MONDAY, Sept. 24 (HealthDay News) -- Trampolines may be hazardous to your child's health, pediatricians warn.

The American Academy of Pediatrics reaffirms its earlier cautions about home trampoline use in a new report, published online Sept. 24 in the journal Pediatrics.

"The very forces that make trampoline use fun for many children also lead to unique injury mechanisms and patterns of injury," wrote the report authors. "Pediatricians should only endorse use of trampolines as part of a structured training program with appropriate coaching supervision and safety measures in place."

Rates of trampoline-related injuries have decreased since 2004, but accidents still happen and many have serious consequences, they added.

Almost 98,000 trampoline-related injuries occurred in the United States in 2009, which resulted in 3,100 hospitalizations, according to the National Electronic Injury Surveillance System. Children appear to be injured more often than older jumpers.

Fractures and dislocation accounted for nearly half the injuries treated in kids aged 5 and younger, according to the academy, a professional association of pediatricians.

Common injuries in all age groups include sprains, strains and bruises. Falling off the trampoline -- which accounts for up to 39 percent of all injuries -- often has serious consequences. Likewise, doing somersaults and flips can lead to permanent head and spinal injury, the authors warned.

According to the new article, three-quarters of trampoline-related injuries take place when more than one person is on the mat, and many accidents occur when an adult is watching.

The same cautions recommended for home trampoline use apply to trampolines in jump parks, the authors added.

The academy's first statement on trampolines was issued in 1999 and updated in 2006.

Trade groups and manufacturers have made efforts to improve the safety of trampolines in recent years, adding heavier padding and stricter warnings about appropriate use, for example.

But the report says research on netting and other safety features hasn't shown a lowering of injury rates, and experts say home trampolines are still unsafe.

"Although injury rates in children associated with trampoline use have been declining since 2004, the chance of sustaining a severe injury still remains exceedingly high, even with adult supervision," said Dr. Robert Glatter, an emergency medicine physician at Lenox Hill Hospital in New York City. "The use of padding with trampolines do not, in reality, safeguard against the high number of injuries on the mat, and may lead to a false sense of added protection."

Glatter said pediatricians should continue to discourage recreational trampoline use among children and teenagers. "But for those families of children who continue to engage in trampoline use, it is recommended that only a single jumper be present on the mat at any particular time," he said. He also advised against allowing flips and somersaults in a recreational environment.

Dr. Jose Rosa-Olivares, medical director of the Pediatric Care Center in Miami Children's Hospital, said he routinely counsels parents on how to avoid sports and recreational injuries, and this includes limiting trampoline use.

"We discourage the home and recreational use of trampolines and remind parents of the serious risks associated with their use," Rosa-Olivares said.

More information

The U.S. National Institutes of Heath talks about preventing head injuries in children.