Pediatricians are again actively discouraging trampoline use.

Pediatricians are again actively discouraging trampoline use, noting high rates of injury and little or no safety benefit from use of protective netting and padding. They are also warning families with trampolines to be sure their homeowner's insurance covers any trampoline-related injuries.

The recommendation was published Monday online in the journal Pediatrics.

The new statement from the American Academy of Pediatrics (AAP) "strongly discourages" use of trampolines at home or on the playground, but the group doesn't take a position on use in sports and structured training, citing lack of data. It instead offers suggestions for enhancing safety in those settings.

The group first warned parents and other consumers against letting children play on trampolines and playgrounds in 1999, which led many trampoline manufacturers to add safety features like net enclosures to their product. There's no data showing that reduced injuries, the pediatricians said, and such features "provide a false sense of security," they said.

"As best we can tell, the addition of safety nets and padding has actually not changed the injuries we have seen," Dr. Susannah Briskin, a sports medicine specialist who helped draft the new statement, told Reuters.

Trampoline injuries have decreased from 111,851 people seeking treatment in emergency departments in 2004 to 97,908 in 2009. That doesn't mean they're safer, she said.

"Even though there has been a decrease in injuries," she said, "I caution people against taking that too literally because the number of trampolines has also decreased."

Of the injuries, the National Electronic Injury Surveillance System found that 3,100 required hospitalization, the AAP said. Rates of injuries appear higher for children than for adults, but injuries span age groups.

The pediatrician group said that three-fourths of injuries happen when more than one person jumps on the mat at a time, and not doing that tops recommendations for improving safety. The smallest and youngest on the mat at a time are usually at greater risk for significant injury, and that's especially true for children 5 and younger, they said. Forty-eight percent of injuries in that young age group resulted in fractures or dislocations.

Common injuries across age groups include sprains, strains and contusions. Falls account for as many as 39 percent of injuries and "can potentially be catastrophic," the AAP said in a written statement. It estimates that one in 200 trampoline injuries results in such permanent neurological damage.

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Among the most significant injuries are those to the cervical spine from failed attempts at somersaults and flips. Those injuries can be permanent.

"Many injuries have occurred even with adult supervision," the group warned.

Mark Publicover, founder and president of JumpSport Inc, a trampoline maker in San Jose, Calif., told Reuters that if parents ban trampolines, kids are apt to injure themselves in other activities, from tree climbing to skateboarding. "If you look at all those activities, a safety-enclosed trampoline is safer by hours of use," he said.

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