US academy warns of risks from shopping trolleys

BMJ 2006; 333 doi: (Published 17 August 2006) Cite this as: BMJ 2006;333:369
  1. Doug Kamerow
  1. Washington, DC

    More than 24 000 children in the United States were treated in hospital emergency departments in 2005 as a result of injuries from shopping trolleys, say a policy statement and technical report in the August issue of Pediatrics (2006;118:825-7 and

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    Seats for children are often at the highest point of the shopping trolley—maximising the distance in the event of a fall


    Eighty five per cent of injured children were under 5 years old, and the most common injury sites were the head and neck, says the report, by the American Academy of Pediatrics' injury, violence, and poison prevention committee. Fractures were the most common cause of admissions related to trolleys.

    Falls from trolleys and trolleys tipping over are responsible for over 80% of injuries related to trolleys. Most trolleys are designed to hold children in the highest point of the trolley, which maximises the distance of any potential fall, says the report. Most trolleys have child lap restraints, but these are rarely used and may be ineffective, it says. However, more than 80% of shoppers leave their children unattended at some time during a shopping trip, the authors say, adding that public education campaigns have not been effective in preventing these injuries.

    In the policy statement the academy recommended that stores should increase the safety of their trolleys and adopt other safety strategies for young children. It suggested that parents should not bring young children on shopping trips unless a second adult was available to supervise them. If that is not possible, parents should use buggies, put their children in low level, four wheel wagons, or use baby carriers in which the child is held in a pack against the chest. Some stores offer special trolleys with buggy-like attachments at the front that are low to the ground and safer.

    In addition, the association recommended that healthcare professionals should educate their patients about the risks of sitting their children in shopping trolleys. They also urged that manufacturing standards be revised to include guidance on child restraints and trolley stability and that the US Consumer Product Safety Commission should monitor and enforce the standards.

    Bill Greer, a spokesman for the US supermarket industry, said that customer safety was important to supermarkets but that the design and safety of trolleys need to be tackled by the manufacturers.

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