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Lawnmowers Versus Children: The Devastation Continues
Mariano Garay1, William L Hennrikus2, Joseph Hess3
1Penn State Hershey College of Medicine, Hershey, PA, USA.
Insights
Lawnmower injuries in children remain a significant concern, with no change in incidence over 12 years. Most injuries, particularly severe ones, involved ride-on mowers and younger children, highlighting the need for public awareness campaigns.
Area of Science:
- Pediatric Trauma
- Injury Prevention
- Public Health
Background:
- Lawnmower accidents cause severe injuries in children.
- Safety guidelines were introduced in 2001.
- Ride-on mowers are linked to more severe pediatric injuries.
Purpose of the Study:
- To determine the incidence and severity of lawnmower injuries in children (2002-2013).
- To analyze injury variations by age group.
- To identify the types of lawnmowers involved and amputation rates.
Main Methods:
- Retrospective analysis of the Pennsylvania Trauma Outcome Study database (2002-2014).
- Inclusion of children aged 0-17 years admitted for lawnmower-related injuries.
- Stratification by age and analysis of injury severity scores and amputation data.
Main Results:
- Median incidence was 5 per 100,000 children annually.
- Younger children (0-6 years) had higher injury severity scores.
- 53% of patients required amputation; ride-on mowers caused 92% of identified injuries.
Conclusions:
- Serious pediatric lawnmower injuries did not decrease over the study period.
- Preventing young children from being near or operating mowers could prevent 69% of accidents.
- Annual public awareness campaigns are recommended to mitigate risks.
Background:
Accidents with lawnmowers can cause mutilating injuries to children. Safety guidelines regarding the use of lawnmowers were promoted by professional organizations beginning in 2001. The Pennsylvania Trauma Systems Foundation maintains a database including all admissions to accredited Levels 1 to 4 trauma centers in the state. The annual rates of admission for children in our state and the severity of injuries subsequent to introduction of safety guidelines have not been reported, to our knowledge. Ride-on lawnmowers have been associated with more severe injuries in children.
Questions/Purposes:
We asked: (1) What was the incidence of hospital admissions for children with lawnmower-related injuries during 2002 to 2013 and did the incidence vary by age? (2) What was the severity of injuries and did the severity vary by age? (3) How often did these injuries result in amputation? (4) What types of lawnmowers were involved?
Methods:
This was a retrospective study using a statewide trauma registry. We queried the Pennsylvania Trauma Outcome Study database for children 0 to 17 years old admitted to trauma centers in Pennsylvania between January 2002 and January 2014 with injuries resulting from lawnmower-related accidents. All accredited Levels 1 to 4 trauma centers in the state are required to submit their data to the Pennsylvania Trauma Systems Foundation which maintains the Pennsylvania Trauma Outcome Study database. Demographic information, Injury Severity Scores, International Classification of Diseases procedure codes, and injury location codes were recorded. Type of lawnmower was determined from the narratives and was identified in 60% (119/199) of patients. Traumatic and surgical amputations performed during the index hospitalization were included in the analysis. Information on later surgeries was not available. Subjects were stratified by age: 0 to 6, 7 to 12, and 13 to 17 years old.
Results:
The incidence of lawnmower injuries in Pennsylvania was a median five of 100,000 children (range, 4-12/100,000) during the study period. The median age was 6 years (range, 1-17 years). The median Injury Severity Score was 4 (range, 1-75). Children 0 to 6 years old had higher median Injury Severity Scores (median, 8; range, 1-75) compared with those 13-17 years old (median, 4; range, 1-20; difference of the medians, 4; p < 0.001). A total of 53% of the patients (106/199) underwent at least one amputation. There were 83 amputations in or of the foot, 18 in the leg, 14 in the hand, and three in the arm. Ride-on lawnmowers accounted for 92% (110/119) of mowers identified by type.
Conclusions:
The incidence of serious injuries to children owing to lawnmower-related trauma did not change during the 12-year study period. If children younger than 6 years had not been near the lawnmower and those younger than 12 years had not been operating one, at least 69% of the accidents might have been prevented. We recommend annual publicity campaigns during spring to remind the public of the dangers of lawnmowers to children.
Level Of Evidence:
Level IV, therapeutic study.