Lawn mower-related injuries among children

Despite current safety efforts, thousands of U.S. children need emergency medical care for preventable lawn mower-related injuries each year.

According to a study published in the August issue of Pediatrics and conducted by researchers at the Center for Injury Research and Policy (CIRP) in the Columbus Children's Research Institute at Columbus Children's Hospital, an average of 9,400 persons 20 years old and younger receive treatment in a U.S. hospital emergency department annually, with 25% of the injuries incurred by children younger than five years.

Using data from the National Electronic Injury Surveillance System of the U.S. Consumer Product Safety Commission, researchers analyzed an estimated 140,700 lawn mower-related injuries to children who were 20 years of age and younger treated in hospital emergency departments from 1990 through 2004.

"Lawn mowers are an important cause of pediatric injury," said CIRP Director Gary Smith, MD, DrPH, the senior study author and a faculty member of The Ohio State University (OSU) College of Medicine. "We found that the annual number of lawn mower-related injuries remained relatively consistent during the 15-year period studied, which demonstrates that current injury prevention strategies are inadequate. 'Passive' (or automatic) protection that is provided by safer product design is the strategy with the highest likelihood of success in preventing these types of injuries."

Boys sustained 78% of the injuries with the average age of those injured falling between 10 and 11 years old. Lacerations (41%) were the leading type of injury, followed by soft tissue injuries (21%), burns (15%) and fractures (10%). The most common body region involved was the hand/finger (34%), followed by lower extremity (almost 19%) and foot/toe (nearly 18%). Eye and facial injuries accounted for 10% and upper extremity injuries accounted for 7%. Ninety-seven percent of amputation injuries occurred to the foot/toe (nearly 50%) and hand/finger (47%). Nearly 87% of the injuries among children who were hospitalized involved amputations, lacerations, or fractures.

David Vollman, the other study author from the OSU College of Medicine, said, "We recommend revision of the American National Standards Institute/Outdoor Power Equipment Institute voluntary safety standard (B71.1-2003) to include more rigorous performance provisions regarding prevention of penetration of feet and toes under the mower and into the path of the blades. We also recommend better shielding of hot mower parts from access by young children and equipping all ride-on lawn mowers with a no-mow-in-reverse default feature."

"The over-ride switch for the no-mow-in-reverse feature should be located behind the ride-on mower operator," Smith added, "This would require the operator to look behind the mower before disengaging this safety feature and mowing in reverse. This simple design change could prevent hundreds of devastating back-over injuries to children each year in this country."

"The American Academy of Pediatrics recommends picking up objects from the lawn before mowing and use of a grass catcher or shield for the mower discharge area to reduce the risk of foreign body projectiles," Vollman said. "It's also important to wear eye protection and long pants while mowing to reduce the risk of injury from objects being flung outward from the mower blades."

"Mowing the lawn at home or as a source of employment for youngsters is almost a rite of passage in this country," Smith said. "It is tragic that this activity continues to cause tremendous pain and suffering, and in many cases permanent disabilities, when improved product design standards could prevent most lawn mower-related injuries."

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