About 3.3 million children were treated in U.S. emergency rooms for a toy-related injury between 1990 and 2011, says a new study by researchers at the Center for Injury Research and Policy at Nationwide Children’s Hospital.

The number of injuries increased about 40 percent during the 22 years observed by the researchers. Much of that increase, researchers say, was linked to ride-on scooters.

“A child’s job is play, and toys are the tools,” said Gary Smith, the study’s senior author and director of the Center for Injury Research and Policy at Nationwide Children’s Hospital. “We want children to explore, challenge themselves and develop while using those tools safely.”

Kids under 3 who were treated for toy related injuries were most likely to choke on small toys or parts. Just over 40 percent of injuries to kids 5 to 17 were due to accidents with foot powered riding toys such as scooters, wagons or tricycles. According to the study, from 2000, after the scooters first came on the market, through 2011, there were an approximately 580,000 injuries. “The frequency and increasing rate of injuries to children associated with toys, especially those associated with foot-powered scooters, is concerning,” said Smith. “This underscores the need for increased efforts to prevent these injuries to children. Important opportunities exist for improvements in toy safety standards, product design, recall effectiveness, and consumer education.”

Smith has toy selection and supervision advice for parents:

• Pay attention to age restrictions and use instructions
• Check all toys to be used by very young children for small parts
• Use riding toys on dry, flat surfaces away from vehicle traffic.
• Supervise kids under 8 using riding toys and have kids use helmets, elbow pads and knee pads
• Check Recalls.gov to see if any toys you own have been recalled.

The study was published in Clinical Pediatrics