Study led by CHOC trauma surgeons urges stronger regulation, injury prevention efforts
The frequency and rate of pediatric bounce house injuries has increased steadily since 2000, and kids will continue to get hurt in inflatable play structures unless injury prevention measures are stepped up and safety regulations are improved, a CHOC-led study has found.
The report, “Distribution of Injury in Inflatable Jumping Amusements in the U.S. Over the Last 20 Years,” is the latest example of how CHOC, as a recently designated Level 1 pediatric trauma center, is bolstering its status as a regional leader in educating parents and kids about injury prevention.
Part of that effort includes an increased focus on research. The bounce house study, published in the Journal of Pediatric Surgery on late December 2021, comes on the heels of another trauma-related study on pediatric dog bites.
“There’s a false perception that these devices are safe,” said CHOC pediatric surgeon Dr. Saeed Awan, senior author of the report. “This paper is just the starting point. It’s important that we published it, but we need to move beyond that.”
Key findings of bounce house injuries
The study looked at the rate of injury in children ages 2 to 17 from 2000 to 2019.
Breaking down injuries in five-year periods, it found that 82,748 kids were hurt in bounce houses during the period from 2015-19, compared to only 5,599 during 2000-2004.
From 1995 to 2010 alone, there was a 15-fold increase in the number of bounce house-related injuries, and this rate has the potential to increase as at-home inflatable devices have become more available, according to researchers.
“Although healthcare providers and parents have articulated concerns related to the use of inflatable devices for almost 30 years, these warnings have gone unheeded,” the report said.
Researchers including Elizabeth Wallace, MPH, an administrator in the CHOC Research Institute and John Schomberg, Ph.D., a biostatistician in CHOC’s department of nursing, used the National Electronic Injury Surveillance System (NEISS) to identify pediatric patients hurt in bounce houses.
The NEISS is a nationally representative probability sample of about 100 hospital emergency departments, including approximately 20 pediatric EDs, as opposed to a national registry of documented injuries.
Also involved in the study were CHOC’s Makenzie Ferguson, RN, BSN, injury prevention coordinator for the trauma program Dr. Troy Reyna, pediatric surgeon; Dr. Maryam Gholizadeh, pediatric surgeon; and Dr. Yigit Guner, pediatric surgeon. Olivia Vukcevich, of the School of Medicine at the University of California, Riverside, also participated.
Although most bounce-house injuries (96.4%) are minor enough to allow for patient discharge from the ED, more industry regulation and community education is needed to keep kids from getting hurt from being struck while inside the inflatable play structure, falling out of it (35.8%), or a combination of the two, the study found.
Some key findings of the bounce house study:
- Boys (53.9%) are more likely to get hurt than girls (46.1%)
- The most-reported injuries were fracture (25.8%), muscle strain (25.7%), and contusion (14.5%)
- Most kids (around 96%) were hurt in bounce houses at their homes
- The lower extremities were the most prevalent area of injury
- Although rare in both kids under 6 as well as over 6, concussion was almost twice as likely to occur in the older age group
- Most injuries (70%) occur from May to October
With a lack of safety awareness, bounce houses are a ‘free for all’
Unlike similar bounce devices such as trampolines, there continues to be limited medical literature and public policy surrounding the safety of bounce houses, the study noted.
“Regulations may exist, but they differ by manufacturers and policies can vary by state,” Elizabeth said.
As a mother of a 6-year-old, Alexis, Elizabeth keeps a particularly keen eye on her daughter when she plays in bounce houses at homes, noting that bounce houses at carnivals and other community events usually have an adult closely supervising the kids.
“At private birthday parties, it’s kind of a free for all,” Elizabeth said.
Risk factors of a kid getting injured include lack of effective adult supervision (the closed structure of the bounce house may give parents a false sense of security, the study noted), the number of participants exceeding device restrictions, and a participant mix that includes different ages and weights, the report said.
John suggested that manufacturers put stickers inside the bounce houses warning about capacity and potential dangers, and suggested their design can be modified to prevent parents from being sealed off outside the inflatable play structures.
“We don’t have any reason to believe bounce houses have become more dangerous,” John said. “I think they are as dangerous as they’ve always been. Over the years, they’ve changed a lot in terms of their attractiveness to customers, but not in terms of how safe they are.”
He added: “Nothing will happen unless we’re a bit more active on the education, engineering and enforcement side.”
“Education involves not only families, but also the device manufacturers and the rental companies to make sure these products are safe and fun,” she said.
Elizabeth said Makenzie already is doing “amazing” work in injury prevention.
“And I think this is another area where we can raise awareness and come up with some ways to actually make a difference — at least in our community,” she said.
Learn more about research at CHOC