More than 53 million children in the United States spend almost one-fourth of their total waking hours in school or on school property. An estimated 10 to 25 percent of the more than 14 million unintentional injuries sustained by children ages 14 and under each year occur in and around schools.

Annually, one in 14 students suffers a medically attended or temporarily disabling injury at school. Public attention often focuses on school violence. However, studies indicate that school-age children are nine times more likely to sustain an unintentional injury than to be the victim of an intentional injury while at school. Playgrounds are associated with the majority of injuries among elementary school students. Athletics, including both physical education classes and organized sports, account for the majority of injuries among secondary school students.

DEATHS AND INJURIES

• An estimated 2.2 million children ages 14 and under sustain school-related injuries each year.
  
• Eighty percent of elementary school students will see a school nurse for an injury-related complaint over a two-year period.
  
• Approximately 715,000 sports- or recreation-related injuries occur in and around schools each year.
  
• Approximately 13,000 playground equipment-related injuries occur on school playgrounds during school hours.
  
• In 1998, 21 children ages 14 and under were killed and an estimated 6,000 were injured in school bus- related incidents. Sixty-two percent of the deaths were child pedestrians.
  

WHEN AND WHERE SCHOOL DEATHS AND INJURIES OCCUR

Playground-Related Injuries

• Playground injuries are the leading cause of injury among children ages 5 to 14 in the school environment. Nearly 40 percent of playground-related injuries occur during the months of May, June and September.
  
• More than 70 percent of playground equipment-related injuries involve falls to the surface and 9 percent involve falls onto equipment.
  
• Lack of supervision is associated with 40 percent of playground injuries. A recent study found that children play without adult supervision more often on school playgrounds (32 percent of the time) than on playgrounds in parks (22 percent) or child care centers (5 percent).
  

Sports-Related Injuries

• The rate of injury per 1,000 students for students participating in organized school sports is more than five times that of students participating in physical education classes. However, physical education classes account for a greater number of injuries than organized school sports.
  
• Among organized school sports, football has the highest injury rate, followed by basketball, baseball, wrestling and gymnastics. Most organized sports-related injuries (60 percent) occur during practice rather than during games.
  
• The majority of organized sports injuries are from falls, collisions, being struck by an object or overexertion. Almost 75 percent of all school-related spinal cord injuries occur during sports activities.
  

School Bus-Related Injuries

• Ninety percent of students who are nonfatally injured in school bus-related incidents are injured as occupants.
  
• Pedestrians account for almost three times as many school bus-related fatalities as bus occupants. Many injuries occur when children are boarding or exiting the school bus due to the driver’s "blind spot," which extends approximately 10 feet around the bus.
  
• Most school-age pedestrian deaths occur in the afternoon. Forty-one percent of the fatalities occur between 3 p.m. and 4 p.m.
  

WHO IS AT RISK

• Children ages 10 to 14 account for 46 percent of school-related injuries.
  
• Boys are three times more likely to sustain a school-related injury than girls.
  
• Half of all school-age pedestrians killed in school bus-related crashes are between the ages of 5 and 7.
  

HEALTH CARE COSTS AND SAVINGS

• School-related injuries to children ages 14 and under result in an estimated $2 billion in medical spending each year. School bus-related injuries alone account for $21 million of these medical costs.
  
• The total annual cost of school-related injuries to children aged 14 and under exceeds $74 billion, which includes medical spending, quality of life lost and future earnings.
  

PREVENTION TIPS

• Implement an annual school safety checklist and regularly maintain all equipment and facilities.
  
• Train school staff in emergency first aid and CPR.
  

Playground Safety

• Avoid asphalt, concrete, grass and soil surfaces under playground equipment. Acceptable loose-fill materials include hardwood fiber mulch or chips, pea gravel, fine sand and shredded rubber. Surfacing should be maintained at a depth of 12 inches and should extend a minimum of 6 feet in all directions around stationary equipment. Rubber mats, synthetic turf and other artificial materials also are safe surfaces and require less maintenance.
  
• Always supervise children when using playground equipment. Prevent unsafe behaviors like pushing, shoving, crowding and inappropriate use of equipment. Ensure that children play on age-appropriate equipment.
  

Sports Safety

• Make sure the following are included in any sports program: proper physical and psychological conditioning, use of appropriate safety equipment, a safe playing environment, adequate adult supervision, and enforcement of safety rules.
  
• Match and group children according to developmentally appropriate skill level, weight and physical maturity, especially for contact sports.
  

School Bus Safety

• Teach children to arrive at the bus stop early, wait for the bus to come to a complete stop before approaching the street, watch for cars, and avoid the driver’s blind spot.
  
• Ensure that children stay seated at all times and keep their heads and arms inside the bus while riding.
  
• When exiting the bus, children should be taught to wait until the bus comes to a complete stop, then exit from the front using the handrail to avoid falls, and cross the street at least 10 feet in front of the bus.
  

12/99 This information was compiled by the National SAFE KIDS Campaign.