Review of Paediatric Lawnmower Injuries

Paediatric lawnmower injuries pose a significant public health concern for families and healthcare providers. The need for further insight and advocacy for prevention of lawnmower injuries was identified at a collaborative session of the paediatric and trauma divisions at the 2024 Canadian Orthopaedic Association Annual Meeting. The aim of this study was to review the past 10 years of data from North American databases regarding the incidence, nature, severity, and prevention strategies pertaining to lawnmower injuries among children. Review of the National Electronic Injury Surveillance System (NEISS) of the United States Consumer Project Safety Commission was conducted for children under 19 years of age from 2014–2023. Data on demographics, injury patterns, location of injury, and mechanism of injury were retrieved and analyzed. Additionally, an assessment of consumer product guidelines and public-facing position statements from relevant physician groups was performed. The NEISS database estimated 51,022 lawnmower-related injuries occurred in the paediatric population between 2014 to 2023. In total 13,549 incidents involved children under 7 years of age, of these, 853 fractures and 941 amputations were estimated. Notably, 45% of the total amputations affected children in the 0 to 6 years of age group. In contrast, 30% of amputations occurred in 16 to 18 year-olds, primarily involving amputation of fingers and toes. In the older age group, the most common mechanism of injury was cleaning the lawnmower chute. In children under 7 years of age, amputations were more severe and affected multiple limbs. The primary mechanisms of injury for this younger population included being run over by a lawnmower (26%) and playing near a lawnmower (12%). The Paediatric Orthopaedic Society of North America, American Academy of Orthopaedic Surgeons, and American Academy of Paediatrics published position statements on power lawnmower safety, emphasizing preventative measures such as keeping children indoors during lawnmower use, wearing protective equipment, and educating children and parents on the dangers of lawnmowers. Paediatric lawnmower-related injuries range from minor to catastrophic. Analysis of data over the past decade indicates an overall decline in lawnmower accidents in the U.S.A. from 2014 to 2023 compared to the previous ten-year period. A notable decrease in incidents occurred in 2021 and 2022, possibly related to COVID-19; however, there was a corresponding uptick in incidents in 2023. Of concern was the high incidence of fractures and amputations in children less than 7 years old. Enhanced attention to this issue in the Canadian context has been called for by paediatric orthopaedic surgeons managing these potentially life-altering injuries. The development of updated position statements issued by multidisciplinary teams, to be disseminated through schools, community centers, and family physician offices needs to be addressed.