Hazard versus Risk versus Injury Outcome Part 2

In my last column I ended with this paragraph…

Children fall in a course of their day whether it is on the playground or not. Falls can result in some level of harm to the individual, but falls can provide many other positive outcomes. Playgrounds provide opportunities for free play where a child can experience freedom of choice and the consequences of their choice. Children will learn and develop decision making skills. Their bodies will become stronger and healthier over time as they gain better balance, agility, and strength. They will learn new skills as they push themselves beyond the boundaries they have set for themselves. When they go beyond their abilities, they will again fail and probably fall yet continue to learn lessons from their failures. Children will learn to control their emotions and will modify their behavior to cope with whatever they may be feeling at the time. They will learn to work with others and establish or modify the rules and limits they or others place on their play environment world. The point is children learn by doing whatever it is that they do when given the opportunity for free unstructured play including the foreseen and unforeseen consequences that come with free play.   

So where should we go with the ASTM F1487 Standard now and in the future?

If we can accept the fact children get injured during play and this is part of their learning experience, then we should be able to find a way to move forward with the task of providing guidance for those who design and manage children’s play spaces. This is going to take some changes in the way we are currently doing business.

Regardless of what ASTM does, where should the CPSC go now and in the future? Each owner/operator has to think about these unknowns and make their own decision based on a thorough risk assessment of the many variables and management decisions that must be considered here in the USA. Other than the DOJ 2010 Standard there is no Federal Law for public playgrounds. Some states have passed legislation for public playgrounds. Our decisions will vary based on the laws and regulations applied to the different types of playgrounds and by the owner/operator’s self-imposed policies and procedures that are considered reasonable and customary for those who will utilize these facilities.

I would prefer we collectively move towards a more hazard based standards process than to try and define each and every type of play component imaginable. We cannot keep pace with innovations within the industry if we keep trying to close the barn door after the horse has already left. When we look at play we cannot begin to imagine what the child is thinking as they enter the playground. If you tell your child not to do something, the first time you are not there to remind them of that rule or the potential consequence, they will go right back to that place and try it on for size so to speak. Isn’t that part of the learning experience? We all have to learn to think for ourselves.

If we look at things from the risk assessment process and identify the level of hazard and consequence that is unacceptable to the societal norm, we might just be successful in adding more fun, challenge, and risk taking in a controlled safer environment that is being managed, inspected, and maintained to some acceptable industry standards. That is assuming we have already considered the consequences of reasonable foreseeable use versus the societal benefits of risk and challenge in a child’s developmental.

So let’s go back to the falls issue. Children fall. They fall running on the sidewalk or on the hard surface play area within the schoolyard knowing for the most part bad things can happen. When they fall on that surface from elevated play equipment, we expect there to be appropriate impact attenuating surface in place and properly maintained. If the school age child sees a concrete surface under and around the play equipment, they understand that if they fall they can get hurt. The problem is they might not yet appreciate the extent of the consequences. They will not appreciate the consequences of falling on a soft looking surface under and around the play equipment that is not compliant to the ASTM F1292. Neither condition is acceptable. Accordingly, the CPSC states injuries will still occur even with compliant age appropriate playground equipment and proper surfacing. That being said, how can we define a play component or play type beyond the basics we already have without becoming a design standard?

Regardless of what we design and how we intend for the users to interact with a piece of equipment, children always seem to do something we would describe as beyond reasonable use or misuse. The main point here is that when the fall occurs, the first thing we need to do is ask ourselves if the surfacing where the fall occurred was appropriate and compliant to the current standard. If it isn’t, we need to go no further. The compliant equipment did not push the child or make them jump. The child took a risk and challenge whether or not they were developmentally ready for the task at hand. It was their choice and no child should be forced to undertake a task they are not voluntarily ready to take on their own.

Are you listening parents and grandparents? Instead of trying to put square pegs into round holes maybe we need to sit back and first consider the known safety concerns. Then we should look at predictable outcomes and establish some parameters or levels of injury acceptance. We should always do our best to meet all local requirements and national industry best practices. We do not have a crystal ball. If we go much beyond a basic risk management approach that mitigates safety concerns and known hazards, we are destined to fail to meet our children’s developmental needs and worse yet we may potentially fail society as a whole.  

So what is a hazard on a playground?

Playing in a busy street has a higher probability of harm than playing in a schoolyard playground. So, what is a playground hazard? I would propose something along these words many of which will be proposed to the ISO Task Group on international playground terminology.

KUTSKA’s CURRENT DEFINITION OF HAZARD – An UNFORESEEN SAFETY CONCERN that when identified and analyzed with a RISK ASSESSMENT PROCESS (based on a RISK ANALYSIS and RISK EVALUATION) is seen by a consensus of all stakeholders to exceed the level of TOLERABLE RISK during REASONABLE FORESEEABLE MISUSE by the INTENDED USER likely to result in a high probability of HARM defined as a LEVEL OF INJURY which is unacceptable to societal norms.

What is risk? Walking across the busy street without a crosswalk, stop sign, or traffic light is a risk that we take each and every day. Is it acceptable for a five year old child to take this risk on his own? In most societies, it would not be acceptable.

Is swinging on a bench style swing seat an acceptable level of risk for that same five year old child? I think there is more risk and skill involved with this style seat as compared to a belt style seat. A belt style seat wraps around or grabs the hips and thighs of the user thereby providing more control and support. Is this an acceptable level of risk for a five year old child to deal with on his own? In some societies and playground locations it might be, but in other locations the owner’s risk assessment might select the belt type swing seat based upon their past experience with both swing seat types and the age of the users that frequent that playground. It is their risk assessment, and it does not deprive the child from a swinging experience, but it does deprive them from the additional challenge.

KUTSKA’s CURRENT DEFINITION OF RISK -  A foreseen occurrence that combines the probability of occurrence of harm and the severity of that harm as perceived by the INTENDED USER.

TERMS AND DEFINITIONS UNDER CONSIDERATION FOR INTERNATIONAL HARMONIZATION

Hazard – Potential source of harm.

Hazardous Event – Event in which a situation may result in harm.

Hazardous situation – Circumstances in which people, property or the environment are exposed to one or more hazards.

Harm – Injury or damage to the health of people, or damage to property or the environment.

Risk – Combination of the probability of occurrence of harm and the severity of that harm. Note: The probability of occurrence includes the exposure to a hazardous situation, the occurrence of a hazardous event, and the possibility to limit the harm.

Risk assessment – Overall process comprising a risk analysis and risk evaluation.

Risk analysis – Systematic use of available information to identify hazards and to eliminate risk.

Risk evaluation – Procedure based on the risk analysis to determine whether a tolerable risk has been achieved.

Risk reduction measure (protective measure) – Any action of means to eliminate hazards or reduce risk.

Residual risk – Risk remaining after risk reduction measures (protective measures) have been taken.

Reasonably Foreseeable Misuse – Use of a product or system in a way not intended by the supplier, but which may result from readily predictable human behavior.

Note 1: readily predictable human behavior includes the behavior of all types of human being, e.g. the elderly, children, and persons with disabilities

Note 2: in the context of consumer safety, a trend is emerging to use the term “reasonably foreseeable use” as a synonym for both “intended use” and “reasonably foreseeable misuse.”

Tolerable risk – Risk which is acceptable in a given context based on the current values of society.

Note: the terms “acceptable risk” and “tolerable risk” are synonymous

Safety – Freedom from unacceptable risk, but not safe.

Note: Safety is achieved by reducing risk to a tolerable level.

Safe – The state of being protected from recognized hazards that are likely to cause harm.

Note: there is no such thing as being absolutely safe, that is, the complete absence of risk. In turn there is no product or system that is without some risk.

Other Terms and Definitions

Life-Threatening Injury – An injury to any part of the human body which is serious or resulting in permanent impairment, that would be categorized as AIS (abbreviated injury scale) of 4 (serious with survival probable) or greater.

Debilitating Injury – An injury that diminishes or weakens the human body and has a legacy of greater than 1 month and that could be categorized as AIS (abbreviated injury scale) of 3 (severe, but not life-threatening).

Note: debilitating injuries would include requiring surgery, concussions that require removal from play to medical attention.

Serious Injury – An acute physical injury requiring medical or surgical treatment or under the supervision of a qualified doctor or nurse, provided in a hospital or clinic and includes injuries such as burns, fractures, lacerations, internal injury, injury to organ, concussion, internal bleeding, etc.