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The epidemiology of lawn trimmer injuries in the United States: 2000-2009
Abstract
Yard maintenance equipment is potentially dangerous, and some of the more frequency used equipment (e.g., lawn mowers) has been extensively studied. However, the extent of lawn trimmers as a source of injury has not previously been explored.
Data from the Consumer Product Safety Commission's National Electronic Injury Surveillance System were used to estimate the number of patients treated in U.S. emergency departments for lawn trimmer-related injuries. Injury rates were calculated according to age, sex, and race, and characteristics of the injury event were determined.
An estimated 81,907 injuries involving a lawn trimmer occurred from 2000-2009. The incidence generally increased over time. Men, people aged 40-49, and Caucasians were the groups most likely to be injured. The most commonly injured body part was the head, specifically the eye, accounting for 42.5% of the injuries. Contusions and abrasions were the most common type of injury to the head, but lacerations were the most common injury to the extremities, and strains/sprains were the most common injury to the trunk.
Although previous research on lawn trimmers has focused exclusively on injuries to the eyes, the results of the current study show that such injuries are one component of the problem. Because most of the injuries were due to foreign objects, it is important that the use of adequate safety gear be emphasized when operating lawn trimmers.
Results suggest that lawn trimmer design changes and better safety education for trimmer use can reduce the rate of injury and reverse the current trend.
... The differences may be partly attributed to differences in native culture, socioeconomic status, and lifestyles of populations in each region. Grass-trimmer-related injuries and projectile impacts have also been described in previous reports [27][28][29]. Eye injuries were frequently documented in the incidences related to these devices [28]. ...
... Grass-trimmer-related injuries and projectile impacts have also been described in previous reports [27][28][29]. Eye injuries were frequently documented in the incidences related to these devices [28]. Therefore, further education on the potential risk of IOFB while engaging in activities such as using metal-on-metal equipment or others that could generate high velocity projectile objects should be emphasized. ...
Introduction
Retained intraocular foreign body (IOFB) remains an important cause of acquired visual impairment. The visual prognosis following treatments for eyes with retained IOFB was observed to be distinct from other mechanisms of open globe injury due to the specific nature and associated circumstances. This study evaluated the risk behaviors, visual results, and predictive values of Ocular Trauma Score (OTS) in determining visual outcomes in patients with IOFB that were not related to terrorism.
Methods
Medical records of patients who underwent surgical interventions between January 2015 and December 2020 were retrospectively reviewed.
Results
A total of one hundred and sixty-one patients (162 eyes) were recruited. The patients had a mean (standard deviation) age of 47.6 (14.0) years with working male predominance (93.2%). The majority of patients were injured by activities related to grass trimming (63.4%) and metallic objects were the main materials causing injuries (75.7%). Following treatments, the proportion of eyes having vision worse than 20/400 decreased from 126 eyes (77.8%) to 55 eyes (33.9%) at final visit. Ocular trauma score (OTS) had a high potential prediction for final vision in eyes in OTS categories 4 and 5. However, the discordance of final visual acuity distribution was observed in some subgroups of eyes in OTS categories 1 to 3.
Conclusion
This study highlights the significance of IOFB related eye injuries in a tertiary care setting. Decision making on treatments should be carefully considered, particularly in eyes in lower OTS categories, in light of a rise in the proportion of patients who experience improved vision after IOFB removal.
... There are many phenomena occurring in the environment, which may have a negative influence on the human body [1][2][3][4][5][6]. The use of machines and devices, additionally influences on the growth of danger of our health owing to the emission of vibration and noise, which occurs during work [5][6][7][8][9][10][11]. ...
... As the example of very popular domestic device, which uses this type of drive we can take lawnmowers. The big number of lawnmowers and the extended time of their use make [10][11], that the vibration and noise are more dangerous for the environment and the operator. ...
The study presents the important issue of the noise emission, generated by single-cylinder internal combustion engine constructions. This type of engine is used in drives of different types of machines and devices, including transport machines. In the study, the measurements and results analysis were conducted, which aim was to estimate the influence of the engine capacity, their power and the change of the technical condition on the generated noise. The researches of exemplary lawnmowers, equipped in this type of drive, showed the reduction of the sound level, together with the increase of the engines capacity and power decrease, and the increase of the noise (a few decibels) caused by the change of the technical condition during the operation.
... Since most graves are located in the mountains, lawn trimmers are preferred over lawnmowers. Lawn trimmers lack extensive shielding, increasing the probability of ejected debris hitting the operators, which together possibly increases the incidence of ocular and periocular injuries [25]. A single center-based ocular injury study conducted in the Republic of Korea has revealed that most open-globe injuries are associated with weedcutting on Korean Thanksgiving Day in the autumn season, which conforms to our current findings [26]. ...
... Since most graves are located in the mountains, lawn trimmers are preferred over lawnmowers. Lawn trimmers lack extensive shielding, increasing the probability of ejected debris hitting the operators, which together possibly increases the incidence of ocular and periocular injuries [25]. A single center-based ocular injury study conducted in the Republic of Korea has revealed that most open-globe injuries are associated with weedcutting on Korean Thanksgiving Day in the autumn season, which conforms to our current findings [26]. ...
... Since most graves are located in the mountains, lawn trimmers are preferred over lawnmowers. Lawn trimmers lack extensive shielding, increasing the probability of ejected debris hitting the operators, which together possibly increases the incidence of ocular and periocular injuries [25]. A single center-based ocular injury study conducted in the Republic of Korea has revealed that most open-globe injuries are associated with weedcutting on Korean Thanksgiving Day in the autumn season, which conforms to our current findings [26]. ...
In an aging society, the annual frequency of older adult patients with ocular and periocular injuries has consistently increased. We aimed to identify the epidemiological characteristics and factors associated with severe ocular and periocular injuries in older adult patients. This retrospective, multicenter study was conducted using the regional eye injury registry of four tertiary teaching hospitals at a single metropolitan city in the Republic of Korea from August 2016 to December 2020. We enrolled adult patients aged ≥65 years and classified them as having severe or mild eye injuries. Next, we compared the epidemiological characteristics of the two study groups and determined the risk factors associated with severe eye injury through logistic regression analyses. Of the 1185 older adult patients, 279 (23.5%) had severe eye injuries. Males comprised most (823, 69.5%) of the study population. The most common location wherein the injury occurred was the street/highway for men and the home for women. Fall was the most common causative activity; however, farm work or mowing predominated as reasons for men and home activity for women. Multivariable logistic regression analysis revealed that male sex (adjusted odds ratio (aOR): 1.91, 95% confidence interval (95% CI): 1.34–2.77), 70–74 years (aOR: 1.49, 95% CI: 1.05–2.11), hammering/nailing (aOR: 5.84, 95%CI: 1.71–21.75), and mowing (aOR: 2.51, 95% CI: 1.04–6.60) acted as risk factors for severe eye injury. In conclusion, older adult patients with ocular and periocular injuries occurred more commonly among men, and the most common causative activity of injury was a fall. Severe eye injury tended to occur in men aged 70–74 years while performing hammering/nailing and mowing activities.
... The younger geriatric age groups were also more likely to experience ocular injury with sports-related products. This may be explained by younger patients performing more physical activity and physical work/labor requiring tools due to better fitness and coordination [20]. The age group distribution may also be influenced by other factors, such as sex at birth; for example, a study by Kamboj et al. found that the ratio of females to males reporting ocular exposure to cleaning products increased with age [21]. ...
The purpose of this study was to assess trends in consumer-product-related geriatric ocular injuries using National Electronic Injury Surveillance System (NEISS) data. Understanding the specific consumer products and settings coded in the NEISS dictionary that contribute to geriatric (≥ 65 years) ocular injuries, along with changing patterns during events like the COVID-19 pandemic, provides crucial insights for tailoring therapy and preventative strategies. This ultimately may reduce the burden of eye injuries on both older adults and healthcare systems.
This was a retrospective population-based cohort study. The NEISS database was used to study eye injuries in geriatric adults from 2010 to 2021. Patients were categorized by age groups (65–74, 75–84, 85–94, ≥ 95 years), and data on demographics, injury types, product categories, and COVID-19 impact were collected. Pearson’s chi-squared test (with p < 0.001 taken to indicate significance) was used to assess differences in expected ratios between age groups.
A total of 168,685 eye injury cases in adults aged 65 years and older were analyzed. Household items, tools, and gardening products accounted for over 75% of injuries. Most injuries occurred at home (65.3%). Contusions/abrasions (40.3%) and a foreign body (19.3%) were common diagnoses. Females had more household-item-related injuries, while males had more foreign body injuries. Regarding therapeutic disposition, 93.7% of all injuries were treated/examined and released, which showed a decreasing trend as age increased, while hospital admission/transfer rates increased with age. Compared to before COVID-19, the percentage of injuries during COVID-19 due to tools decreased (from 22.5% to 18.3%), while injuries due to gardening/lawn/landscaping/patio products increased (from 13.8% to 15.3%).
Our study characterizes geriatric ocular injuries and COVID-19 impact, highlighting common products and locations. Different age groups showed different injury patterns. Understanding these trends can aid injury prevention strategies for consumers and healthcare providers. Demographics and injury frequencies differed based on age and sex. Future research should further explore post-COVID-19 trends.
... In cases of lawn mower injuries, the most frequently injured body part is the hand/finger, followed by the lower extremity, with the head/neck being the least frequently injured. 1 By contrast, the head, specifically the eye, was the most frequently injured body part when using a lawn trimmer. 2 Open-globe injuries are encountered more frequently while operating lawn trimmers than other industrial tools, owing to the material from the blade or ground accidentally shooting toward the eye at high speeds, leading to devastating injuries of the eye. ...
Purpose:
Work-related ocular trauma remains the leading cause of unilateral visual impairment worldwide. Many preventable work-related ocular injuries continue to occur, even at home. This study describes the characteristics, surgical techniques, and prognostic factors of lawn trimmer-related open-globe injuries in eastern Taiwan.
Methods:
This was a retrospective, consecutive case series study. Slit-lamp biomicroscopy, dilated fundoscopy, and orbital computed tomography (CT) images were collected.
Results:
Twenty-six eyes of 26 patients were enrolled in the study. Fifteen patients (57.7%) had an intraocular foreign body (IOFB). The IOFB was metallic in 13 cases and glass and stone in the other 2 cases. Seven IOFBs (46.7%) were retained in the anterior chamber, 7 (46.7%) in the posterior segment, and 1 (6.7%) in the intraconal space. Univariate analysis showed that the presence of IOFB trended toward the development of endophthalmitis; however, this was not statistically significant (hazard ratio, 2.25; 95% confidence interval 0.35-14.61; P = 0.658). Eleven patients had metallic IOFBs noted on CT scans with metal artifacts, whereas two patients had small metallic IOFBs without metal artifacts. One patient had a glass IOFB mimicking metal artifacts on the CT scan. In one case, CT failed to reveal the IOFB, and an intralenticular metallic foreign body was incidentally found intraoperatively.
Conclusion:
Our study provides a broad characterization of lawn trimmer-related open-globe injuries. The informative and diverse findings of IOFBs on CT scans will help clinicians detect and recognize IOFBs more precisely and perform the surgery without causing further damage.
... Chen et al. (2012) studied the tendency of accidents in China's coal mines and the characteristics of human factors. Leinert et al. (2012) investigated the epidemiology of lawn trimmer injuries in the United States during 2000-2009. Empirical studies also confirmed a longitudinal association between the business cycle and workplace injury at national level (e.g., Boone and van Ours, 2006;Song et al., 2011) and industrial level (e.g., Asfaw et al., 2011;Davies et al., 2009). ...
Objective
The aim of the study is to present four cases of lawn mowers injuries as a cause of serious visual acuity impairment.
Material and Methods
A retrospective study of four patients admitted in 2013–2015 to the Department of Vitreoretinal Surgery in Lublin with severe open or closed globe injury, one with an intraocular foreign body (IOFB). The presence of eye protective equipment was assessed, as well as visual acuity, eye tissue condition before and after treatment, and applied therapy.
Results
In all cases an improvement was achieved in local conditions. The intraocular foreign body was removed, wounds sutured and damaged tissues placed in position. All eyeballs were saved. In three cases, visual acuity was improved to a usable level. Three patients underwent pars plana vitrectomy, one with IOFB removal from the vitreous cavity.
Conclusions
Lawn mower induced eye injuries are a significant cause of serious visual acuity impairment or blindness. The presented study shows that lawn mower eye injuries are still a therapeutic, social and economic problem, yet are very preventable with proper eye protection and patients’ education. Current prevention strategies are inadequate, and therefore should be updated.
Objectives/hypothesis:
As our population ages, injuries attributable to falls continue to increase, impacting healthcare delivery. Evaluation of craniofacial trauma with focus on elderly patients remains an underappreciated concern. Our objectives were to evaluate injury trends associated with elderly bathroom falls, as this information may be useful for counseling and preventive purposes.
Study design:
Database review.
Methods:
The National Electronic Injury Surveillance System was evaluated for craniofacial trauma among patients 60 years and older presenting to the emergency department (ED) (2010-2014). Injury descriptions were reviewed for mechanism of injury, patient demographics, and other injury characteristics.
Results:
In total, 7.2% of the estimated 3.4 million ED visits for elderly craniofacial trauma were bathroom related. Females comprised the majority (60.9%) of patients, and a plurality of patients were in their 80s. A greater proportion of facial injuries resulted from syncope (16.6% vs. 10.9% compared to head injuries). Toilets facilitated a greater proportion of facial insults and were more likely to require admission; the most common mechanism was "falling off." Showers contributed a majority of head injuries and had a lower median age than toilet injuries. Fractures comprised 12.6% of facial injuries; of craniofacial fractures, common sites included the nose (54%), mandible (6%), and orbit (6%). Admitted patients were significantly older than those who were released.
Conclusions:
Bathroom falls result in a significant proportion of elderly traumatic injury. The trends we present offer the opportunity for targeted preventative measures to decrease the occurrence of these events. Additionally, this information may adjunct a detailed history and physical to ensure appropriate patient management.
Level of evidence:
4 Laryngoscope, 2016.
Purpose: This study was aimed to determine demographics, clinical characteristics, and factors associated with work-related eye injury in Northern Thailand. Design: A prospective case series. Methods: Eye injuries from any cause treated at a university-based hospital in Northern Thailand from March 2007 to June 2008 were included. In addition to comprehensive eye examination and standard treatments, patients' occupation, type of activity at the time of injury, alcohol consumption, and eye protection were studied. Eye injuries were classified based on the Birmingham Eye Trauma Terminology System. Demographic and clinical data were documented using a form adapted from the United States Eye Injury Registry. Results: Of the 101 eyes (97 patients) with work-related injury, 94% were men with a mean age of 39.5 +/- 12.9 years (range, 19-72 years). Ninety-eight percent (95/97 patients) did not use protective eyewear. Open-globe injuries were found in 58/101 (57%) eyes. Agricultural workers experienced a higher number of open-globe injuries (37/58 eyes, 64%), whereas construction workers experienced a higher number of closed-globe injuries (25/43 eyes, 58%). In multivariable logistic regression models, nailing (odds ratio, 97.2; 95% confidence interval, 2.6-363.4; P = 0.01) and motorized grass trimming (odds ratio, 14.3; 95% confidence interval, 1.0-206.2; P = 0.05) were significantly associated with open-globe injuries when compared with closed-globe injuries. Significantly greater numbers of eyes with open-globe injuries had final vision equivalent to legal blindness (visual acuity, <3/60) compared with closed-globe injuries (42% vs 12%, P = 0.001). Conclusions: Work-related open-globe injuries are relatively more common among agricultural workers in Northern Thailand. Protective eyewear should be aggressively promoted among workers engaged in nailing and motorized grass trimming.
Nylon line grass trimmers are commonplace in America's lawn armamentarium. As their number has increased, so has the potential for ocular injury from objects thrown from these tools. A patient of ours was injured by an intraocular piece of nylon line thrown from one of these tools. The patient required removal of the foreign body, lensectomy, and anterior vitrectomy to rehabilitate her eye. This report again demonstrates the need for eye protection when using any type of lawn equipment. We think manufacturers of these products should label them to show that eye protection is necessary for the safe use of these tools.
To examine injuries among patients treated in an emergency department (ED) related to the use of a riding lawn mower.
Data were obtained from the National Electronic Injury Surveillance System for the years 2002-2007. National estimates of ED visits for injuries associated with the use of a riding lawn mower were analyzed. Narrative text entries were categorized to provide a detailed record of the circumstances precipitating the injury. Average annual rates were calculated and logistic regression analyses were employed to determine risk estimates for patient disposition and demographic characteristics related to ED visits for injuries associated with riding mowers.
From 2002 through 2007, there were an estimated 66,341 ED visits for injuries related to the use of riding lawnmowers in the U.S., with an average annual rate of 6.0 ED visits per 100,000 males, and 1.6 ED visits per 100,000 females. Older adults had higher rates of ED visits for injuries (7.2/100,000) than younger age groups. The most common injuries involved contusions (24%); sprains/strains (22%) and fractures (17%). The majority of patients (90%) were treated and released the same day. Results of logistic regression analyses revealed that older adults were more likely to be hospitalized when compared to younger age groups; and incidents involving rollovers [OR=5.45 (95% CI=3.22-9.23)] and being run over [6.01 (95% CI 3.23-11.17)] were more likely to result in hospitalization when compared to all other circumstances of injury.
Riding mowers present injury patterns and circumstances that are different than those reported for push mowers. Circumstances related to injuries and age groups affected were varied, making prevention of riding mower injuries challenging. APPLICATION/IMPACT: Findings support the need to increase awareness and/or change the design of riding mowers with respect to risk of rollover injuries.
Ocular trauma from nylon line lawn trimmers is becoming more prevalent. Previous case reports have described penetrating trauma caused by these tools. We managed three cases of fungal keratitis caused by injuries from nylon line trimmers. Fungal keratitis should be strongly considered as the cause of any corneal ulcer related to trauma from a nylon line lawn trimmer.
Nylon line lawn trimmers represent a source of potentially devastating ocular trauma. Five cases of ocular trauma associated with the use of line trimmers are reported. These case reports document new mechanisms and circumstances of injury, including trauma from debris other than nylon line fragments and injury to bystanders. Furthermore, injuries are often serious, with two of these patients requiring an evisceration or enucleation after endophthalmitis developed. In one patient, six different organisms were cultured and another patient exhibited an Aspergillus organism and Propionibacterium acnes. As nylon trimmers gain in popularity, they will become an increasingly frequent source of ocular injury. A retrospective 40-month review of 85 cases (87 eyes) of penetrating and perforating ocular trauma shows line trimmers to be the fifth leading cause of such injury.
A 58-year-old man sustained a penetrating injury in the left eye from a nylon cord fragment from an electric rotary weed trimmer. Repair of the corneal laceration, foreign body extraction, and anterior vitrectomy were performed. One year post injury the visual acuity was stable at 6/60. The need for protective eyewear when using power tools is emphasized.
We update the epidemiology of lawnmower injuries, together with leading mechanisms of lawnmower injury in the United States, for the entire age range by using nationally representative data.
Data were obtained from the National Hospital Discharge Survey 1996-2003 and the National Electronic Injury Surveillance System 1996-2004.
Individuals in the 60- to 69-year age group had the highest push mower injury incidence in 2004, whereas those in the 70 years and older age group had the highest riding mower injury incidence. Children younger than 15 years also had a substantial injury incidence. Individuals in the 15- to 19-year age group had the highest rate of hospitalizations caused by lawnmower injuries from 1996 through 2003, with 0.72 per 100,000 person-years (95% confidence interval 0.07 to 1.36). Debris from under the mower hitting a body part or entering the eye was the most common mechanism for lawnmower injury. The second most common mechanism of injury was nonspecific pain onset after the ordinary operation of the mower. Fracture of 1 or more phalanges of the foot was the most common diagnosis among lawnmower injury hospitalizations, with 34.4%, followed by traumatic amputation of the toe, with 32.4%. There is an increasing trend of lawnmower injuries in the United States during the last 9 years.
Lawnmower injuries increase with age, with peaks in persons older than 59 years. Given the high incidence of projectile-related injuries, improved protective apparel and eyewear could lower the rate of injury for all age groups. The increasing trend of lawnmower injuries in the United States suggests that more must be done to prevent lawnmower injuries.
Our objective for this study was to describe the epidemiology of lawn mower-related injuries among children in the United States.
A retrospective analysis was conducted of data from children who were 20 years and younger in the National Electronic Injury Surveillance System of the United States Consumer Product Safety Commission for 1990-2004.
There were an estimated 140700 lawn mower-related injuries to children who were 20 years and younger and treated in hospital emergency departments in the United States during the 15-year period of 1990-2004. This yielded an average of 9400 injuries annually, or 11.1 injuries per 100000 US children per year. The mean age was 10.7 (SD: 6.0) years, and 78% were boys. The leading type of lawn mower-related injury sustained by patients was a laceration (41.2%), followed by soft tissue injury (21.4%), burn (15.5%), and fracture (10.3%). The most common body region injured was the hand/finger (34.6%), followed by lower extremity (18.9%) and foot/toe (17.7%). The eyeball/face and upper extremity accounted for 10.6% and 7.4% of injuries, respectively. Burns accounted for 34.5% of injuries to the hand/finger compared with 5.5% to other body regions. Ninety-seven percent of amputation injuries occurred to the foot/toe (49.5%) and hand/finger (47.5%) compared with 3% of amputations to other body regions. Burns accounted for 41.8% of injuries among children who were < or = 5 years of age compared with 6.5% of injuries to children who were older than 5 years. Foreign body injuries accounted for 4.8% of injuries among children who were > or = 12 years of age compared with 1.6% of injuries to children who were younger than 12 years. Amputations (31.9%), lacerations (28.8%), and fractures (26.0%) accounted for almost 87% of injuries among children who were admitted or transferred to another hospital. In contrast, lacerations (42.3%), soft tissue injuries (23.3%), and burns (16.9%) predominated among children who were treated and released to home from the emergency department. Children with amputations were more likely to be admitted than children with other types of injury.
Injuries related to lawn mowers are an important cause of pediatric morbidity. The relative consistency of the number of lawn mower-related injuries to children during the 15-year study period is evidence that current prevention strategies are inadequate. Passive protection that is provided by safer product design is the strategy with the highest likelihood of success in preventing these ongoing injuries. The lawn mower voluntary safety standard American National Standards Institute/Outdoor Power Equipment Institute B71.1-2003 should be revised to include more rigorous performance provisions regarding prevention of penetration of feet and toes under the mower and into the path of the blades, shielding of hot mower parts from access by young children, and equipping all ride-on lawn mowers with a no-mow-in-reverse default feature with location of its override switch behind the seating position of the ride-on mower operator. By locating the no-mow-in-reverse override switch behind the ride-on mower operator, the operator would be required to look behind the mower before mowing in reverse.