Child vehicular heat stroke deaths

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Children left in cars can die of heat stroke; when this is the result of a caregiver inadvertently leaving them in the car, this is sometimes termed forgotten baby syndrome or fatal distraction. Incidents have occurred in multiple countries. In Italy and Israel, laws have been passed to help prevent such incidents.

Contents

Background

Child in a rear-facing car seat in the front passenger seat, beside the driver Rear-facing infant car seat.jpg
Child in a rear-facing car seat in the front passenger seat, beside the driver
Child asleep in a rear-facing car seat behind the driver's seat, likely not visible to the driver SAKIKO is sleeping peacefully! (30736591845).jpg
Child asleep in a rear-facing car seat behind the driver's seat, likely not visible to the driver

Until the 1970s, child passenger safety was not a focus of legislation or a concern for manufacturers in the US. In the 1980s, states began to develop child-safety laws. In the 1990s, the Academy of Pediatrics and the National Highway Institute created child-passenger safety guidelines which included requiring children under a certain age or weight be in a car seat. Most car seats for babies were rear-facing seats that could be strapped into the front passenger seat, which meant a parent or caregiver was constantly aware of the child's presence in the seat. In the mid-1990s, concerns developed about the safety of rear-facing car seats when airbags deployed, and the recommendations changed to placing all car seats into the back seat. For rear-facing car seats in particular, this meant that a parent would see the same thing -- the back of a car seat -- from the driver's seat, whether that car seat had a child in it or not. [1] : 76  [2]

According to Erika Breitfeld, writing in the Berkeley Journal of Criminal Law, "Amplifying the problem, children frequently fall asleep during car rides...Not surprisingly, more than half of the children who die from vehicular heatstroke are under the age of two and in rear-facing car seats." Breitfeld's 2020 analysis concluded that "more children died from hyperthermia than ever died due to front-seat airbags" and that there was a direct correlation between the recommendations to place rear-facing child seats into back seats and children being inadvertently left in cars. [1] : 76 

Causes

Each year, around the world, dozens of children die of vehicle-related hyperthermia. [3] Because these numbers began to rise after the popularization of air bags [4] : 7  and rear-facing child safety seats, [1] : 76  researchers began to suspect that memory may be the culprit. [5] According to Consumer Reports , inadvertently leaving a child in a car could happen to any parent or caregiver. [6]

According to David M. Diamond, a psychology professor at the University of South Florida who has been studying the phenomenon since 2004, the phenomenon is a consequence of tension between the brain's habit-memory and prospective-memory systems, [7] which is resolved when basal ganglia "habit memory" suppresses the "prospective memory" system of the hippocampus and the prefrontal cortex, [1] : 78, 83  [8] [9] resulting in a false memory and what he calls "autopilot". [8] [9] [10] Other psychologists have suggested the phenomenon is functionally similar to forgetting keys in a car [11] or forgetting to post a letter. [12]

Diamond has identified "stress, sleep deprivation, and change in routine" as common causes. [9] Almost inevitably a child requiring a rear-facing child seat represents a change in routine for its caregivers. It also almost inevitably represents stress and sleep deprivation for the same reasons.[ citation needed ] Stephen Cowen, a psychology professor at the University of Arizona, has said that stress can render a person "more attentive to the immediate sensory stimuli or threats in your environment but not as attentive to your more distant memory of leaving your children in the car". [13]

Public reactions

According to Safe Kids Worldwide, nearly 1 in 4 parents admit to having forgotten a child three and under was in the car with them. [14] According to Diamond, over 25% of parents with children under 3 have lost awareness of the child being present in the car at some point during a drive; [1] : 77  however many people believe they themselves could not forget a child in the car with them. [15] [8]

Typical reactions from those hearing about such incidents are condemnation of the parent or caregiver, suspicion of their motives, and a belief that a competent and loving parent or caregiver could never forget they had a child in the car with them. [1] Ed Hickling, a clinical psychologist, theorizes that people want to believe bad things do not happen to good people, and that the universe or that a just God would not allow such horrific things to happen. [15] According to Breitfeld, "we have a visceral response to blame someone". [1] : 92 

Prevention efforts

In 2019 Italy required all child car seats be equipped with an alarm. [16] In 2021 Israel enacted laws requiring such safety systems be installed in . [17]

There are multiple products available that can help solve the problem through technology, including alarms that go off it a back door was opened before starting the car and isn't opened again after the car is turned off, car-seat alarms (which detect whether a child is buckled in), and end-of-trip reminders. [18] [19] [15] [20] Research suggests people won’t buy and use such products because they don't believe they could make such a mistake themselves. [13]

In 2001, General Motors announced that by 2004, all models would be equipped with sensors, but by 2020 that had not happened. [21] In 2019, the Association of Global Automakers and the Alliance of Automobile Manufacturers committed to the standardization of rear-seat-occupant alert systems by 2025. [22]

In the US, the Infrastructure Investment and Jobs Act included a mandate for action by the U.S. Department of Transportation to propose rules. The National Highway Traffic Safety Administration has estimated rules will be proposed in April 2025. [23]

Incidence

A study of Brazilian incidents examining 31 cases (including 21 fatalities) from 2006 to 2015 found that 71% of cases involved a parent inadvertently leaving a child in a car. [24] A study of Italian incidents found 8 vehicular-related hyperthermia deaths between 1998 and 2017. [25] A study of Indian cases found 40 fatalities from 2011 to 2020. [26] A study of Canadian incidents found one death per year, [27] with most being a result of being inadvertently left in the car. [18] Between 2008 and 2016, 23 children died in Israel of heat stroke in cars. [20] Between 2007-2009, there were 7 child deaths from heatstroke in France and Belgium. [28] In Australia as of 2023 there were an average of two incidents yearly. [29]

In the United States, around 38 children die annually after being left in vehicles. [30] [3] In 2018, 52 children died of hyperthermia in cars in the United States. [31] In 2024, 40 children died in the US. [32] In the US, more than half of deaths are due to caregivers inadvertently leaving the child in the car, and around a quarter happen when a child gets into a car without the caregiver's knowledge. [1] [2] [33] The remainder occur when a child is intentionally left in a car due to caregiver neglect or ignorance. [1] [2] [33]

Children are also rescued from cars, but the data is less clear in such instances. According to Kidsafe WA, approximately 5,000 children are rescued every year from cars in Australia. [29] According to the UK Automobile Association in 2016, they are called to get children out of cars an average of 7 times every day. [34]

Notable cases

References

  1. 1 2 3 4 5 6 7 8 9 Breitfeld, Erika (2020). "Hot-Car Deaths and Forgotten-Baby Syndrome: A Case Against Prosecution" (PDF). Berkeley Journal of Criminal Law. 25: 72–106.
  2. 1 2 3 Fleming, Alexandra Rockey (18 July 2024). "She Lost Her Husband and Toddler in Hot Car Tragedy. Now Virginia Mom Fights to Save Others (Exclusive)". People.com . Retrieved 19 March 2025.
  3. 1 2 Lee-Kelland, Richard; Finlay, Fiona (2019). "GP3 'Forgotten baby syndrome': a systematic review and analysis of caregiver intention" (PDF). Archives of Disease in Childhood. 104 (Suppl. 3). doi:10.1136/archdischild-2019-epa.69. S2CID   208413251.
  4. ↑ Forston, Jacob W.; Fradella, Henry F. (2022). "A Content Analysis of Criminal Cases Concerning Unattended Children in Vehicles Between 1990 and 2021: Empirically-Based Suggestions for Reform" (PDF). Chapman Law Review. 26: 1–55.
  5. ↑ Rudd, Rodney; Prasad, Aloke; Weston, Doug; Wietholter, Kedryn (July 2015). "Introduction and Background". Functional Assessment of Unattended Child Reminder Systems (PDF) (Report). National Highway Traffic Safety Administration. p. 2.
  6. ↑ "Be Careful: Research Shows That Anyone Could Forget a Kid in a Hot Car". Consumer Reports. 25 April 2024. Retrieved 19 March 2025.
  7. ↑ Pelletiere, Nicole (14 July 2016). "'Forgotten Baby Syndrome': A Parent's Nightmare of Hot Car Death". ABC News .
  8. 1 2 3 Rosenblatt, Kalhan (27 June 2017). "Hot Car Deaths: Scientists Detail Why Parents Forget Their Children". NBC News .
  9. 1 2 3 Thomas, Emily A. (18 August 2022). "Research Shows That Anyone Could Forget a Kid in a Hot Car". Consumer Reports .
  10. ↑ Groves, Anna (26 July 2018). "You say it could never happen, but it does. Here are the reasons infants are left in cars". Milwaukee Journal Sentinel .
  11. ↑ Minton, Leslie (24 May 2018). "Study: Hot cars can hit deadly temperatures in as little as one hour". Arizona State University .
  12. ↑ "Mother suffered 'forgotten baby syndrome', death inquest told". BBC News . 22 March 2017.
  13. 1 2 Purtill, Corinne (27 June 2017). "The neuroscience that explains the awful truth that anyone is capable of accidentally killing their child". Quartz .
  14. ↑ "NEW STUDY: 14% OF PARENTS SAY THEY HAVE LEFT A CHILD ALONE INSIDE PARKED VEHICLE DESPITE THE RISKS OF HEATSTROKE". Safe Kids Worldwide . Retrieved 20 March 2025.
  15. 1 2 3 Weingarten, Gene (8 March 2009). "Fatal Distraction: Forgetting a Child in the Backseat of aCar Is a Horrifying Mistake. Is It a Crime?" (PDF). Washington Post .
  16. ↑ "Italy: Fines for child seats without alarm signal". 24 April 2024.
  17. ↑ Stub, Zev (27 June 2021). "From August 1: Devices to prevent drivers from forgetting kids in cars". Jerusalem Post .
  18. 1 2 Roy, Lillian (22 August 2022). "'Forgotten baby syndrome' is more common than you think. Here's how technology can help". CTV News .
  19. ↑ Speck, Emilee (16 June 2022). "7 apps and smart technology designed to prevent heatstroke deaths in children". Fox Weather .
  20. 1 2 JTA. "For 5th time since May, Israeli child dies of heat in parked car". Times of Israel . Retrieved 20 March 2025.
  21. ↑ Lawrence, Eric D. (29 July 2020). "More vehicles are sitting parked during the coronavirus pandemic – and they're a risk to kids". USA Today . Retrieved 19 March 2025.
  22. ↑ Maddireddy, Mihir (5 September 2019). "Rear-Seat Occupant Alerts Will Be Standard on All Cars by 2025". Car and Driver .
  23. ↑ "Hot Cars: Federal Legislation & Technology". Kids and Car Safety. Retrieved 19 March 2025.
  24. ↑ Costa, Driely; Grundstein, Andrew (July 2016). "An Analysis of Children Left Unattended in Parked Motor Vehicles in Brazil". International Journal of Environmental Research and Public Health. 13 (7): 649. doi: 10.3390/ijerph13070649 . PMC   4962190 . PMID   27399747.
  25. ↑ Scozzari, Gitana; Bert, Fabrizio; Gualano, Maria R.; Siliquini, Roberta (February 2020). "Forgotten children in parked vehicles: a review of Italian fatalities". Minerva Pediatrica (in Italian). 72 (1): 55–59. doi:10.23736/S0026-4946.18.05125-3. PMID   29381013. S2CID   34039091.
  26. ↑ Siddiqui, Gulnaz Fatima; Singh, Mukesh Vir; Shrivastava, Anubha; Maurya, Manisha; Tripathi, Ambuj; Siddiqui, Shahid Akhtar (July 2021). "Children Left Unattended in Parked Vehicles in India: An Analysis of 40 Fatalities from 2011 to 2020". Journal of Tropical Pediatrics. 67 (3). doi:10.1093/tropej/fmaa075. PMID   32929468.
  27. ↑ Ho, Karen; Minhas, Ripudaman; Young, Elizabeth; Sgro, Michael; Huber, Joelene F. (April 2020). "Paediatric hyperthermia-related deaths while entrapped and unattended inside vehicles: The Canadian experience and anticipatory guidance for prevention". Paediatrics & Child Health. 25 (3): 143–148. doi:10.1093/pch/pxz087. PMC   7147705 . PMID   32296275.
  28. ↑ Geoghegan, Tom (21 July 2014). "Hot car deaths: The children left behind". BBC News . Retrieved 20 March 2025.
  29. 1 2 Kordic, Mya (12 September 2023). "Fatal distraction is a condition where children are forgotten in cars, and it can happen to anyone". ABC News . Retrieved 20 March 2025.
  30. ↑ Null, Jan (30 May 2023). "Heatstroke Deaths of Children in Vehicles" . Retrieved 6 June 2023.
  31. ↑ Stevenson, Chris (9 August 2019). "Their children died in hot cars – now they're fighting for legislation to stop it happening again". The Independent .
  32. ↑ "2024 Hot Car Deaths". Kids and Car Safety. Retrieved 19 March 2025.
  33. 1 2 "Technology in Vehicles Today". Kids and Car Safety. Retrieved 19 March 2025.
  34. ↑ Lancefield, Neil (15 July 2016). "Seven children in the UK are rescued from locked cars every day". The Independent . Retrieved 20 March 2025.
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