A Survey Exploring Contributing Risk Factors for Pediatric Lawn Mower Injuries

Treyton Krupp, BS
Priyanka Vakkalanka, PhD
Charles Jennissen, MD

Riding lawn mowers are the third leading cause of pediatric amputations. Children <5 years of age are at greatest risk. We hypothesize that children who have riding lawn mower injuries as bystanders are often given rides on lawn mowers and other vehicles not meant to have passengers, thus making young children more likely to approach an operating mower. Our study’s aim was to investigate the circumstances surrounding pediatric riding lawn mower injuries to identify potential contributing risk factors and behaviors that lead to these events.

Followers and members of both a public and a private lawn mower injury support and prevention Facebook page who had or were aware of children who had suffered a serious riding lawn mower-related injury were invited to complete an electronic survey on Qualtrics. Questions addressed the circumstances, injuries, and behaviors before and at the time of the incident, including a history of prior recreational rides on lawn mowers or other vehicles. Duplicate cases were removed. Frequencies and chi-square analyses were completed with IBM SPSS Statistic Build 1.0.0.1327.

Surveys were completed on152 injured children. Approximately 70% were completed by a parent and about 20% by an adult survivor of a childhood incident. About 70% of respondents were from the South or Midwest census regions. The majority of injured children were Caucasian (94%), male (62%), and ?5 years of age at the time of the incident (82%). Bystanders were 69% of those injured, 24% were riders on the lawn mower, and mower operators and others were both ~4% each. Overall, bystanders were younger than other injured children with 88% vs. 69% being ?5 years of age, respectively (P=0.012). The highest proportion of incidents occurred in May and June (~40%) and approximately half occurred between 1-5pm. The lawn mower operator was male in approximately three-quarters of cases with a father/stepfather being the operator in half. Overall, 60% of injuries occurred while traveling backwards, and 30% while moving forward. Three-quarters (76%) of bystander incidents occurred while moving in reverse as compared to 17% of non-bystander incidents (P<0.0001). Overall, 90% had an amputation or permanent disability. Nearly all (95%) of injured bystanders had an amputation and/or permanent disability versus 78% of non-bystanders (P<0.05). Only 5% of bystander injuries occurred to the upper extremity as compared to 40% of non-bystanders (P<0.01). Over three-quarters of bystanders (77%) had received a ride on some type of work or recreational vehicle prior to their injury. One-half of bystander victims had received at least one ride on a lawn mower prior to their injury incident.

Child bystanders seriously injured by riding lawn mowers were frequently given prior rides on lawn mowers and other vehicles not meant to have child passengers. Engineering changes to prevent mower blade rotation when traveling in reverse and not giving children rides on lawn mowers (both when mowing and when not mowing) may be critical in preventing these serious injuries

1. Participants will be able to list at least three circumstances common in riding lawn mower incidents leading to serious injury, including amputation, in children.
2. They will be able to state at least two differences between riding lawn mower injuries involving child bystanders as compared to child passengers.
3. Attendees will be able to describe at least two interventions that may help decrease serious riding lawn mower injuries in children.

Randomized Controlled Trial on the Effect of a Specially Designed Children’s Book on Safe Sleep Attitudes, Knowledge and Practices

Paula Valino Ramos, BS
Pam Hoogerwerf, BS
Penny Smith, BSN, RNC-NIC
Carolyn Finley, MSN, RN, CNL
Morgan Swanson, BS
Uche Okoro, MBBS, DrPH
Charles Jennissen, MD

Our study objective was to identify the sources mothers learned about safe sleep practices and determine if a specially designed safe sleep picture book increased knowledge, attitudes and/or practices of mothers over traditional methods such as written pamphlets/handouts and other background educational influences regarding safe sleep.

From November 2019-September 2020, expectant mothers at obstetric clinics in an academic tertiary care hospital received gift boxes at their 28-week prenatal visit that included a safe sleep informational card hand-out. In addition, gift boxes were randomized to have or not have the safe sleep children’s picture book, “sleep baby, safe and snug”. Those consenting to participate were surveyed at their 28-week prenatal and postnatal visits about safe sleep knowledge, attitudes, and planned or present practices regarding their infant’s sleep. Unfortunately, after the study began, most mothers did not have an in-person postnatal visit due to the COVID-19 pandemic. Thus, text messaging was used to contact participants to encourage them to take the postnatal survey on-line. Frequency, chi-square and Fischer’s exact test analyses were performed using Microsoft SAS software, V.9.4.

Eighty percent (814/1023) of eligible women completed the prenatal visit survey. Of these, 44% (355/814) completed the postnatal survey. The most common source participants stated they had heard, seen or read anything about safe sleep was from a healthcare provider (90%), while the second most common was from friends/family (60%). About two-fifths of recent mothers stated they had heard, seen or read something about safe sleep from books (43%), social media (42%) and during prenatal classes (38%). Few had received information about safe sleep from magazines (7%) or TV/radio (5%). Although all participants received a safe sleep informational card hand-out in their gift box, only 53% reported they had heard, seen or ready anything related to safe sleep from a handout or pamphlet. Less than three-fifths (56%) of those that had received a safe sleep picture book in their gift box reported having heard of or read the book. However, of those that did, over half (54%) reported having learned from the book and over two-fifths (41%) reported having shared information from the book with others. Despite this, we found no significant differences between participants regarding their safe sleep knowledge, attitudes or infant sleep practices by whether they did or did not receive, did or did not hear of, or did or did not learn something from the safe sleep picture book.

Only about one-half of recent mothers reported reading anything about safe sleep from a handout or pamphlet when all of them had received at least one such item. Almost three-fifths that recalled receiving a specially designed safe sleep picture book reported learning from the book; such items may be more useful in sharing safe sleep messages for some populations than handouts and pamphlets.

1. Participants will be able to name the two most common sources from which mothers hear, see or read anything about safe sleep.
2. They will be able to identify a common type of educational method regarding safe sleep that is often ignored by mothers.
3. Attendees will be able to describe an innovative method to share safe sleep information that may be effective for some new mothers.