By JoNel Aleccia Health writer
msnbc.com
updated 6/2/2008 8:35:25 AM ET 2008-06-02T12:35:25

In a house with six kids under the age of 10, including a set of twins, bunk beds were almost inevitable, said Tiera McMahon of Fort Worth, Texas.

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Still, the 41-year-old mother resisted the urge for more space — and the pleas of her boys — because she just wasn’t certain about safety.

“Bunk beds were one of the hardest things for me to go to because of the accidents,” said McMahon, who finally broke down and bought the beds nearly three years ago.

Her 9-year-old sons, Austin and Devin, have yet to take a header off the top bunk, said McMahon, who credits a list of strict rules for their lack of bumps and bruises.

But McMahon is right to worry. A comprehensive new study found that nearly 36,000 children and adolescents are treated for bunk bed-related injuries in the nation’s emergency rooms each year.

Almost 573,000 kids from infants to age 21 suffered injuries significant enough to warrant a visit to the ER between 1990 and 2005, according to an investigation by the Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital in Columbus, Ohio.

Nearly half of the injuries occurred in children under 6, but there also was a surprising jump in accidents among 18- to 21-year-olds, who were more than twice as likely to be hurt as kids ages 14 to 17.

The analysis, published in the June issue of the journal Pediatrics, is the first to look at trends in injuries related to one of the most common sleeping arrangements for youngsters in America, said co-author Lara B. McKenzie, an assistant professor at the injury research center.

McKenzie said the data shows a clear need for parents and others to pay greater attention to bunk bed safety.

Most injuries caused by falls
Nearly three-quarters of the kids were hurt by falls from bunk beds, with about 30 percent suffering serious cuts, nearly a quarter reporting bruises and scrapes and about 20 percent suffering fractures. More than 10 percent sustained concussions.

Half of the children suffered injuries to the head and neck or the face, the study showed. Children younger than 3 were about 40 percent more likely to sustain head injuries than older kids. Because they have a higher center of gravity, young children tend to fall head-first, the authors noted.

About 60 percent of the kids injured were boys, which doesn’t surprise McMahon. Her own boys are pretty calm, but she worries about the rowdiness of some of their friends.

“We’ve always had a play room and when we do have guests over, the bedrooms are off limits,” said McMahon, who chats with other mothers on the networking site www.cafemom.com.

It’s not clear exactly how many children sleep in bunk beds. Top youth furniture manufacturers estimate that bunks represent up to 30 percent of the wholesale market for youth beds, said Patricia Bowling, a spokeswoman for the American Home Furnishings Alliance.

But that doesn’t take into account hundreds of thousands of previously sold beds, or the bunk beds and lofts that people have built themselves, McKenzie noted.

Plus, the new study analyzed only injuries that were treated in emergency rooms, not those seen in clinics or by private doctors or those that were taken care of at home.

“We may actually have underestimated the number of injuries that occur,” she said.

Fatalities are rare
The data didn’t allow accurate tracking of fatalities caused by bunk bed injuries, but the deaths appeared very rare, perhaps a half dozen during the 16-year study, she added.

Also, overall deaths associated with bunk beds began to decrease in the mid-1990s, after a campaign and new regulations to prevent asphyxia accidents among kids whose heads became trapped in the spaces of bunk bed guard rails or between the rails and mattresses.

The study should serve as a warning, especially to parents of kids younger than 6, who shouldn’t sleep on the upper bunk, McKenzie said. Although it wasn't clear exactly why more injuries occurred among those 18 to 21, college-age kids and their parents should double-check the sturdiness of beds in dorms and other settings. Young people of all ages should be reminded not to horse around on the beds, she added.

Bunks can be fun, but be careful
But for many parents, the biggest concern about bunk beds has been about refereeing the fight for the top spot, not safety. Craig Sanders, 44, a teacher from Houston said he bought bunks for his 6-year-old twins, Colby and Brady, because he had such fond memories of his own childhood sleeping situation.

“My brother and I shared a bunk bed and I remember we had this secret handshake we would do every night between the beds,” Sanders recalled.

The number and extent of the injuries reported in the new study surprised Sanders, who planned to take another look at his boys' beds.

“Everything else, you pay attention to, but bunk beds? It’s an afterthought,” Sanders said.

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