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Sledding as a fun winter activity has been a popular forever. Yet, each year 20,000 youngsters a year are hurt and 9 percent suffer traumatic brain injury researchers warn. Whether they’re gliding on plain plastic saucers or high-tech snow tubes, children and teens on sleds account for at least 20,820 injuries in the United States each year, according to a first-ever analysis of U.S. emergency room reports.

And the numbers are even more concerning when considered in light of the limited number of days sledding is usually undertaken. Overall, researchers estimate that nearly 230,000 children and teens age 19 and younger were treated for sledding injuries in emergency departments between 1997 and 2007. A new report was published in a recent issue of the journal Pediatrics.

But sledding is still dwarfed by injuries caused by other childhood pastimes. About 275,000 kids suffer non-fatal bicycle injuries each year, according to the National Safe Kids USA campaign. About 82,000 kids are treated for trampoline injuries, and about 61,000 kids are hurt skateboarding.

But understanding the cause of the sledding injuries can help reduce the number even lower. Children between the ages of 10 and 14 accounted for largest proportion of injuries, 42.5 percent, followed by children ages 5 to 9, 29.5 percent. Boys made up nearly 60 percent of the cases.

Fractures were the most common injury, accounting for 26 percent of the injuries, followed by bruises and abrasions, 25 percent, and then cuts and sprains at 16 percent apiece. Alarmingly, the head was the most frequently harmed body part, and more than 9 percent of the kids hurt sustained traumatic brain injuries.

Typically the option of helmet use is up to the individual. Washington, D.C., mandates helmets for sledders younger than 16, and in Massachusetts, a bill introduced by Sen. Steven C. Panagiotakos that would require sledding helmets for kids under 13 remains on the docket.

Many cities, such as St. Paul, Minn., and Anchorage, Alaska, suggest, but don’t require, that sledders use helmets.

In addition to a helmet, there are other steps that families can take to sled safely:

First, make sure to pick a sledding area clear of obstacles. The most common cause of injury, contributing to 50 percent of cases, was collision, which usually occurred when kids slid into fixed objects like trees, poles or benches.

Second, avoid streets and highways. Sledding on streets accounted for only about 2 percent of all injuries, but the kids hurt in those kinds of accidents were more likely to suffer head injuries or be hospitalized, often because they slide into the path of cars.

Finally, use common sense. Nearly 6,000 kids were hurt while being pulled on a sled behind a vehicle, including cars, trucks, snowmobiles, ATVs and lawnmowers.

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