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Shopping Cart–Related Injuries to Children

An estimated 24200 children younger than 15 years, 20700 (85%) of whom were younger than 5 years, were treated in US hospital emergency departments in 2005 for shopping cart–related injuries. Approximately 4% of shopping cart–related injuries to children younger than 15 years require admission to the hospital. Injuries to the head and neck represent three fourths of all injuries. Fractures account for 45% of all hospitalizations. Deaths have occurred from falls from shopping carts and cart tip-overs. Falls are the most common mechanism of injury and account for more than half of injuries associated with shopping carts. Cart tip-overs are the second most common mechanism, responsible for up to one fourth of injuries and almost 40% of shopping cart–related injuries among children younger than 2 years. Public-awareness initiatives, education programs, and parental supervision, although important, are not enough to prevent these injuries effectively. European Standard EN 1929-1:1998 and joint Australian/New Zealand Standard AS/NZS 3847.1:1999 specify requirements for the construction, performance, testing, and safety of shopping carts and have been implemented as national standards in 21 countries. A US performance standard for shopping carts (ASTM [American Society for Testing and Materials] F2372-04) was established in July 2004; however, it does not adequately address falls and cart tip-overs, which are the leading mechanisms of shopping cart–related injuries to children. The current US standard for shopping carts should be revised to include clear and effective performance criteria for shopping cart child-restraint systems and cart stability to prevent falls from carts and cart tip-overs. This is imperative to decrease the number and severity of shopping cart–related injuries to children. Recommendations from the American Academy of Pediatrics regarding prevention of shopping cart–related injuries are included in the accompanying policy statement.