title: Influence of voluntary standards and design modifications on trampoline injury in Victoria, Australia.
abstract: OBJECTIVE
  To examine the influence of the voluntary Australian trampoline standard (AS 4989-2006) and market-driven design modifications on relevant trampoline injuries.
  
  
  METHODS
  Trend and intervention analysis on frequencies and proportions of hospital-treated trampoline-related injury in Victoria, Australia, extracted from the Victorian Emergency Minimum Dataset from 1 July 1999 to 30 June 2013. The injuries relevant to the AS were contact with spring and frame, and multiple-user injury. Falls from trampolines were relevant for netted trampolines, a market-driven modification.
  
  
  RESULTS
  Frequency of all trampoline injuries increased by 11.4% (95% CI 10.0% to 11.7%) on average each year. Spring and frame, and fall injuries increased to a lesser extent (8.7%, 95% CI 6.9% to 9.8% and 7.3%, 95% CI 5.8% to 8.3%, respectively). Multiple-user injuries increased by 21.0% (95% CI 16.3% to 21.9%). As a proportion of all trampoline injuries, spring and frame injury and falls injury decreased, while multiple-user injuries increased. The intervention analysis showed no significant change in spring and frame injuries associated with the AS (p=0.17). A significant increase was found for multiple-user injuries (p=0.01), in particular for the 0-year to 4-year age group (p<0.0001), post 2007.
  
  
  CONCLUSIONS
  There was little evidence for an effect of the voluntary standard on spring and frame injury and none for multiple-user injury. Netted trampolines appear to be associated with a decrease in falls from trampolines but an increase in injuries to multiple users. A mandated trampoline safety standard and a safety campaign including warnings about multiple users is recommended. Continued monitoring of injury data will be required.
authors.affiliation: Monash Injury Research Institute, Monash University, Melbourne, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Ashby
authors.affiliation: Faculty of Engineering and IT, University of Technology Sydney, Sydney, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Eager
authors.affiliation: Monash Injury Research Institute, Monash University, Melbourne, Australia.
authors.forename: Angelo
authors.initials: A
authors.lastname: D'Elia
authors.affiliation: Monash Injury Research Institute, Monash University, Melbourne, Australia.
authors.forename: Lesley
authors.initials: L
authors.lastname: Day
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000293:Adolescent; D017677:Age Distribution; D001265:Athletic Injuries / Q000453:epidemiology / Q000517:prevention & control*; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D011482:Protective Devices / Q000706:statistics & numerical data*; D011998:Recreation; D012449:Safety; D019876:Sports Equipment / Q000009:adverse effects* / Q000592:standards*; D015599:Trauma Severity Indices; D014739:Victoria / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000517:prevention & control*