The December 2019 death of two toddlers in a hot car highlights the danger posed by heated enclosures to children as we head into summer. Despite the collective grief following this tragedy, it’s unlikely to be the last case of vehicular infant heat stroke this season. While the annual number of Australian hot car infant deaths is not available, KidsAndCars.org, the US-based advocacy group, has tracked 53 US hot car infant deaths so far in 2019, second only to the 54 deaths reported in 2018. Since 1998, over 800 children have died in hot cars according to the National Safety Council (USA), with these fatalities on the rise. The frequency of these deaths has contributed to the phrase of 'Forgotten Baby Syndrome'.
The obvious question is “how can this happen so frequently?” or as posed by University of South Florida's Professor David Diamond “How can loving and attentive parents, with no evidence of substance abuse or an organic brain disorder, have a catastrophic lapse of memory that places a child’s welfare in jeopardy? In his recent paper addressing the question, Prof. Diamond identified that loss of awareness of a child in a car is a failure of prospective memory, that is, failure to remember to execute a plan in the future. He summarised the factors that contribute to prospective memory failure in the figure below.
It could be argued that the majority of these causes are considered part of everyday life, and as such, reversing their contribution would be challenging. So, what can be done to prevent these tragedies? Guard and Gallagher concluded from their analysis of 171 infant hot car deaths that prevention could have been achieved by:
keeping cars locked
educating parents (Australian government online resources)
implementing informed childcare transportation policies
passing relevant laws (Currently vary between states - up to $36K fine/10yrs prison)
working with auto and child safety seat manufacturers to build in warnings and other design features.
Combining the factors of Figure 1 and the above prevention strategies, the provision of a reminder cue could prove to be the most effective. In early November, Italy legislated the use of car seat safety devices that alert drivers when a child has been left in the vehicle for infants under 4 years of age. Parents that do not utilise the devices are fined and lose points on their licence for the initial offence, and a 15-day loss of licence for a second breach. Other countries are likely to follow the Italian lead with the Hot Cars Act of 2019 currently under consideration by US politicians.
We urge Australian legislators to review current safety guidelines in an effort to prevent a repeat of last Decembers tragedy.
References
Diamond DM (2019). When a child dies of heatstroke after a parent or caretaker unknowingly leaves the child in a car: How does it happen and is it a crime? Medicine, Science and the Law 59(2):115-126.
Guard A, Gallagher SS (2005). Heat related deaths to young children in parked cars: an analysis of 171 fatalities in the United States, 1995-2002. Injury Prevention 11(1):33-7.