The growing popularity of inflatable bouncers at children's parties and other venues has a down side: Bouncer-related injuries more than doubled from 2008 to 2010, climbing from 5,345 to 11,311.
That averages out to 31 children per day seen in hospital emergency rooms, or one child every 46 minutes, according to a new national study appearing today in the online version of Pediatrics.
"This is an emerging hazard. The rapid increase was a real surprise," said pediatrician and epidemiologist Gary Smith, the study's senior researcher. He is director for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio.
The bouncer study "really brings home the frequency of these injuries across the country," Dr. Smith said.
The study's data come from the National Electronic Injury Surveillance System, which collects information from 100 emergency rooms that are considered representative of all 6,100 ERs across the country. Using those numbers, researchers make weighted probability estimates projected for the entire country. This, Dr. Smith said, makes the study even more reliable and useful.
The authors aren't sure what's behind the injury spike, but the main cause is probably higher exposure as bouncers appear at more play locations and events. It's also possible that parents were quicker to seek emergency room treatment for their children.
Dr. Smith didn't believe design changes made bouncers more hazardous. "We've seen no evidence of that," he said. But he hopes that the study will prompt manufacturers to look for ways to make them safer.
Fractures were the most common type of injury. Only 3 percent of all children seen in emergency rooms for bouncer injuries were admitted to the hospital, but of those, 80 percent had broken bones. Concussions and closed head injuries accounted for 7 percent of those hospitalized.
"The more than 4,500 estimated concussions and [closed head injuries] in this study demonstrate that bouncers pose serious risks beyond skeletal injuries," the report says.
Children in the study were hurt most often by falling on or in a bouncer (26 percent), followed by falling off, jumping off or getting on or off (17.2 percent), jumping on a bouncer (16.6 percent), and playing in or on a bouncer (15.4 percent). Other causes were colliding with another person in the bouncer or being pushed or pulled by someone else; someone falling on the child; doing a stunt; and getting caught on something on the bouncer.
The study sample was 45 percent girls, who were injured less often than boys. Older children were less likely to have upper extremity injuries and more likely to have them in the lower extremities.
Dr. Smith hopes that parents, when informed of the risks, will take steps to minimize accidents.
First, they should limit usage to children 6 years old and up. "Developmentally, children under that age don't have the same coordination skills," he said.
An adult should always be there to supervise, preferably someone who understands how injuries occur.
Also important: Limit the number of children bouncing at the same time and make sure they are of similar size and age. That eliminates bigger children falling on smaller ones.
"This is similar to trampoline accidents, where a lot of injury is on the mat," Dr. Smith said. When children of different sizes bounce close to each other on either device, the mat may be not be ready to take their weight when they come down. Instead, it may launch them in a different direction, causing them to fall on their arm or atop each other.
The researchers are not suggesting that bouncers be banned or that children be bubble-wrapped like fine china. Kids will play, fall and get hurt with or without inflated bouncers, and it's axiomatic that more usage would mean more accidents.
"That doesn't mean we dismiss these number as a non-issue," Dr. Smith said. "If there's an outbreak of infectious disease and we said it was because there were more viruses, that wouldn't make the numbers any less concerning. If there's a way to prevent West Nile or the incidence of bouncer-related injuries, that's what we need to do as public health people."
Children, he said, stop playing a sport or other physical activity most often because of an injury incurred in the process, he said.
"The smart way to keep them active is to have them do things safely. Then they won't get injured and quit."
He would also like to see guidelines from the public health and medical communities and the Consumer Product Safety Commission similar to those on trampolines.
"They would be credible sources to get the word out."
Sally Kalson: firstname.lastname@example.org or 412-263-1610. First Published November 26, 2012 5:00 AM