More than 20,000 children were treated in United States hospital emergency departments in 2005 for shopping cart-related injuries.

According to a study published in the August issue of Pediatrics and conducted by Gary Smith, MD, DrPH, director of the Center for Injury Research and Policy (CIRP) in the Columbus Children’s Research Institute at Columbus Children’s Hospital, it was found that an in-store safety intervention successfully increased the use of child safety-restraints in shopping carts.

This study looked at the effectiveness of an in-store intervention to increase the use of shopping cart restraints for children five years of age and younger.

The in-store intervention consisted of greeters at the store entrance who encouraged the use of appropriate shopping cart restraints, plus a cash incentive coupon. Three stores served as intervention sites, and four stores were non-intervention sites. Trained study personnel conducted the observations unobtrusively in all seven stores, recording the status of shopping cart restraint use as caregivers approached the store checkout areas.

The increase in safety-restraint use in shopping carts was greater in the intervention stores than in the control group of stores. In the intervention stores, the percentage of correct restraint use increased from 15% before the intervention to 49% after.

“The good news is that we were able to significantly increase restraint use by young children in shopping carts with a modest in-store intervention,” said Smith, the study author and a faculty member of The Ohio State University College of Medicine. “However, one-half of the children still remained unrestrained or incorrectly restrained despite our efforts.”

“Use of child restraints in shopping carts is only part of the solution to the problem of shopping cart-related injuries to children,” said Smith. “Shopping cart redesign to prevent falls and tipovers passively (or automatically), such as seating children close to the floor in a cart, offers the best protection against these injuries, because it obviates the need for frequent human action and vigilance. Unfortunately, the current safety standard for shopping carts in the U.S. does not adequately address the performance of cart restraint systems and does not address tipovers at all. This safety standard must be strengthened to effectively prevent these injuries.”

Four percent of the 20,700 U.S. children, who received treatment for a shopping cart-related injury in a hospital emergency department in 2005, required hospital admission. Fractures were the most common (45%) diagnosis of those hospitalized. Head and neck injuries accounted for 79% of the injuries requiring emergency treatment. Deaths have been reported from falls from shopping carts and cart tipovers.

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