From carnivals to birthday parties, kids love jumping around inside inflatable bouncers. But thousands of them are hurt every year, a new study shows. And the number of injuries is soaring. The study found that about 30 children a day now are being treated in emergency rooms for bouncer injuries. Researchers got their numbers from the Consumer Product Safety Commission. Bouncer injuries treated in hospitals increased from fewer than 1,000 in 1995 to nearly 11,000 in 2010. The numbers doubled just since 2008. Researchers said they were surprised by the rapid increase. Kids most often got hurt by falling inside the bouncer or tumbling out of it. Bumping into other kids also caused injuries. Broken bones, sprains and strains were the most common injuries. Some children had only bruises. But about 7% had concussions. Manufacturers have guidelines designed to promote safe use. They include not allowing too many kids in the bouncers at once and not mixing older and younger kids. The journal Pediatrics published the study. The Associated Press wrote about it November 26.

By Henry H. Bernstein, D.O.
Harvard Medical School

What Is the Doctor's Reaction?

Inflatable bouncers are fun for children. You may know them as moonwalks, bounce houses or jumpers. Inflatable bouncers are often found at places for sports and recreation. You'll see them at carnivals, schools, churches, malls, birthday parties and even in your own backyard!

Inflatable bouncers seem soft and look padded. Parents think this makes them safe. Think again. Many children are hurt each year playing on inflatable bouncers.

A new study published in the journal Pediatrics looked at injuries from inflatable bouncers. The study covered the 21 years beginning in 1990. Almost 65,000 children were treated in emergency rooms for bouncer injuries. That is a lot of injuries!

Lately, injuries from bouncers are becoming even more common:

• The number and rate went up 15-fold between 1995 and 2010.
• The increase in injuries more than doubled in just the 3 years between 2008 and 2010.
• In fact, 31 children were treated each day in an emergency room for a bouncer-related injury in 2010.

Boys were more likely than girls to be hurt. Children between 6 and 12 years old got injured more than other children. The average age of injured children was 7.5 years.

The most common injuries were broken bones (28%) and sprains or strains (27%). Most of these injuries were to the arms (shoulder, forearm, wrist, hand) or legs (hip, thigh, ankle, foot). Some were bumps and bruises. But some children had concussions.

Falling was the top way children got hurt on inflatable bouncers. Falling in or on the bouncer was most common. Sometimes kids collided with each other. Children also got hurt falling out of, jumping out of, or getting on or off the bouncer.

Thankfully, fewer than 1 in 25 of the injured children needed to be put in the hospital overnight or kept more than a day for observation.

What Changes Can I Make Now?

Jumping on an inflatable bouncer may be a good way to get exercise. This can be a fun way for children to be physically active, which is always healthy for them.

Saferparks.org, a nonprofit public service organization, suggests the following precautions. Following them can help to keep your children safe while playing on inflatable bouncers.

• Limit the number of children in the bouncer at one time.
• Do not allow older children to jump with younger children.
• Make sure children are supervised at all times.
• Pay attention to the weather. Avoid use on windy and wet days.
• Make sure the bouncer is secured to the ground.

Suppose you are renting an inflatable bouncer for a birthday party or event. Consider these questions before doing so.

• Does the company deliver, set up and supervise the use of the equipment? Proper setup is very important. Make sure that the company trains its setup crew. The inflatable bouncer must be put on level ground. It has to be anchored by stakes or weights.
• Does the company offer trained operators to supervise its use? Adult supervision is extremely important to make sure all children are safe while playing on the bouncer.
• Does the company properly maintain its equipment? Make sure the bouncer is clean and not damaged. Companies should follow manufacturer's advice and operating instructions. Equipment should also be maintained and inspected for safety on the recommended schedule. Be sure to ask the operator about his or her experience, safety record and employee training programs.
• Does the company have adequate liability insurance? Cities, schools and many churches require inflatable companies to be properly insured. Ask to see the company's certificate of insurance.

What Can I Expect Looking to the Future?

Expect actions to be taken to improve protection of children on inflatable bouncers. Bouncers cause injuries similar to trampolines. But they get less attention than trampolines do. The American Academy of Pediatrics (AAP) has a policy about trampolines, but not about bouncers. With the number of injuries going up, the AAP may offer similar advice for inflatable bouncers.

There are no official safety guidelines about use of inflatable bouncers. Each manufacturer decides on its own about the safety features. Policymakers should write guidelines for safer inflatable bouncer use and improved design.