Lawn Mower Injuries

Lawn Mower Injuries

Well, in the northern hemisphere the weather is making my lawn look awesome!!  Why we are obsessed with green lawns, I don’t know, but I can’t judge as I also enjoy a lush lawn.  Unfortunately, all of this obsessive behavior of lawn maintenance can unnecessarily endanger our children.  I know that Injury Prevention isn’t the most exciting topic for us to discuss (we have covered SubmersionsFirearms, and Laundry Pods previously), but an ounce of prevention is greater than a pound of cure, especially, when there is no great “cure” for mangled limbs.  Let us look at an unfortunately common summer-time danger: Lawn Mower Injuries.

 

Lawn Mower Injuries: Frightening Numbers

  • Amount of Lawn Mower Related Injuries

    • Recognized as a substantial health concern since the 1950’s.
    • Estimated # of power lawn mower associated injury cases: [Robertson, 2003]
      • 1997 – 60,016
      • 1998 – 75,375
      • 1999 – 69,480
      • 2000 – 79,892
      • Doesn’t look like we are learning our lesson or heeding the warnings.
    • Riding lawn mowers associated with ~20% of the injuries.

 

  • Lawn Mower Physics

    • Typical 26-inch rotary mower blades spin at 3,000 RPMs! [Park, 1976]
      • Can generate 2,100 ft lb of kinetic energy.
      • The momentum of the mower blade tip is equal to a 1.17 lb weight traveling 232 mph!
    • Speed Kills
      • Kinetic energy is related to the SQUARE of the blade velocity… higher speeds lead to more potential damage.
      • Dull blades require greater speed to do the same cutting job (why it is recommended to keep blades sharp).

 

  • Children are at Great Risk

    • Older individuals and children < 15 years of age have higher incidences of injuries. (Costilla, 2006)
    • Their smaller size can make the physical force from the lawn mower more devastating.
    • Their smaller size allows a greater proportion of the body to be involved in the injury.
    • Pediatric admission and treatment cost for lawn mower injury estimated at $90 million. (Loder, 1997)
    • Estimated annual burden for prosthetic costs range from $43 million to $75 million. (Loder, 2004)

 

Lawn Mower Injuries: Types of Damage

  • Direct Injuries
    • Upper and Lower extremity injuries are the most common.
      • Amputations occurred in at least 30% of cases in many studies.
    • Torso injury possible in infants who are run over.
    • Deformity is common, but death is potential!
  • Indirect / Missile Injuries
    • Many cases of patients injured from projectiles thrown from spinning blades.
      • One study found penetrating trauma from flying debris was most common cause of injury. (Costilla, 2006)
      • Case report of penetration of the vena cava (McKamie, 2007) and pericardial tamponade. (Esfahani, 2013).
    • Stresses importance of clearing cutting region from free debris.
  • Burns
    • From direct contact of hot engine or exhaust.
    • From mishaps with spilled fuel that ignites.
  • Infection
    • Wounds are prone to become infected.
    • Often contaminated with a broad range of organisms including gram positive and negative bacteria in addition to myobacteria and fungi. (Harkness, 2009)
    • Bone infection is also potential complication.
  • Psychologic
    • As with any devastating injury, there can be lasting psychologic consequences.
    • See Dog Bite and PTSD

 

Lawn Mower Injury Prevention:

  • Again, every opportunity to help reduce potential future injuries should be looked at as a means to keep our patients healthy (and prevent them from needing your services in the future).
  • Here are a few pointers you can remind people of:
    1. LAWN MOWERS ARE NOT TOYS 
      • Yes, I know the toy stores sell toy lawn mowers… this is likely a ill-advised.
      • The picture of the toddler “mowing” the grass adjacent to the parent with the lawn mower that has a blade spinning at 3,000 RPMs is not a picture we should support!
    2. No child < 14 years of age should operate a powered lawn mower!
      • In one study 85% of the children who were injured were < 14years of age. [Loder, 1997]
    3. Mowing the Lawn is NOT A BYSTANDER Sport!
      • Projectiles thrown from the machine’s blades can do irreversible damage!
      • Young children may wander in the path without the operator being aware.
    4. Safety devices are there for safety, not annoyance. Do NOT disengage them!
      • Seems counterproductive, but some of the safety devices can be disengaged.
      • Some mowers can be made to allow the blade to spin while moving in reverse.
      • Keep all safety devices engaged.
    5. Clear the Path!
      • Lawn mowers are designed to cut grass… not tree branches or thick brush.
      • Cleaning the path of debris can help reduce the risk of launching projectiles.
    6. Gravity always wins.
      • Avoid steep slopes.
      • When mowing lower slopes, do not mow them crosswise.

References

Esfahani SA1, Yousefzadeh DK. Pericardial tamponade with a normal cardiopericardial silhouette due to a penetrating metallic projectile propelled by a lawnmower. Pediatr Cardiol. 2013;34(8):2044-6. PMID: 23184019. [PubMed] [Read by QxMD]

Harkness B1, Andresen D, Kesson A, Isaacs D. Infections following lawnmower and farm machinery-related injuries in children. J Paediatr Child Health. 2009 Sep;45(9):525-8. PMID: 19702605. [PubMed] [Read by QxMD]

McKamie WA1, Schmitz ML, Johnson CE, Ray T, Sanford GB, Dyamenahalli U, Imamura M. Superior vena cava perforation in a child from a lawnmower projectile. Clin Pediatr (Phila). 2007 Nov;46(9):847-9. PMID: 17641123. [PubMed] [Read by QxMD]

Costilla V1, Bishai DM. Lawnmower injuries in the United States: 1996 to 2004. Ann Emerg Med. 2006 Jun;47(6):567-73. PMID: 16713787. [PubMed] [Read by QxMD]

Nugent N1, Lynch JB, O’Shaughnessy M, O’Sullivan ST. Lawnmower injuries in children. Eur J Emerg Med. 2006 Oct;13(5):286-9. PMID: 16969234. [PubMed] [Read by QxMD]

Lau ST1, Lee YH, Hess DJ, Brisseau GF, Keleher GE, Caty MG. Lawnmower injuries in children: a 10-year experience. Pediatr Surg Int. 2006 Mar;22(3):209-14. PMID: 16421702. [PubMed] [Read by QxMD]

Loder RT1, Dikos GD, Taylor DA. Long-term lower extremity prosthetic costs in children with traumatic lawnmower amputations. Arch Pediatr Adolesc Med. 2004 Dec;158(12):1177-81. PMID: 15583104. [PubMed] [Read by QxMD]

Robertson WW Jr1. Power lawnmower injuries. Clin Orthop Relat Res. 2003 Apr;(409):37-42. PMID: 12671483. [PubMed] [Read by QxMD]

Loder RT1, Brown KL, Zaleske DJ, Jones ET. Extremity lawn-mower injuries in children: report by the Research Committee of the Pediatric Orthopaedic Society of North America. J Pediatr Orthop. 1997 May-Jun;17(3):360-9. PMID: 9150027. [PubMed] [Read by QxMD]

Park WH, DeMuth WE Jr. Wounding capacity of rotary lawn mowers. J Trauma. 1975 Jan;15(1):36-8. PMID: 1117466. [PubMed] [Read by QxMD]

Sean Fox

I enjoy taking care of patients and I finding it endlessly rewarding to help train others to do the same. I trained at the Combined Emergency Medicine and Pediatrics residency program at University of Maryland, where I had the tremendous fortune of learning from world renown educators and clinicians. Now I have the unbelievable honor of working with an unbelievably gifted group of practitioners at Carolinas Medical Center. I strive every day to inspire my residents as much as they inspire me.

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