Editor’s note: This story was originally published on CNN.com in 2013.

(CNN) — From carousels to roller coasters, part of summer fun for many kids is a trip to the local carnival or a nearby amusement park. But experts are warning that children need to be supervised on rides because of the risk of injuries.

On Monday, three girls were injured after falling from a Ferris wheel at a county fair in eastern Tennessee. A 10-year-old boy was killed Sunday on the world’s tallest water slide in Kansas.

Researchers from Nationwide Children’s Hospital in Columbus, Ohio, studied Consumer Product Safety Commission information on youngsters who were taken to emergency rooms for amusement ride injuries during a 20-year period. Their study, published in the May 2013 issue of the journal Clinical Pediatrics, looked at fixed-site rides, such as those at major amusement parks, as well as mobile rides, which included rides at local carnivals, state fairs and shopping mall arcades.

The rides “included anything from coin-operated rides to Ferris wheels, carousels, bumper cars, roller coasters and any type of ride like that,” said Tracy Mehan, lead researcher of the study.

The researchers used data on 92,885 children under the age of 18 who were treated for amusement park type of injuries in emergency rooms, from 1990 to 2010. More than 70% of the problems occurred during the summer months, when amusement parks are open and state fairs are often being held. That averages out to 4,423 injuries each year and 20 injuries daily from May through September. The Tennessee and Kansas amusement park accidents were not included in the study.

The injuries ranged from head and neck problems to injuries to the face, arms and legs. Soft-tissue injuries — damage to ligaments, muscles and tendons — were the most common. Serious injuries made up only a very small percentage.

It was not just the bigger rides that caused problems, researchers noted. Data showed that even mall rides could be dangerous.

“Many of the injuries of these rides are over hard floors, and children are falling on a hard floor and are ending up with head injuries,” Mehan noted.

Amusement injuries in recent years

Every year, theme parks in North America attract 375 million guests, according to the International Association of Amusement Parks and Attractions.

Consumer Product Safety Commission statistics for 2015 are not available, but a review of the raw data found about 45,000 injuries associated with amusement attractions and water slides nationwide; about 30,000 of these cases involved those under the age of 18.

“Based on the number of people that go to amusement parks each year, the relative number of injuries is, fortunately, small,” said Dr. Gary Smith, the 2013 study’s senior author and the president of the Child Injury Prevention Alliance. “But there’s still potential for serious injuries.”

Oversight needed but hard to achieve

Authors of the 2013 study say more regulations need to be in place to make these rides safer. Scott Wolfson, a spokesman for the Consumer Product Safety Commission, said that’s easier said than done.

“Back in the early ’80s, our authority to oversee fixed-site rides was taken away from us,” he said. “We do deal with mobile rides, like those at local carnivals, but we are a small agency, and it’s tough to oversee every fair that sets up for a short period of time.”

“Although the U.S. Consumer Product Safety Commission has jurisdiction over mobile rides, regulation of fixed-site rides is currently left to state or local governments, leading to a fragmented system,” Smith said. “A coordinated national system would help us prevent amusement ride-related injuries through better injury surveillance and more consistent enforcement of standards.”

Little to no progress, however, has been made to establish a system that collects better-defined data to help identify problems and reduce injuries since the 2013 study, Smith said.

He said that such effort would require a lot of work from the government, and the cost of additional resources would be hard to overcome, especially for departments that are already underfunded and understaffed.

How to keep your children safe

The study authors noted that parents can do their part to help keep children safe by following a few simple guidelines.

Always follow all posted height, age, weight and health restrictions. Make sure to follow any special seating order and/or loading instructions. Always use safety equipment such as seat belts and safety bars. Make sure children keep hands and feet inside the ride at all times. Know your child. If you don’t think he/she will be able to follow the rules, keep him/her off the ride. Trust your instincts. If you are worried about the safety of the ride, choose a different activity. Avoid “mall rides” if they are over a hard, unpadded surface or if they don’t have a child restraint such as a seat belt.

The authors say theirs is the first study to look at the national rate of child ER injuries involving amusement rides in the United States.

Aria Hangyu Chen, special to CNN, contributed to this report.