When kids hurt themselves in a bathtub, usually from a fall or slip, the accident occurs despite the fact that nearly always an adult is watching them, new research shows.

U.S. investigators found that slips and falls cause more than 80 percent of the injuries kids receive from bathtubs; other types of scrapes, scalding and near-drowning accounted for the rest.

Since the study showed that 85 percent of children under 5 who were hurt in the tub were being supervised by an adult, simply increasing supervision may not be enough to keep kids safe at bathtime, says the research team in the journal Clinical Pediatrics.

Instead, study author Dr. Gary Smith at the Center for Injury Research and Policy at Columbus Children’s Hospital in Ohio suggested that tub manufacturers make sure that newer tubs provide better friction for wet feet.

“The best parent in the world can’t supervise their child 100 percent of the time,” said Smith. “Passive, automatic protection works the best,” he told.

In the meantime, he recommended placing shower mats in bathtubs while kids are washing.

According to Smith and his colleagues, since the 1970s parents have been urged to protect their bathing children from burns and drowning. Recommendations include the use of baby bath seats, and keeping water temperature below a certain level.

However, relatively few studies have looked at the dangers of tub falls in childhood, and how to keep kids safe, the authors note in their article. To investigate further, they reviewed the medical records of all children treated for tub injuries at a pediatric facility with 70,000 emergency room visits per year.

The researchers reviewed 204 cases involving children aged 4 months to 16 years that occurred over the course of 3 years. Eighty-two percent of children were hurt from falls or slips, most often receiving cuts to the head or face. None of the injuries were life-threatening.

“It was surprising to see slips and falls accounting for so many” injuries, said Smith, who is also based at the Ohio State University College of Medicine and Public Health in Columbus.

The investigation showed that less than 40 percent of parents were using slip-resistant strips inside the tub, and less than 30 percent had bath mats inside the tub. However, more than 80 percent of parents said they made changes to the tub after their child’s injury, such as padding faucets and adding slip-resistant surfaces.

SOURCE: Clinical Pediatrics, May 2005.