Editor's Spotlight/Take 5: Lawnmowers Versus Children: The Devastation Continues

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Mass-media campaigns have a solid track record of improving healthy behaviors. Road-safety campaigns, for instance, have reduced the number of automobile crashes and increased crash survival by promoting the use of seatbelts, infant booster seats, reductions in speeding, and the use of helmets for motorcyclists and bicyclists. Public-service announcements and advertisements have helped increase the number of children getting vaccinated, reduced the number of children dying from sudden infant death syndrome, and decreased the use of aspirin in young children due to potential dangerous side effects [5].
Put in this context, the medical community's media campaign educating the public on the best practices for avoiding pediatric lawnmower injuries should have resulted in a decrease in lawnmower accidents. But that simply has not been the case. According to Douglas G. Armstrong and his team from Penn State University, the incidence of serious injuries to children due to lawnmower-related trauma held steady during their 12-year study period.
Have we done enough? The American Academy of Pediatrics disseminated a policy statement on lawnmower injuries some 15 years ago [2, 4]. Since then, the American Academy of Orthopaedic Surgeons [1] and The Pediatric Orthopaedic Society of North America [1] jointly have followed suit. Why have these efforts—along with the safety modifications offered by manufacturers—failed to decrease pediatric lawnmower injuries? What can be done to more-effectively reach parents and caregivers with a safety message that conveys the horrific lifelong consequences of a child injured by a lawnmower?
The message is clear: We need more-effective public safety advocacy to protect our children from severe, preventable injuries. Physicians should take an active role in getting the message out by contacting local media when these accidents happen or, even better, prior to them happening. Advocacy at a local level, perhaps coinciding with the publication of reports such as this one by Armstrong and his team, may go a long way toward embracing our important role in public health.
Legislative action, such as restricting lawnmower use to individuals above a certain age, may help, but mowing a lawn is a rite of passage for many American teenagers, so recommending age guidelines along with better training for youth prior to operating these machines would likely be better accepted by the public than an age restriction.
As a specialty, we must not turn our backs on the vexing problem of preventable orthopaedic injuries. We are on the front line treating these injuries; we must also be on the front line of preventing them.
Join me in the Take-5 interview that follows with senior author Douglas G. Armstrong MD as we take a critical and fresh look at the best ways to deliver public-safety campaigns to protect our children from lawnmower and other serious, preventable injuries.
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