04 Jun Children Continue To Suffer Serious Injuries From Lawnmowers

MedicalResearch.com Interview with:

Dr. Smith

Gary Smith, MD, DrPH
Director, Center for Injury Research and Policy
Nationwide Children’s Hospital
Columbus, OH

MedicalResearch.com: What is the background for this study?

Response: Lawn mowers continue to be an important source of serious pediatric morbidity in the United States (US) with initial treatment of pediatric lawn mower-related injuries costing about $90 million annually. The long-term physical, psychological, and financial effects of these traumatic injuries can be devastating for those injured and for their families.

This study comprehensively analyzes data over a 25-year period using a nationally representative database to evaluate the epidemiologic characteristics, including mechanism of injury, of lawn mower-related injuries to children in the US. It also provides a discussion of relevant injury prevention strategies.

MedicalResearch.com: What are the main findings?

Response: An estimated 212,258 children younger than 18 years of age received emergency treatment for lawn mower-related injuries from 1990 through 2014, equaling an average annual rate of 11.9 injuries per 100,000 US children.

The annual injury rate decreased by 59.9% during the 25-year study period.

The leading diagnosis was a laceration (38.5%) and the most common body region injured was the hand/finger (30.7%). Struck by (21.2%), cut by (19.9%), and contact with a hot surface (14.1%) were the leading mechanisms of injury.

Patients younger than 5 years old were 7.01 times more likely (95% CI: 5.69-8.64) to be injured from contact with a hot surface than older patients. A projectile was associated with 49.8% of all injuries among patients injured as bystanders.

Patients injured as passengers or bystanders were 3.77 times more likely (95% CI: 2.74-5.19) to be admitted to the hospital than lawnmower operators.

MedicalResearch.com: What should readers take away from your report?

Response: Automatic safety measures that are designed into the lawn mower are the best way to prevent injuries from mowers. Shields can help keep hands and feet from penetrating under the mower, while also protecting the blades from large objects. Prevention of amputations from mowers is especially important because they are often severe, can require multiple surgical interventions, and result in permanent disability. To help prevent back-over injuries, every ride-on mower should be equipped with a no-mow-in-reverse (NMIR) mechanism. ANSI/OPEI B71.1-2003 required all ride-on mowers (except zero-turn radius and front-mount mowers) manufactured after September 1, 2004 to be equipped with a NMIR feature, which disengages the blades when the mower is shifted into reverse.

However, most of these mowers also are equipped with an override switch that allows the operator to reengage the blades while in reverse. Currently, this switch is located in front of the operator on almost all mower models with a NMIR override. Operators are able to reengage the mower blades while traveling in reverse without ever looking behind them, which negates the safety purpose of the NMIR mechanism. Manufacturers should place the override switch on the back of the mower behind the operator’s seat to force the operator to turn around and look behind him/her before reengaging the blades. Currently, only a handful of models have the override switch on the back. In addition, some ride-on mowers automatically reset the override switch to “off” when the operator shifts into a forward gear (the safest design), while others only reset when the operator manually turns off the override or when the engine is shut off (less safe designs). A rearward proximity warning device, rearward camera, and even a simple rearview mirror are additional potential strategies for reducing the risk of back-over injuries.

In addition to safer mower design, there are other strategies to prevent lawn mower-related injuries to children, including those promoted by the US Consumer Product Safety Commission and the American Academy of Pediatrics. Follow these important tips to help prevent lawn mower-related injuries:

• Teach and supervise teens. Children should be at least 12 years old to operate a push mower and at least 16 years old before using a ride-on mower. An adult should supervise teens before they are allowed to operate a lawn mower on their own.
• Kid-free zone. Children should never be passengers on ride-on mowers and children younger than 6 years of age should be kept indoors during mowing. Never let children play on or near a lawn mower, even when it is not in use.
• Before you mow. Pick up any stones or other objects in the grass. Objects thrown by a lawn mower can cause severe eye and other injuries. Put on protective eyewear and make sure you are wearing sturdy shoes.
• While you mow. When using a walk-behind lawn mower, use a mower with a control that stops it from moving forward if the handle is released. Always mow going forward. If you absolutely have to mow in reverse, always look behind you before you start backing up.
• Turn it off. Wait for the blades to stop completely before removing the grass catcher, unclogging the discharge chute, or crossing gravel roads.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Lawn mower-related injuries continue to be a cause of serious morbidity among children. Although the annual injury rate decreased significantly over the study period, the number of injuries is still substantial, indicating the need for additional prevention efforts. In addition to educational approaches, opportunities exist for implementation and evaluation of improvements in mower design and lawn mower safety standards.

The authors have no financial disclosures or conflicts of interest relevant to this study.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Children treated for lawn mower-related injuries in US emergency departments, 1990–2014
Ren, Karen S. et al. Published online March 13, 2017
The American Journal of Emergency Medicine , Volume 0 , Issue 0 ,
DOI: http://dx.doi.org/10.1016/j.ajem.2017.03.022

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on June 4, 2017 by Marie Benz MD FAAD