State-of-the-Art Pediatrics

Lawnmower Safety – Prevent Tragedy

Author: Dale Jarka, MD | Pediatric Orthopedic Surgery | Associate Professor, UMKC School of Medicine

Column Editor: Amita R. Amonker, MD, FAAP | Pediatric Hospitalist | Assistant Professor of Pediatrics, UMKC School of Medicine 

The weather is finally spring-like! The trees are budding, the flowers are blooming, the grass is growing, and the lawn mowers are coming out of the garage. Unfortunately, for pediatric orthopedic surgeons, the first lawn mower injury of the season is a despised but predictable rite of spring.

Children are fascinated by lawn mowers, especially the riding variety. And there is a novelty about them at the beginning of the mowing season. Often the operator, not infrequently a grandparent, lets the child ride with them. Injuries typically happen when the child falls off and under the mower blade. Or the child runs after the mower from behind and unseen, tries to climb on, slipping underneath, or the child gets backed over. Another common way children are hurt is by projectile or “missile injuries” from objects propelled at explosive speeds by the mower blades.

Nationally, roughly 9,500 children end up in emergency departments each year with lawn mower-related injuries. They range from burns after touching hot engines and puncture wounds from flying debris, to limbs severed by blades that spin at 3,000 rotations per minute (RPM). 

We recently reviewed our hospital’s 20-year experience with these injuries. The majority of the injuries were in the lower extremities, and distressingly 40% of the patients sustained some degree of amputation. As other pediatric studies have shown, we saw two peaks of incidence: age 15, these being the often-inexperienced operators of the mowers, and a larger peak at age 4. These younger children were more often injured by a riding mower, frequently when the operator was mowing in reverse and did not see nor hear the child.

Over the last 20 years, there have been some important safety features added to the mowers. Some newer riding mowers do not permit mowing in reverse, for example, to help prevent back-over injuries. The newer push mowers also require that the bar switch on the handle be continuously pressed to operate the device. 

Despite this, the annual incidence of pediatric lawn mower injuries has held steady over the last two decades. The safety feature described above can be disabled with enough effort. As one of the attending surgeons in my fellowship would say, “It’s difficult to make something foolproof, as fools are so ingenious.”

The American Academy of Pediatrics has for many years advocated for lawn mower safety. Some of the key points:

• Children should be at least 12 years of age to operate a walk-behind power mower or hand mower safely, and at least 16 years old to operate a riding lawn mower safely. 
• Make sure that children are indoors or at a safe distance well away from the area that you plan to mow. 
• Never allow children to ride as passengers on ride-on lawn mowers or garden tractors.

Lawn mower injuries are tragic, can be devastating with lifelong sequalae, and are 100% preventable! We need to help save families from having to deal with this tragedy. As pediatricians, parents and members of your community, please be advocates for lawn mower safety. Follow the above safety guidelines yourself. Help spread the word among your patients and neighbors. And stop and speak up if you see kids being put in danger: riding on the mowers or being around them. Your efforts might save a life, a limb and a family.

References:

1. Bachier M, Feliz A. Epidemiology of lawnmower-related injuries in children: a 10-year review. Am J Surg. 2016 Apr;211(4):727-32. Epub 2016 Jan 6.
2. Fletcher AN, Schwend RM, Solano M, Wester C, Jarka DE. Pediatric lawn mower injuries presenting at a Level-I trauma center, 1995 to 2015: A danger to our youngest children. J Bone Joint Surg Am. 2018 Oct 17;100(20):1719-1727.