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Evaluation of North Carolina child care safety regulations
  1. J B Kotch1,
  2. J M Hussey1,
  3. A Carter2
  1. 1Department of Maternal and Child Health, School of Public Health, University of North Carolina at Chapel Hill
  2. 2Division of Child Development, North Carolina Department of Health and Human Services
  1. Correspondence to:
 Dr Jonathan Kotch, Department of Maternal and Child Health, CB# 7445, Rosenau Hall, University of North Carolina, Chapel Hill, NC 27599–7445, USA;


Introduction: The goal of this study was to track any changes in injuries and injury hazards during the first 3.5 years of implementation of the North Carolina Child Care Commission’s 1996 playground safety regulations.

Methods: All reports (n=5402) of medically attended injuries in regulated child care settings in North Carolina during the period 1 January 1997 through 30 June 2000 were reviewed and analyzed. A total of 294 playground safety inspections were conducted in November and December 1998 in randomly selected North Carolina child care centers, and the playground safety inspections were repeated in 76 child care centers in August 2000. Finally, in 1999 a 1992 child care center director self assessment of safety features in classrooms was sent to the directors of 291 of the 294 centers.

Results: The annual rate of reported, medically attended injuries occurring in regulated child care facilities in North Carolina declined by 22% from 1997 to 1999. The playground safety inspections in the year 2000 revealed that, for nine of 10 playground concerns and 12 of 18 playground safety hazards, average ratings were equal to or better than those of 1998. Finally, the director surveys revealed no dramatic changes in classroom safety hazards since 1992.

Discussion: This study represents the first time that the authors are aware of that a significant decline in state-wide child care injury rates has been associated with improved regulation of playground safety in the US.

  • child day care centers
  • consumer product safety
  • government regulation
  • DCD, Division of Child Development
  • UNC-CH, University of North Carolina at Chapel Hill
  • child day care centers
  • consumer product safety
  • government regulation
  • DCD, Division of Child Development
  • UNC-CH, University of North Carolina at Chapel Hill

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  • ** No summary report of enrollment was prepared for June of 1998, so center enrollment for that month was estimated by averaging the enrollment counts for May and July of 1998.

  • Smoke detector present; smoke detector tested at least monthly; Poison Control Center number posted; records of children’s injuries kept.

  • No choking foods served to under 5s; poisonous substances either not present or stored in secure areas; hot water <120°F at faucet; 911 or other emergency number posted; first aid kit present; syrup of ipecac present.

  • * Enrollment data as of 30 September 2001