Ride-On Mower Injuries in Children

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1 Committee on Accident and Poison Prevention Ride-on mowers or lawn tractors are common lawn and field mowing vehicles used in the United States. An estimated 7.65 million such mowers are in operation annually. They are larger, more mechanically complex to operate, and much more powerful than their walk-behind counterparts. As a consequence, the risk of injury and possible death to children from these vehicles is high but almost entirely preventable. A 1988 Hazard Report by the Consumer Product Safety Commission, based on statistics from the National Electronic Injury Surveillance System Special Mower Surveys (1983 to 1986), stated that there are approximately 19 1 ride-on mower injuries and 75 deaths in the United States annually. This indicates an annual injury rate of 2.5 injuries per 1 ride-on mowers. Two thirds of the injuries occurred when mowers were in use (mowing, driv- ing, or operating nonmowing attachments); one third occurred when mowers were not in use (being stored, loaded or unloaded from a trailer, maintamed, or climbed on or played with in a parking area). Approximately 83% of in-use injuries occurred to the operators; 17% to nonoperators such as bystanders or passengers. Most nonoperators injured were children less than 1 years of age. Approximately 7% of all injuries required hospitalization. This is twice the estimated rate of hospitalization for all other consumer-product-related injuries. The percentage hospitalized was progressively higher in children 15 years of age or younger and in adults 56 years of age or older. Twenty-five percent of the estimated annual injuries (4775) and 3% of the deaths (23) occurred to children 15 years of age or younger. Most of the pediatric injuries and deaths were in the mower inuse, nonoperator category. However, 14% of the This statement has been approved by the Council on Child and Adolescent Health. The recommendations in this statement do not indicate an exclusive course of treatment to be followed. Variations, taking into account individual circumstances, may be appropriate. PEDIATRICS (ISSN 31 45). Copyright 199 by the American Academy of Pediatrics. mower in-use operator injuries occurred to children 5 to 15 years of age (2% between 5 and 9 years of age and 12% between 1 and 15 years of age). This indicates that older children and young adolescents are frequently allowed to operate these vehicles. The most common means of injury to children were runover or backover by another driver, falls from mowers on which they were riding, or falls from a trailer or cart being pulled by the mower. Typically, the injured child darted or fell in the path of the mower while playing in the mowing area. Incidences of runover or backover occurred predominantly in children younger than ten years of age and accounted for 6% of all mower in-use injuries and 2% of all deaths. Lacerations, amputations, and fractures were the most common injuries. The latter two injury categories occurred predominantly when the mower was in use and accounted for a significant proportion of hospital admissions. Fingers were the most cornmonly injured body part (37%); the distal aspects of both the upper and lower extremities sustained 71% of all injuries. Most deaths were due to the mower blade striking the head or chest. PREVENTION OF INJURY Before the Consumer Product Safety Commission Hazard Report regarding ride-on mowers, the frequency and seriousness of injuries from these vehicles in children were not appreciated widely. It is now imperative that measures be taken to prevent or minimize these injuries and their associated morbidity and mortality. What can pediatricians and other physicians involved in the care of children and adolescents do to protect children from ride-on mower injuries? The American Academy of Pediatrics believes that prevention of pediatric ride-on mower injuries could be effected if (1) parents were educated concerning the frequency, severity, and common means of injury; (2) appropriate age and training requirements were instituted to operate these vehicles; and (3) manufacturers were urged to investigate and develop a more safely designed product. Although most ride-on mowers now have a deadman switch Downloaded from by guest on April 19, 219 PEDIATRICS Vol. 86 No. 1 July

2 that shuts off the engine when the blades are engaged and the operator leaves the mower seat, this is not enough to provide maximum safety. PARENT EDUCATION Since ride-on mower injuries and death in children commonly occur when they are playing in the mowing area and are subsequently run over or backed over, physicians should advise parents that children must not be allowed to play or be adjacent to areas where ride-on mowers are being used. Children are also vulnerable to being struck by rocks or other objects propelled by the mower blade. Young children, especially those 5 years of age or younger, should be kept indoors during mowing. Children should not be allowed to ride with the mower operator or ride in carts or trailers being towed behind the mower. They should also be taught not to play on or around the mower, even when it is in storage and not in use. Finally, children must not operate ride-on mowers, even with adult supervision, until age and instruction requirements have been established and met. In a recent comparative study of 22 of the most popular ride-on mowers (Consumer Reports. June 1989: ), the following major areas for improved safety were found: (1) prevention of the front wheels raising (wheelies) when the clutch is abruptly released in high gear on level ground without a grass-catcher attached; (2) blade-stop within 3 seconds after the operator releases the deadman control; (3) speed controls to assure that mowers cannot travel in reverse as fast as they go forward; (4) single control for both speed and direction; and (5) automatic engine shutdown unless the transmission is in neutral and the parking brake set before the driver leaves the seat. These recommendations must be met and other safety measures investigated. If these cannot be achieved voluntarily in the near future, then appropriate federal safety standards will be required so that maximum safety can be achieved. Manufacturers should also provide detailed product safety information in the operation manual that accompanies each new mower. Warning labels regarding safety hazards should be applied directly to the vehicles. Dealers should also provide safety information and instruction at the time of sale. OPERATING AGE AND TRAINING REQUIREMENTS Currently, no age-specific criteria for use have been established by the manufacturers or by law. The American Academy of Pediatrics believes that ride-on mowers should have age and training criteria similar to those recently recommended for two-, three-, and four-wheeled unlicensed, all-terrain vehicles.2 Thus, an age of at least 14 years and a specified period of operational training and safety instruction should be required to operate these yehides. Although they do not travel as fast as other four-wheeled vehicles, ride-on mowers have a high potential for injury because of the complexities involved in the use of the clutch, gears, brakes, and mower blade. Maturity, coordination, and judgment are necessary for safe operation. PRODUCT INFORMATION AND SAFETY DEVICES At present, the ride-on mower industry has only voluntary safety standards, developed by the Outdoor Power Equipment Institute. These standards were upgraded in 1984 to conform to the riding mower portion of the voluntary American National Standards Institute Comprehensive Mower Standard. Although the industry has generally met these standards, they do not provide adequate protection. CONCLUSIONS Ride-on mower injuries in children are needlessly common and often severe with a high incidence of major limb amputations, head injuries, and death. Most injuries can be prevented by appropriate parental education, instituting age and training criteria for operations, and developing safer mowers. Pediatricians should work to protect children from injuries from these vehicles. COMMITTEE ON ACCIDENT AND POISON PREVENTION, 1989 TO 199 Mark D. Widome, MD, MPH, Chairman Joel L. Bass, MD William E. Boyle, Jr, MD Katherine K. Christoffel, MD, MPH Murray L. Katcher, MD, PhD Sylvia H. Micik, MD Liaison Representatives Gerard M. Breitzer, DO, American College of Osteopathic Pediatricians John S. O Shea, MD, Ambulatory Pediatric Association Juan Rodriguez, MD, MPH, Centers for Disease Control Peter Scheidt, MD, MPH, National Institute of Child Health and Human Development Richard Stanwick, MD, Canadian Paediatric Society 142 RIDE-ON MOWER Downloaded INJURIESfrom by guest on April 19, 219

3 Section Liaisons James S. Reilly, MD, Section on Otolaryngology Joseph J. Tepas, III, MD, Section on Surgery George Thompson, MD, Section on Orthopaedics Susan B. Tully, MD, Section on Pediatric Emergency Medicine Designated Representative George Rutherford, US Consumer Product Safety Commission REFERENCES 1. Smith EVT. HazardAnalysis: Ride-on Mowers. Washington, DC: Directorate for Epidemiology, Consumer Product Safety Commission; May American Academy of Pediatrics, Committee on Accident and Poison Prevention. All-terrain vehicles: two-, three-, and four-wheeled unlicensed motorized vehicles. Pediatrics. 1987;79: Lawn Tractors: Can They Cut It? Consumer Reports. June 1989: Downloaded from AMERICAN by guest ACADEMY on April 19, 219 OF PEDIATRICS 143

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5 Pediatrics 199;86;141 The online version of this article, along with updated information and services, is located on the World Wide Web at: Pediatrics is the official journal of the American Academy of Pediatrics. A monthly publication, it has been published continuously since Pediatrics is owned, published, and trademarked by the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, Illinois, 67. Copyright 199 by the American Academy of Pediatrics. All rights reserved. Print ISSN: Downloaded from by guest on April 19, 219