children who fall off monkey bars or a slide onto a soft surface are less likely to be seriously hurt than those who drop onto a hard surface; a child who trips or runs into a plastic or cushioned goalpost would suffer less harm than one who smacked into a metal post, she added.
But nothing in the study suggests that kids should be kept indoors or not allowed to play, the authors stress.
"We are not saying that children shouldn't run or fall or play or be active," Macpherson said. "It's really critical to children's development to do all of those things."
"What we're saying is they should do it in the most environmentally safe context that's possible and reasonable."
Doug McCall, executive-director of the Canadian Association for School Health, agreed that kids need to be kids - and that includes having the freedom to play.
"Play is positive, that's clear. Play is good for learning, particularly in the younger kids," McCall said from Surrey, B.C. "But there must be a fine line in terms of when play becomes reckless."
McCall said studies such as this one need to be done on a more regular basis and at a national level to see if injuries among school-aged children and youth are occurring more or less frequently over time.
"To my knowledge, this is not being done in Canada," he said, noting that with accidental injury being the leading cause of death among children and youth, a national strategy to prevent kids from getting hurt is also critically needed.
The goal of the association, a coalition of about 100 groups from across Canada, is to promote the health, well-being and safety of children.
When it comes to injury prevention in schools, it recommends a comprehensive plan that involves not just the school, but also parents and the community.
"Because that's how behaviour gets changed, if the kids get reinforcing messaging ... parents doing the right things, talking to the kids in the right way about injury prevention, about safety," he said.
"And then, of course, the kids can be taught to be safer, and so making sure messages are in the classroom as well."
