Contributing factors for pediatric bystander lawn mower-related injuries: A qualitative study

Mikayla Gibson, BS
Briah Drewry, BS
Maia Bibbs, Undergraduate
Treyton Krupp, MD
Pam Hoogerwerf, PhD
Charles Jennissen, MD

Riding lawnmowers are the most frequent cause of major limb amputation in young U.S. children, and in the majority of these events the child is a bystander. Pediatric lawn mower injury research has been minimal. Our objective was to investigate the circumstances of pediatric bystander riding lawn mower injuries and identify behaviors that may precipitate these events.

Followers/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 lawn mower-related injury were invited to complete an electronic survey on Qualtrics which included open-ended questions regarding supervision and circumstances of the event. Injuries involving push mowers and duplicate cases were removed. Qualitative analysis of responses was independently performed by three research team members, and differences in coding were resolved through an iterative process. Descriptive analyses of responses were performed.

Of the 140 injured children identified, 97 were bystanders. Major themes identified that contributed to the injury event included: Supervision Issues (40%), Child Not Perceiving Danger (40%), Child Allowed to be in Vicinity of Mower (23%), Mowing in Reverse (51%), and Other Mower-Related Issues (15%). Sub-themes for Supervision Issues included: Distracted Supervisor (34%)--which was sub-categorized into attending other children, doing another task, visiting/talking with other adults, and supervisor was mower operator, and Child Not Supervised (7%)—which was sub-categorized into miscommunication, supervisor could not see child, and no designated supervisor. Sub-themes for Child Not Perceiving Danger included Lawn Mower Rides (17%)—which was sub-categorized as child running up to mower wanting a ride, and child had received a mower ride day of injury, and Child Approached Mower (24%)—which was sub-categorized as child approached mower for a specific reason, child approached mower with no specified motive, and child engaging in play activities with lawn mower or mower operator. Sub-themes for Child Allowed to be in Vicinity of the Mower included Child Playing Near Mower (17%) and Child Doing Another Activity/Not Playing Near Mower (5%). Other Mower-Related Issues included the sub-themes: Ability to Mow in Reverse (7%), Mower Guard/Chute Issue (4%) and Blind Spots (4%).

Contributing risk factors for child bystander lawn mower injuries were identified and reinforce many safety directives including close supervision of children by someone other than the operator, and not allowing children outside when mowing is being performed. Many injured child bystanders were, or may have been, approaching the mower to get rides. Mower rides likely desensitize children to the inherent dangers and lead them to seek rides when the mower is being used. Mower design preventing blade operation when traveling in reverse and not giving children rides on lawn mowers may be critical in decreasing lawn mower-related injuries.

Attendees will be able to:
1. Describe factors that put children at risk for bystander riding lawnmower-related injuries and why careful supervision is so important.
2. Discuss why giving rides to children on lawnmowers increases their risk for lawn-mower-related injury as bystanders.
3. State why mowing in reverse is a problem related to child bystander lawnmower-related injuries and how engineering changes might decrease the risk.