Preventing Child Deaths in Hot Cars

In 1995, EDC’s Anara Guard received a phone call from a federal clearinghouse on child abuse about the death by hyperthermia of a child left in a car. The caller wanted to know how often such accidents happened. “I told them I’d find out and get back to them,” Guard says. “I’ve been finding out ever since.”

Guard took a special interest in what she and other public health researchers believe is an underreported—and preventable—childhood injury and fatality problem. She presented her insights at a National Highway Traffic Safety Administration (NHTSA) meeting in Sacramento last summer. This past April, NHTSA announced a public awareness campaign called “Where’s baby? Look before you lock” to help parents and other caregivers prevent these tragic accidents.

Q: How do children accidentally get left in hot cars?

Guard: We can reliably predict that 35 to 40 children will die this summer in oven-hot cars. Though each case is unique, such tragedies are preventable through a combination of measures. EDC conducted a national study examining 171 heat stroke deaths from 1995 through 2002. We found that nearly 39 percent were attributed to a parent or caregiver’s forgetfulness, and another 27 percent were the result of unattended children playing in unlocked vehicles.

Q: What factors contribute to these accidents?

Guard: People think, “This can never happen to me.” But when there’s a change in daily routine, as often happens during a summer schedule, or during large gatherings such as family celebrations, this tragedy can happen. People look at these incidents as “freak accidents,” but when you examine the patterns over time, there are similarities. Circumstances contributing to children dying in hot vehicles include inadequate adult supervision, poor communication between parents and caregivers, drug and alcohol abuse, motor vehicle design, and parents’ sleep deprivation.

Many states have passed laws making it a traffic offense to leave children unattended, modeled on child passenger safety laws. That’s a step in the right direction as far as policy change. We’re also seeing more developments in technology, such as “smart” car seats that activate an alarm if the child is left in the car seat while the car is not in motion. Requirements for daycare providers to notify parents if a child doesn’t show up could also save lives. We need to do more.

Q: What else can be done?

This problem—like other traffic safety and injury prevention problems—is amenable to a public health approach: define the problem, identify causes, develop and test interventions, implement them, and evaluate the results. We need to engage stakeholders from the domains of child neglect, childcare, pediatrics, vehicle design, alcohol and drug prevention, and more.

When I was growing up, kids occasionally suffocated in abandoned refrigerators and freezers . A combination of laws, refrigerator design change, and education that led to changes in consumer behavior have eradicated this type of accidental death. Now everyone knows to remove the doors from their discarded refrigerators. Hot cars are the abandoned refrigerators of our time. The NHTSA public awareness campaign is a good first step to eliminating this cause of death.