By Lisa Rapaport

(Reuters Health) – Many children are injured by lawnmowers despite safety guidelines in place to prevent these accidents, and kids in rural communities are most at risk, a U.S. study suggests.

Researchers examined data on 1,302 lawnmower injuries in children 1 to 18 years old from 2005 to 2017. In cities, 1.47 kids out of every 100,000 sustained lawnmower injuries, compared to 4.26 kids out of every 100,000 in rural areas, the study found.

Lawnmower injuries in rural areas were not only more common – they were also more serious, on average. Rural children who sustained lawnmower injuries were more likely to be hospitalized and develop complications like infections.

“Although devastating, these accidents are largely preventable,” senior study author Dr. Theodore Ganley of the Children’s Hospital of Philadelphia and colleagues write.

Almost half of the injured kids in the study were between 1 and 5 years old.

“This suggests that these accidents occurred because of a lack of oversight or parental error involving children/babies who had not yet developed the judgment and ability to avoid and recognize the dangers of lawnmowers,” the researchers say.

“Young children in rural areas are particularly at risk for adverse outcomes,” Ganley and colleagues write. “While injury prevention and safety efforts should be a major point of emphasis for all children, recent evidence suggests that educational efforts should be further targeted for rural communities, especially in the Southern and Midwestern United States.”

An estimated 9,400 lawnmower injuries happen to U.S. children every year, researchers note in the Journal of the American Academy of Orthopedic Surgeons.

Lawnmowers are twice as likely to cause injuries as other consumer products, the study team notes. And lawnmowers are responsible for 12 to 19% of traumatic amputations in kids.

To reduce these injuries, the American Academy of Pediatrics (AAP) set lawnmower user guidelines in 1990 and 2001. The American Academy of Orthopaedic Surgery (AAOS) established updated guidelines in 2014, and the Pediatric Orthopedic Society of North America is currently collaborating with the AAP on awareness campaigns, the study team notes.

AAP, for example, recommends that parents and children operating lawnmowers wear close-toed shoes and glasses or goggles, avoid mowing during bad weather, moving across a slope with a push mower or up and down a slope with a ride-on mower, and refrain from pulling the mower backward or mowing in reverse. (

In the current study, children injured by mowers were 7.7 years old on average, and most were male and white.

About 65% of injuries involved the legs and feet; 22% involved the upper extremities. Less often, kids injured their head, neck, face, and torso.

Amputations were common – occurring in 31% of lawnmower injuries – followed by puncture wounds at 29% and fractures or dislocations at 24%.

In rural areas, kids were 1.7 times more likely to have an amputation after a lawnmower accident than in urban areas.

Injuries were most frequent in the summer months of May through August, consistent with greater use of lawnmowers during the summer and confirming what other studies have found, researchers note.

The study included data on injuries treated at just 49 hospitals nationwide, the study team notes. Many of these hospitals were trauma centers, making it possible that the results don’t reflect the number of minor lawnmower injuries that are treated without a hospital visit.

SOURCE: Journal of the American Academy of Orthopedic Surgeons, online October 29, 2019.