New Study Confirms That Children Are Safe On Amusement Rides (You Didn't Hear?)

So, did you hear about the new amusement ride safety report published today in the journal Clinical Pediatrics that actually demonstrates scientifically that amusement ride injuries to children under the age of 17 are exceptionally rare?  How about the scientific study that shows that amusement ride related injuries to this population dropped by an estimated 50% between 1991 and 2003?  Well, surely you must have seen the study, which received institutional review board approval at The Research Institute at Nationwide Children's Hospital, showing that, of those extremely few guests under the age of 17 that are injured on amusement rides, 97.8% are either treated and released or examined and released without treatment?  No?  You didn't see that either?  Yeah ... me neither.  But here's what I did see today:

• Rides Injure More Than 4,400 Children Per Year

• New Study Finds 20 Children a Day During the Summer are Treated in U.S. Emergency Departments for Amusement Ride-Related Injuries

• Thousands of kids hurt yearly on amusement rides

• Amusement park, mall rides injuring thousands of U.S. kids each year  

• Amusement Park Rides Send Kids to the E.R. Every Other Hour

That last one is my personal favorite as the headline was apparently written by someone with a 2nd grade grasp of basic math.  The point is that, today, a seemingly well-respected medical journal published a study that, under any reasonable interpretation, should be viewed as a positive view of the industry's safety record (not that it doesn't have its flaws, but I'll get to that in a minute), but instead it has been portrayed in the media as proving the exact opposite.  While I'm getting a little tired of always having to be the voice of sanity in a sensationalized media circus when it comes to the industry (just once, I would like for my friends in the media to report the actual story on the industry, and not the story in the headlines above), I guess I'll jump in again.  Someone has to tell you what's really going on.  Might as well be me.

So here's what you didn't read in the other stories reported today (or at least most of the other stories - I haven't read them all you know).  

1.  Does the study make the point that approximately 4400 children per year are injured on amusement rides? 

Yes.  But without any context, that number is meaningless. As I've point out before, context matters here.  A lot.  The study concludes that "From 1990 to 2010, an estimated 92,885 ... children [17 years of age or younger] sought treatment in hospital EDs (Emergency Departments) for injuries involving amusement rides, for an annual average of 4,423...injuries."  While the media has zeroed in on that figure, most of the reports leave out the context also contained, at least to some degree, in the study.  Most of today's media reports commited the same sin of omission as the Consumers Digest report did just a few weeks ago, they gloss over or ignore completely the total number of guests that ride amusement rides each year - a number necessary to put the average injury statistic in context.  So, let's try to put some context around those 4,423 injuries.

The study credits National Safety Council statistics that show that "attendance at establishments with US fixed-site rides was estimated to be 290.1 million in 2010 alone."  Now, let's ignore for the moment that this number does not include attendance at carnivals and fairs (but the injury stats do) and let's assume that this 290.1 million guests represents all guests riding amusement rides in 2010.  And while the study makes no attempt to quantify how many of these 290.1 million guests are seventeen years of age or younger, let's assume (pretty conservatively, I think) that 33% of those guests are in that age bracket (and I'm just making that up from personal observation in the park - I think there is a good chance that the percentage is actually much higher than that).  Put all this missing context together and you discover that the 4423 children the study says are, on average, injured on amusement rides each year represents 0.0046% of guests seventeen years of age or younger.  Put another way, this means that 99.9954% of children never get injured on a ride.  But 4400 children per year sounds a lot worse in a headline than "Study Shows 0.0046% Of Children Injured Yearly On Amusement Rides."  Who would want that headline out there?  

2.    The study demonstrates that the overwhelming majority of injuries on amusement rides are not serious enough to require hospitalization.

The study actually goes into some detail about the "disposition from emergency department" for each of the injuries reviewed.  In other words, it calculated what treatment, if any, was required for those children that sought medical attention for amusement-ride injuries.  The report found that the VAST majority of emergency room visits were resolved either through treatment and immediate release or through a simple examination and release without any treatment.  97.8% of those injuries fell into that category.  Only 1.5% of those injuries resulted in hospitalization, transfer to another hospital, or holding the patient for more than 24 hours for observation.  That's about 66 children on average each year.  Nationwide.  Using the assumptions I have used above (and if anyone has more precise numbers - just let me know and I'll redo the math), the percentage of children injured on an amusement ride seriously enough to require hospitalization is staggeringly small - 0.0000069% to be exact.  That is an exceptionally good figure.  Anyone know why no one is reporting it?  Yes, its based on some attendance assumptions that some may quibble with, but why is no one bothering to mention that the study unambiguously concludes that 97.8% of injuries that do occur are, apparently, minor enough to require little or no treatment at an ER?  Hmmmm... I wonder.

3.  The study shows that amusement safety has vastly improved.

Now, thankfully, I have actually seen this one statistic reported in the media.  Thank you USA Today (even if you do have to read all the way to the bottom to find it).   One of the most exciting conclusions in the Clinical Pediatrics study is this:  "The injury rate per 100,000 children [age 17 and younger] for injuries involving amusement rides ranged from 4.41 ... in 2003 to 8.79 ... in 1991[.]"  Read that again and let it sink in.  In 1991, according to the data reviewed, their were approximately 8.79 injuries on amusement rides per 100,000 children.  By 2003, that number had dropped to 4.41.  That is a decrease in amusement ride injuries of nearly 50% in only 12 years.  This is exciting news to those of us who consistently strive to improve ride safety.  That number shows that the industry's efforts are working.  It shows that ride safety, which was already quite good, has actually improved.  Any industry would love to see a 50% reduction in its injury rate.  That improvement is something to be quite proud of.

4.  Is this study perfect?  Are you saying it has no flaws?

Absolutely not.  There are certainly problems with the study, but the somewhat refreshing thing that comes along with apparently objective studies, as opposed to some other reports **cough, cough, Consumers Digest, cough, cough** is an actual acknowledgment of the shortcomings in the analysis.  In other words, the authors of this study know that it has problems and they own up to them.  For example, 

• The authors acknowledge that their widely reported conclusion that fixed-site rides account for a slightly greater percentage of injuries than mobile or "mall" rides (i.e. coin-op rides) may be erroneous because the study assumes that all roller-coaster, log flume, and alpine slide injuries occurred at fixed-site locations even though these rides are found at carnivals and fairs as well.
• The authors acknowledge the shortcomings of the NEISS data collection system used by the Consumer Product Safety Commission (read my earlier post if you want to know more about the NEISS system).  On the one hand, the authors note that NEISS data "exclude injured children seeking care in non-ED settings," which could potentially increase the number of injuries that may actually exist.  On the other hand, the authors acknowledge that NEISS data may overstate injuries because injury estimates "are affected by the proximity of parks to hospitals participating in the NEISS, and NEISS sampling is not based on the geographic distribution of amusement parks" - a point I have made before.

The Clinical Pediatrics study is imperfect.  The authors admit that it is.  But this objectivity is what gives this study some credibility beyond the seemingly biased and pre-determined "studies" that have come before it.  While some in the industry may take issue with any report that draws attention to the undeniable fact that guests sometimes are injured on amusement rides, I take a different view of this study.  To me, it represents the best shot I've seen at an unbiased assessment of injury data - using the best data (imperfect as it may be) available.  At bottom, it is impossible to read this study as anything other than supporting the conclusion that the amusement industry is a safe place to take your children this summer.  And that is a conclusion that should be welcome news to both the industry and our guests as the summer season is about to begin.