Best Practices

Falls Prevention and Playground Safety

Nationally, falls are the leading cause of nonfatal unintentional injuries and emergency department visits for children ages 0-14. Each year, more than 2.3 million children ages 14 and younger are treated in hospital emergency rooms for fall-related injuries. In Colorado, falls are also the leading cause of injury-related hospitalizations for children ages 1-14. Falls account for 28% of the injury-related hospitalizations for children under the age of one, 37% for ages 1-4, 42% for ages 5-9, and 27% for ages 10-14.


The types of falls resulting in hospitalization mirror the developmental stages and activities of growing children. Infants are at greatest risk for falls from beds and other furniture (30%) and falls on stairs (16%). Falls on stairs often involve an adult falling while carrying the child. Toddlers ages 1-4 experience falls from beds and other furniture (25%), from buildings or structures (9%), and from playground equipment (10%). Falls resulting in hospitalizations for older children ages 5-14 are most often due to slipping, tripping, or stumbling, including in sports or recreational activities (29%) and playground injuries (22%).


On average, 120 Coloradoans are hospitalized each year for injuries due to falls from playground equipment. The vast majority (92%) are children ages 1-14. Over half (59%) of the hospitalizations involve children ages 5-9.

Reference: Injury in Colorado. Denver, CO: Colorado Department of Public Health and Environment; 2005.


Background Documents


Recommended Strategies

When addressing injury prevention strategies a combination of education, enforcement and engineering has proved to be the most effective approach.

For childhood falls this means:


  • education to parents and other target groups
  • development and enforcement of laws and policies related to playgrounds, recreation and sports safety, and environmental conditions in homes and schools
  • the application of engineering solutions such as safer playgrounds, recreational equipment and home products


A combination of the following strategies could be effective in reducing childhood injury and death:

Coalition Building

The strengths of a community-based coalition are the development of long-term programs, effective leadership, multi-agency collaboration, involvement of the local partners and the ability to develop specific strategies for the appropriate target group(s).


Public Awareness

Use public awareness to increase understanding about childhood injuries due to falls and to increase knowledge about the prevention of injuries and death. Public awareness campaigns, by themselves, have not been shown to reduce injuries. However, the campaigns often provide new information, serve as a reminder and may be an effective component of an overall set of strategies.


School or Child Care Facility Staff Education

Supervision of children is critical in the school or child care setting. Schools and child care facility staff may need additional training in injury prevention.


Parent Education

Parent supervision of children is a critical issue in the prevention of falls. This includes making the home baby- and toddler-proof; using safety equipment; supervising children at home, school and recreational playgrounds; and helping children play sports safely. Parents often over-estimate the ability of their children to make appropriate safety decisions. School, health department and community programs can educate parents about injury risks and prevention measures, as well as parenting skills such as supervision and rule-setting.


Child Education

School-based education is an excellent way to reach the majority of students. Comprehensive curricula have been developed which can lead to an increase in knowledge of students about safe behavior and teach them safety skills. School can include developmentally appropriate instruction on injury prevention within comprehensive health education programs.


Engineering/ Legislation/ Enforcement

  • Modify the environment to create a safer surrounding. Examples are better playground equipment and home and nursery products. Policies and laws that require the use and maintenance of specific safety equipment are also important. These might include playground and school safety standards and practices, building standards for window bars and/or locks, and the regulation of home and nursery products.


Strategy Documents

Related Colorado Programs

 Related Topics


General Fall Prevention

 Injury Prevention Curricula

 Playground Safety