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RECOMMENDATION ON THE PREVENTION OF LEAVING CHILDREN UNATTENDED IN MOTOR VEHICLES

 
THE CONSUMER SAFETY COMMISSION
HAVING REGARD TO the Consumer Code and specifically Articles L. 224-1, L. 224-4, R. 224-4 and R. 224-7 to R. 224-12
 
HAVING REGARD TO petition no. 09-014
 
Whereas,
 
I.       THE REFERRAL AND THE INQUIRY FOR THE RECOMMENDATION
 
A.      THE REFERRAL TO THE COMMISSION
 
In February 2009, the Minister of Sate for Industry and Consumer Affairs petitioned the Consumer Safety Commission to issue a recommendation on the prevention of children left unattended in motor vehicles. The request followed the receipt of a letter from Mr. and Mrs. B., the parents of a little girl who died of dehydration in July 2008 after her father had forgotten her in his car at the company car park for several hours. In the letter, the parents asked that the public authorities promote the installation of child occupancy detection systems in the back seats of motor vehicles, or make it compulsory to install said systems.
 
As a preliminary inquiry highlighted that these accidents were far from being infrequent in France, Europe and abroad, the Commission decided to issue a recommendation on the prevention of leaving children unattended in motor vehicles, as part of its mission to prevent everyday accidents, at its plenary session of 12 March 2009.

B.      THE INQUIRY
 
For the inquiry, the Commission interviewed several organisations to identify and detail the circumstances of the accidents involving children left unattended in parked motor vehicles (Institut de veille sanitaire, Institut National de Prévention et d'Éducation pour la Santé, Observatoire national interministériel de sécurité routière, Institut National de Recherche sur les Transports et leur Sécurité*, etc.).
 
For an update on the latest technologies, the commission assigned AUTO-INNOVATIONS to conduct a study on current technical systems, or potential systems that could prevent the risk of leaving a young child unattended in a motor vehicle.
 
Pursuant to Article L. 224-4 of the Consumer Code, the rapporteur heard the following professionals:
 
-    Dr. Catherine DOLTO, haptotherapist;
-    Dr. Anne GUILLAUME, LAB Director (Laboratoire Accidentologie et Biomécanique, Laboratory of Accidentology and Biomechanics);
-    Dr. Omar CARANTA, psychoanalyst;
-    Professor Stéphane RUSINEK, General Secretary, French Association of Behavioural Therapy (Association Française de Thérapie Comportementale);
-    Mr. François NONIN, Directorate for Traffic and Road Safety (Direction de la circulation et de la sécurité routière) ;
-    Mr. Pierre CHETCUTI, representing VOLVO;
-    Mr. Nicolas BECKER and Mr. Michel SCHOTMAN, representing PEUGEOT PSA;
-    Mr. Frédéric HAUSEMER, representing DOREL.
 
In July, a request for information was submitted to the Directorate for Public Freedoms and Legal Affairs at the Ministry of the Interior, which compiled all the information it could collect. Despite several follow-up requests, including those from the Government Commissioner, the Directorate has not replied to subsequent letters or emails. Therefore, the chapter on the regulations that could be enacted in France is currently incomplete for lack of information on this matter.
 
II.     ACCIDENTOLOGY
 
A.      THE EUROPEAN UNION AND FRANCE
 
Similar to other European countries, in France, there are no unique codes to identify motor vehicle heat related child deaths in the data collection systems on everyday accidents. When they occur, the accidents are sometimes compiled as road accidents, but are usually classified with deaths due to dehydration or hypothermia.  
 
The primary sources of information on child fatalities are the press, television, national and local radio stations, which recount the most dramatic or spectacular cases. As a result, the magnitude of the risk is probably underestimated.
 
For the collection of European data, the Commission asked the European Child Safety Alliance[1], which conducted a survey of its national members. Twelve European countries answered.[2] From 1998 to 2009, 3 deaths have been reported (Netherlands, Iceland and Hungary). In the Czech Republic, a few - nonfatal  - cases of children left unattended in motor vehicles at shopping centre car parks have been reported. Three accidents (2 in Great Britain and 1 in Italy) reported by Anara Guard and Susan Scavo Gallagher in a study mentioned further on, can be added to this list.
 
Some countries, Sweden and Germany for instance, have reported zero accidents, possibly substantiating the idea that a societal factor, particularly in countries where parents take leave of absences for childcare,[3] has an impact.
 
From June 2007 to August 2009, the Commission directly compiled 26 accidents reported in the media: 22 in Metropolitan France, 2 in the Overseas Territories and Departments, and 2 in Belgium (see enclosed appendices 1 and 2), causing a total of 7 fatalities.
 
Thirty-one percent of the 26 cases involved children under the age of one, 54% children were 1 to 3 yers old, and 15% were 3 to 13 years old.
 
The accidents occur in two types of situations:
 
-    When the responsible adult intentionally leaves the child in the car for various reasons (e.g. sleeping child, shopping or chores to do);
-     When the adult forgets the child that he/she is transporting in the vehicle, whereas he/she is supposed to drop the child off at day-care centre, a childcare provider’s, or with a relative.
 
The Commission has no record of a fatality of a child who snuck into a car without the adults’ knowledge.
 
Table no. 1: Children left unattended in a motor vehicle in France from June 2007 to August 2009
 
Responsible Person
Completely forgot
Child left intentionally in the car
Circumstances unknown
Total
Father
5
4
 
9
Mother
2
4
 
6
Father and mother
1
2
 
3
Other relative
1
2
 
3
Professional
2
1
 
3
Unknown
 
1
1
2
Total
11
14
1
26
Total en %
42%
54%
4%
100%
 

The above table highlights that forgetting a child is not the primary cause of the accidents compiled by the Commission (5 fatalities per year). In 54% of the cases at least, the child had been left unattended in the vehicle intentionally (6 fatalities per year). Seventy percent of the accidents can be attributed to the parents. However, one cannot assert (unlike some commentators) that the relevant behaviours were typically maternal or paternal.[4] Similarly, a detailed analysis shows that fatal accidents always have multiple factors, resulting from a chain of circumstances also involving the immediate environment and the usual licensed or formal care providers.
 
B.      OUTSIDE EUROPE
 
Aside from a few non-significant isolated cases, our research on the accidents abroad found sizeable figures in two countries. 
 
From 2004 to 2008 in Israel, official data reported four fatalities of children left unattended in motor vehicles. However in 2008 alone, the press reported 19 cases of children ‘forgotten’ in vehicles, none of which fatal.
 
At the federal level or in the different states of the United States, there is no unique code for compiling and identifying the death of children left unattended in motor vehicles in official epidemiological data collection systems.[5] The press and local law enforcement data are the primary sources of information. Since 1995, several organisations and researchers have conducted multi-year studies on the topic, based on data collected in the media.
 
With support from the Newton Education Development Center in Massachusetts, Anara Guard and Susan Scavo Gallagher published a study entitled  “Heat-related deaths to young children in parked cars: an analysis of 171 fatalities – United States, 1995-2002” (in the February 2005 issue of Injury Prevention). From 1995 to 2002, 233 fatalities of children left unattended in motor vehicles were identified, i.e., about thirty per year, of which 171 met the case criteria for further analysis. Other cases had also been identified during the same period, 6 in Australia, 4 in Japan, and 1 in Malaysia.
 
According to the association Kids and Cars, from 2002 to 2007 in the United States, the death of children forgotten in vehicle passenger compartments would account for 16% of the causes of child mortality occurring in or around parked motor vehicles. Before the 1990’s, the occurrence was rare (4 cases per year from 1990 to 1992), but highway safety experts urged people to place their children on the backseat of motor vehicles, in a rear-facing position for infants and toddlers due to the potential hazards of airbags. Subsequently, the accidents caused by forgetting children on the backseat increased by a factor of three. Today, there are ten times more motor vehicle heat related child deaths than fifteen years ago (110 cases from 2004 to 2006).
 
Based on various studies, the National Safety Council believes that every year an average of 36 children die from hyperthermia in the United States.[6] According to the sources, 40 to 50% of the fatalities can be attributed to parents or relatives forgetting the child and nearly 20% to licensed or formal childcare providers. Twenty percent of the accidents involve children left intentionally in motor vehicles while unsupervised children sneaking into cars accounts for 27% of child fatalities.
 
Table no. 2: Number of U.S. hyperthermia deaths of children left in cars (1998-2008)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Similar to France, the fatality rate tends to decrease with age: dropping from 33% for children under the age of one to 1% for children that are seven years old and more. According to the study, accidents occur at temperatures as low as 22°C. It only takes two to three hours for a child to die. Fatalities occur in every state, but especially in the Midwest (33% of the cases) and Sun Belt states in the southern United States[7] (36 % of the cases).
 

 
Table 3: Hyperthermia fatalities of children left unattended in a motor vehicle by state, in the United States (1998-2008)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Anara Guard and Susan Scavo Gallagher’s analysis of 125 fatalities of children left unattended in motor vehicles occurring from 1995 to 2002 shows that more women (60% of the cases) than men were involved. Another 32 children (25%) were left by an adult who meant to transport them to day-care centre or to a childcare provider in the morning, but had forgotten; the children had only been found in the evening. In 10% of the cases, the parents had addiction issues or mental disorders. In three cases, the adult had drunk a large amount of alcohol or taken drugs at the time of the event. Twenty percent of the children had been in the care of professionals (childcare providers, bus drivers, or baby sitters).
 
III.    RISK ANALYSIS
 
A.      THE CAUSES OF THE EVENTS
 
 
To gain a better understanding of the accident causes, the Commission held a series of hearings of health professionals, physicians, psychologists, behavioural therapy specialists and psychoanalysts.
 
The hearings did not address the accidents caused by abusive adults or adults suffering from proven physical (memory disorders), psychic or psychiatric pathologies rendering them unfit to fulfil their parental obligations. In these cases, the endangerment of the children in their care is permanent and is beyond the scope of the current inquiry.
 
Aside from the above-mentioned extreme cases, after reviewing the accidents reported in the press, in their analysis the professionals make a distinction between forgetting a child in a motor vehicle and leaving it unattended intentionally. 
 
1.      Forgetting a Child in a Motor Vehicle
 
 
 
Neurologists and psychologists recognise forgetfulness as an essential brain function. It is a natural memory ‘maintenance’ mechanism, preserving the individual’s psychic and biological organisation. It removes useless memories, thus clearing the way for updating previously memorised information.[8] Although the mechanism is involuntary, as one does not consciously choose what or when one forgets, it is not completely random. Actually, studies have shown that one forgets or remembers an event more easily depending on the initial attention level, the degree of emotional arousal or valence, the similarity with another event, and the relevance of the event for the individual’s survival.
 
Forgetfulness can indifferently affect one of the numerous memory subsystems.[9] In the case of a child one has to drop off at the childcare provider’s, or at day-care centre, forgetfulness affects the ‘prospective’ memory, viz., the ability to remember to do something in the future. This particularly fragile memory has low information content, but involves complex performance. It entails the process of both remembering a conceptualised - previously unexperienced, albeit routine - action and remembering to remember at the exact time when the action must be performed. It depends on the individual’s motivation to act and the priority given to the memorised tasks. Prospective memory may also be severely altered, if the memory triggering the process causes the disruption of a routine (performance of automatic repetitive tasks requiring very little of the subject’s awareness), or is performed while the individual is under stress, or tired. 
 
David Diamond, Professor at the University of South Florida, a physiology of behaviour, psychology of learning and neurobiology of memory specialist,[10] explains that the reptilian brain, which does not prioritise tasks according to the conscience, morals or affectivity, manages procedural memory. This memory processes information according to a rationale based on resource efficiency and economy. Consequently, adults never forget a child in a motor vehicle, or anywhere else, for the purpose of an allegedly more important task. The child is left so that basic operations that do not require sustained attention can be performed more easily. In conclusion, David Diamond affirms that, “If you’re capable of forgetting your cell phone, you are potentially capable of forgetting your child.”
 
Forgetting a child in a motor vehicle to the point of death is still a rare occurrence. The professionals heard by the Commission actually expressed their reservations about the possibility of drawing general conclusions based on the few exploitable cases collected by the Commission. Furthermore, this type of accident involves the very special connection binding the child and the adult, a connection strongly shaped by individual experience. Therefore, for the experts, these tentative explanations are still only hypotheses at this point. 
 
In the United States, forgetting a child in a motor vehicle is called the ‘forgotten baby syndrome’. Typically, the scenario is virtually always the same: a parent is going to work and forgets to drop off the child at the childcare provider’s or day-care centre. Due to a set of circumstances, the forgotten child is discovered several hours later, or in the evening, in any case much too late to save the child from dehydration. Some US experts still refuse to classify these deaths as everyday accidents and reject pressing charges against the responsible adult. Although the mechanisms of forgetfulness are now explainable, the act itself remains unpredictable.
 
This type of forgetfulness affects all population groups and categories of society, but usually socially well-integrated working populations that have other, older children. Forgetfulness is triggered by stress and fatigue that lower the level of vigilance and increase the recourse to automatic gestures and routines. In this respect, the pace of life, noise, and the multiple visual and sound solicitations in industrial societies are aggravating risk factors. Finally, according to sociologists, late parenthood, working fathers and mothers, nomad tools (i.e., mobile tools operating autonomously and communicating with any other system, object or human being) and the cult of individual performance in every field drive individuals to take on more tasks and juggle with time to the point of forgetting themselves and their relatives.
 
2.      Intentionally Leaving a Child Unattended in a Motor Vehicle
 
In daily life, leaving a young child in a motor vehicle for a short time is not automatically considered dangerous. In some circumstances, it may even seem reasonably justifiable, especially when the absence is very short (quick errand, car park payment, or gas tank fill), when the environment is dangerous for the child or when the child cannot be taken out of the car easily or safely because the parking space is too narrow.
 
There are many reasons for these acts and their authors may match several different profiles:
 
              - People who are completely unaware of the risks that they are exposing the child in the event of extreme heat or cold, but also of the hazards of self-injury or disappearance;
 
             - People who are aware of the risks to the child, but who misjudge the situation (for example, it is not hot enough to cause suffering; their absence will be very short; the car is safer or more comfortable for the child than the place they are going to);
 
             - People who know they are endangering the child, but who leave it in the vehicle anyway through irresponsibility, simple negligence or convenience.
 
The adults’ psychological profiles, their personal history and their environment may explain their behaviour. However, it would be simplistic to leave it at that. According to the experts, there are general socio-cultural factors that affect adults’ relation with children[11] to varying extents and that may prompt them to distance themselves from the child, literally and figuratively.
 
In urban and industrialised societies, health professionals observe that their patients show a growing ignorance of physiological realities and the basic needs of human beings – hence, children –, such as eating balanced meals, drinking lots of fluids, exercising, caring for oneself when ill, to the point where information campaigns on these topics have become vital. In many respects, consumer society has turned children into miniature adults with supposedly the same pace of life, capabilities and desires as adults.[12] In modern images, the family is no longer focused on the child, as was the case for earlier generations. The child must share the adults’ life, not the other way round. The daily environment is arranged so that the child does not become a ‘hindrance’ to the parents’ desires. Actually, one could even say that the child should not prevent them from moving (bike trailers), shopping (child care services in stores or restaurants), and practising their recreation (jogging strollers). It should enjoy the activities and participate at an early age (mini-motorbikes, ski nurseries, and so on).
 
Fast-growing technological advances have made it hard, if not useless, for one generation to transmit any knowledge or skills to the next. The primacy of youth and depreciation of the elders’ experience are becoming increasingly acute with each succeeding technological revolution, thus apparently rendering obsolete the earlier generation’s acquired knowledge. 
 
We now live in cities where shopping centres are on the outskirts of town and can only be reached by car. The car has become a ‘second home’ with built-in air-conditioning and movies. Most often children are in front of a screen during a drive.
 
The concentration of activities in big cities and changing family structures isolate individuals. The rising number of single-parent families (in 2005, they accounted for 1.76 million families and 2.8 million children) or recomposed families, and senior citizens’ active lives during the early retirement years have impacted the ties of family solidarity, often leaving parents alone to cope with all their family and professional obligations.
 
Finally, the consumer rationale conveyed by advertising and institutional messages fosters individuals’ lack of responsibility according to a curative rather than preventive consumer rationale. One ‘consumes’ medical acts and one would rather buy safety than assume responsibility for it, or for one’s health. Therefore, the same attitude is taken toward children’s safety and health.
 
3.      Particular Risks
 
Motor vehicles can also involve three particular risks:
 
a.       Child sneaking into a motor vehicle without an adult knowing it
 
 
Even when parked, a motor vehicle is a hazardous environment for a young child. A child sneaking alone - without an adult knowing it - into an unlocked car exposes it to certain risks, namely:
 
-    Hypothermia (subnormal body temperature) or hyperthermia (heat stroke) in extreme weather conditions;
-    An accident if it starts the cars or releases the hand brake;
-    Fingers may be pinched, cut, or ripped by car doors;
-    Strangulation by a seat belt or power window in old cars that are not fitted with safety systems preventing these hazards.
 
b.       Child entrapped in a motor vehicle fitted with a ‘super lock’ mechanism
 
 
One type of fatality complied by the Commission involved the parents unintentionally locking a sleeping child in a 4X4 parked in their driveway. The vehicle was fitted with a ‘super-lock’ system or deadbolt lock. Once the anti-theft system is on, the car doors cannot be opened from the passenger compartment. The ‘super-lock’ mechanism is not very widespread in Europe and can only be found on upscale vehicles. Super-locks are more commonplace in the United States where there are fatalities of unattended children left in super-locked car every year. Super-lock systems are also often coupled with anti-theft windows on the cars, making it hard for third parties to intervene, because the panes can only be broken with special tools.
 
 
c.       Child entrapped in the trunk of a car
 
 
This type of accident, also only occurring in the United States, is a recurrent cause of death. Children locked in a car trunk, either by accident or during a game, are entrapped and cannot get out alone. Depending on the circumstances, they may die of hypothermia, hyperthermia or suffocation.
 
 
B.      CONSEQUENCES FOR A CHILD OF AN EXTENDED STAY IN THE PASSENGER COMPARTMENT OF A CAR
 
 
For the psychologists and psychoanalysts heard by the Commission, leaving a child unattended in a motor vehicle, intentionally or unintentionally, may have significant psychological consequences. They may include an acute reaction to the feeling of abandonment triggered by the situation. Over time, this will result in anxiety fits and recurrent nightmares, latent depression, or withdrawal symptoms due to a fear of the outside world, or a fear of what may be experienced as another parental abandonment.
 
The physical consequences of leaving a child unattended in the passenger compartment of a car may quickly have fatal consequences. During hot weather, a child left in a motor vehicle may succumb to dehydration following a ‘heat stroke’, i.e., a rise in body temperature exceeding 40°C due to outside heat storage. This may be accelerated by the fact that the baby car seat limits thermal exchange surfaces with the ambient air, as the child is ‘restrained’ in its seat. In this situation, there is no critical temperature. Depending on the child’s general health, a ‘heat stroke’ may occur after a scant twenty minutes of heat exposure. Actually, fatalities have been reported after fewer than two hours spent in a car. 
 
In his July 2005 study entitled “Hyperthermia Deaths of Children in Vehicles” published jointly with Catherine Mac Laren and James Quinn in Pediatrics, Jan Null, Professor of Meteorology at San Francisco State University, analysed temperature rise in motor vehicles according to weather conditions. He concluded that 80% of the heat increase occurred during the first thirty minutes at a rate of 10° to 15°C per fifteen minutes, regardless of the outside temperature. However, the final temperature in the passenger compartment does depend on ambient temperature. Accordingly, temperature may go from 23°C to 40°C within a half-hour and to more than 47°C within an hour. If the vehicle is parked in the sun, reverberation accelerates the process, and leaving a window open has little impact on temperature rise. Only the colour of the motor vehicle and passenger compartment and tinted windows may substantially slow the rise, due to the reverberation effect.
 
Table 4: Temperature rise in °C, in a motor vehicle during one hour
(source San Francisco State University)
 
 
 
 
 
A ‘heat stroke’ also occurs rapidly because young children’s thermal regulation is not adapted to extreme temperatures. Their bodies have low water reserves and their sudation capacity is reduced. Left in a motor vehicle, their body temperature may rise three to five times faster than an adult’s may.
 
This ‘calorie retention’ may rapidly cause irreversible visceral and neurological effects, coma, and death. With young children, advanced dehydration symptoms are: severe exhaustion, hot red dry skin, accelerated heart beat, drop in blood pressure, vomiting and neurological disorders (dilated pupils, convulsions, and loss of consciousness). It may succumb to vital distress in the minutes following the first signs and die of cardiac-respiratory arrest. If the child is asleep, the heat will not wake it. It might die in its sleep, thus unable to cry and alert passers-by.  If it realizes it is alone, panic, irritation or powerlessness may catalyse and amplify the phenomenon.
 
In cold weather, the child may die from hypothermia, characterised by a drop in body temperature to below 35°C. During the first phase, the hypothermic subject shivers; its skin and limbs are cold, its breathing and pulse fast and irregular. During the second phase of severe hypothermia, the shivers cease, the subject gradually becomes lethargic before slipping into a coma, its muscle stiffen, its breathing and pulse become slow and irregular, and finally stop. Individuals in a ‘white death’ state may sometimes be resuscitated, but they may endure irreversible after-effects.
 
 
IV.    PREVENTIVE MEASURES
 
 
A.      INFORMATION CAMPAIGNS
 
Informing about, and building awareness of the risk to children left unattended in motor vehicles, and specifically the ‘forgotten baby syndrome’ are essential for prevention and a prerequisite to the rollout of any concrete measures to limit the resulting accidents. 
 
In the United States, the authorities have rolled out specific prevention campaigns on the fatality risk to young children due to forgetting or intentionally leaving children in motor vehicles. Official prevention messages are regularly broadcast on the media, such as the message of the Golden Gate Weather Services in San Francisco, on the following topic, “Never leave a child unattended in a vehicle” and recalls the penalties incurred.
 
Child protection associations such as The Nevada Parent Teacher Association, The Safe Kids National Coalition,  4 R Kids Sake, or Kids        and cars, parents associations such as Harrison’s Hope   (http://www.harrisonshope.org/zero_seconds.html) or the Christian Charles Lacombe Foundation (http://www.youtube.com/watch?v=NYl-w5CkGt8&NR=1) also directly address these issues and, more generally, the potential hazards of motor vehicles to young children, passengers or pedestrians. 
 
Car makers and auto-clubs are involved in the campaigns or roll out their own. At car parks, some shopping centres post backlit signage displaying the temperature outside and inside the passenger compartment, with a reminder of the dangers of leaving the elderly, children or animals in the cars, even with the windows down. 
 
This type of special campaign does not exist in Europe. Every year in France, prevention initiatives are rolled out on the risks particular to the summer and sun, especially to children’s skin and eyes. Since the summer of 2004, in cases of exceptionally hot weather, numerous countries (Belgium, Spain, France[13], Greece, Hungary, Italy, Portugal, and Rumania) deploy ‘heat wave’ plans including the broadcast of information and general warnings about the risks of sunstroke or dehydration, especially to young children in motor vehicles. However, when queried by the Commission, the INPES confirmed that it did not have the resources to organise special campaigns on the risks to children left unattended in parked motor vehicles.
 
On information websites designed by individuals, parent associations and healthcare professionals, and in trade newspapers, toddler dehydration is primarily explained as the consequence of gastrointestinal disorders, and secondarily of hyperthermia in hot weather.
 
Despite all these initiatives, the forgotten baby syndrome, which may be the cause of more than half the heat-related fatalities of children left unattended in motor vehicle, is not the topic of any preventive information measures in France.
 
 
B.      THE REGULATORY FRAMEWORK
 
 
1.      Europe and Abroad
 
According to the European Child Safety Alliance survey, in Europe there are no specific legal provisions framing the act of leaving a child unattended in a motor vehicle. However, in most States, penal law does make adults liable for negligence, surveillance default or manslaughter.
  
Since 1998 in the United States, 49 criminal proceedings have been initiated against adults considered as responsible for the death of a child left unattended in a motor vehicle. In fewer than 10% of the cases, alcohol, drugs (7%), or proven ill-treatment was the accident cause. In the court cases, 59% of the women against 47% of the men were sentenced to prison time. Most of the time, manslaughter or lax supervision were the charges. Recent trials ended with acquittals or probation for the adults due to a greater awareness of the ‘forgotten baby syndrome’ and the action of associations of parents having lost their child in these circumstances.
 
Still, there is no federal law on the risk. However, fourteen states have passed legislation with criminal sentences for anyone who leaves an unsupervised child in a motor vehicle. In sixteen other states, Bills on these matters have been filed. The states are scattered throughout the land, and understandably, especially in states with the highest accident rates.
 
Table 5: Breakdown of US states with legislation penalising
the leaving of a child unattended in a motor vehicle (2006)
 
 
In the states that have enacted legislation, the minimum age for leaving a child unattended in a motor vehicle varies, and the sentences are more or less severe. Children over twelve are sometimes considered as ‘adult’ companions.

Table no. 6: Sentencing in different states in the United States
 
State
Age of the Child
Fine
Prison
California
Under  7
$100
 
Connecticut
Under 12
$2,000 during the day
$10,000 at night
 
Florida
Under  6 (for 15 minutes)
$100 to $500 depending on the circumstances
 
Illinois
Under 7 (for 10 minutes)
 
2 to 10 years in case of death
Kentucky
Under 8
$1,000 to $10,000
 
Louisiana
Under 6
$500 to $10,000
6 months to 2 years
Maryland
Under 8
$500
Up to 30 days
Missouri
Under 11
$5,000
 
Nebraska
Under 7
$500
3 months
Pennsylvania
Under  6
$300
Up to 90 days
Texas
Under 7
$500
 
Washington
Under 12
$1,000 when the driver leaves to buy alcohol
Up to 90 days when the driver leaves to buy alcohol
 
 
2.      In France
 
 
a.       Criminalisation
 
 
In France, there is no specific legal provision penalising the leaving of a child unattended in a motor vehicle. As in the other European countries or the United States, in French law there are provisions punishing actions involving child harming, such as the abandonment of a minor (Article 227-1 of the Penal Code), the non-fulfilment of parental legal obligations (Article 227-17 of the Penal Code), the endangerment of another person’s life (Article 223-1 of the Penal Code), the deliberate withholding of assistance to a person in danger (Article 223-6 of the Penal Code), especially for health professionals (Article 121-1 of the Penal Code),[14] malpractice for paediatric nurses and childcare providers, or manslaughter (Article 221-6 of the Penal Code). The Court of First Instance of Vienne considered in its opinion of 11 December 2008 on the death of a child left unattended in a vehicle, that there were reasonable grounds for charges of manslaughter.
 
 
b.       The Highway Code
 
 
Article R. 412-2-II of the Highway Code states that any child under ten must be strapped to its seat by an approved child restraint system, appropriate to morphology and weight. The system is not mandatory if the child’s morphology allows it to wear a safety belt. The driver is responsible for the proper transportation of children. Failing to do so, the driver is liable for a fine for fourth-class misdemeanours (€135.00). The obligation has been broadened to include drivers of lorries, buses and coaches with nine seats or fewer.
 
Article R. 412-3 forbids the transport of a child under ten in the front seat of a vehicle, except in some special cases, namely when the backseats are momentarily useless or occupied by children under ten and “when the child is transported in a rear-facing position, with an approved restraint system specially designed for vehicle front seats and when the front airbag is deactivated.” Failing to comply with the provisions is punishable by a fine for fourth-class misdemeanours.
 
Systematically placing infants and toddlers in the appropriate seats on the front seat of motor vehicles where the driver can keep an eye on them would be an efficient means of preventing the risk of forgetting them in the car. Given the accidentology data collected by the Commission, at least one third of the accidents involving infants and toddlers could thus be avoided every year. Article R. 412-3 allows for this option, but does not make it mandatory. However, the practice is still not very widespread in France, the last European country where the practice was authorised (because regulations used to forbid this expressly). Placing children in the front seat is becoming more commonplace mainly for practical reasons: ‘hull’ seats are less expensive than standard baby seats and can be used to carry the child, or can be fitted onto a stroller. The use is strongly encouraged by highway safety services as can be seen in a published flier on baby car seats, where it says, “For the 0 (birth to 10kg) and 0+ (birth to 13kg) group, the child should travel in a rearward-facing baby seat, which will provide the best protection in a head-on collision.”
 
Consequently, the Commission addressed the relevance of introducing a specific offence forbidding and punishing the leaving of a child unattended in a motor vehicle into French law, similar to Decree no. 2003-293 of 31 March 2003 forbidding the use of a mobile phone when driving (Article 412-6 of the Highway Code). This type of provision detailing the offence would allow third-parties to overcome cultural taboos and legitimate  - de facto - any direct or indirect (asking law enforcement to do so) intrusion into an enclosed space (passenger compartment) or private property (a motor vehicle). This provision would also have an educational virtue by warranting the deployment of public and private information campaigns on the causes (specifically forgetfulness) and potential consequences of such acts. 
 
The Ministry of Justice has confirmed that legally nothing runs counter to establishing an offence for the leaving of a young child unattended in a parked vehicle in circumstances liable to endanger its safety. The time required to implement the provision would vary, depending on the assigned degree of seriousness. A Supreme Administrative Court (Conseil d’État) Decree must be enacted for it to be deemed an offence (liable for a 1,500-euro fine); a law must be enacted for it to be deemed a crime punishable by a fine of at least €3,750 and a prison sentence of two months or more. 
 
 
C.      TECHNICAL DEVICES  & SYSTEMS
 
 
In the United States and France, some parents whose children have died in this type of accident, some child protection associations[15] and safety system manufacturers support the idea that installing alarm systems in motor vehicles would limit the number of deaths of children left unattended in the passenger compartment, either intentionally or unintentionally. In the United States, associations have denounced the hazard of super-lock mechanisms on vehicles that have caused the death of several children entrapped in cars, as the doors could not be opened from the inside.
 
The Commission assigned Auto-innovations to conduct a market study that confirmed that warning systems telling a driver leaving a vehicle that a child is still in the car exist or could be available in the short-term. The system may or may not be hardwired to the car. However, installing warning systems comes up against several problems.
The systems should warn an adult (theoretically the driver getting out of the vehicle) that he/she has left a child in the passenger compartment. If the devices are to be optimum warning systems, nothing should prevent their activation - whether the child is alone or not, the weather hazardous or harmless to the child, or the car parked for a short or long time (engine off or on, ignition key in or out, windows down or up, trunk open or shut, doors locked or just closed). The warning per se should be both fast and efficient, exploiting every resource (sound, light, and vibrator) likely to catch the attention of the driver and/or third parties around or far from the vehicle, including emergency services. The system should be reliable, trigger a minimum of false alarms, and not be too hard to use.
 
1.      The Market (see Appendix 3)
 
 
a.       Devices hardwired to the motor vehicle
 
 
As of the publication date of the Recommendation, no preventive child-leaving devices coupled to motor vehicles exist either on the French, European or foreign markets, nor are they being engineered by car makers or equipment suppliers. On the US market, although industry operators or individuals have registered numerous patents, car makers do not offer any system of this type as a feature on standard car models. Due to incurred costs, their representatives are against any law that would make it mandatory for them to fit all cars with these devices.[16]
 
European car makers who largely share this position met the Commission. As their priority is the prevention of road hazards and, in light of the data provided by the Commission, they also feel that the probability of a child left unattended in a motor vehicle is very low and resulting risks cannot be considered as major. They have reservations about the economic efficiency and viability of technical devices for risk prevention.
 
Technical solutions do exist. However, numerous scenarios have to be taken into account, namely the constraints they entail on the position of the child in the motor vehicle (on the backseat, on the front seat but in a rearward-facing position, in a child seat, or asleep on the backseat) and vehicle configuration (two-door vehicles, or three rows of seats).  The problems do not so much involve detecting a critical situation as they do eliminating false alarms that may prompt adults either to ignore the received signal or switch off the system if it becomes too annoying. Signal range must also be powerful enough to transmit in various conditions and over an ample distance.
 
From an economic standpoint, car makers and equipment suppliers say that engineering active safety equipment involves sizeable design and production investments. However, installing this type of device cannot be made mandatory in France alone. The devices must be subject to European directives, or international regulations of the United Nations Economic Commission for Europe (UNECE).[17]
 
The equipment is still an optional feature with an estimate sales price ranging from €1,500 to €3,000. However, the market is now clearly nonexistent, including in the United States although the country has addressed the issue more extensively than European countries have. Actually, few drivers admit that the equipment could be useful, as they cannot even imagine that they might forget their child. Even if they become aware of the risk, according to car makers, a warning device would still be a hard sell; drivers now consider safety as a right that is implicitly included in vehicle purchase. Therefore, safety must not incur any additional expense.
 
Nevertheless, car makers say they are not opposed to studying how to adapt extant or simple warning systems that could act as ‘reminders’, such as the devices reminding drivers that the keys are in the ignition, that seat belts must be fastened, or that headlights are still on when the driver opens the door to leave the vehicle (see §2 below).
 
 
b.       Stand-alone Systems
 
 
On the other hand, several stand-alone warning systems (unconnected to the motor vehicle) against the risk of forgetting a child are manufactured and sold on the US market, or on the Internet. However, system sales are poor, confirming every product marketing study. Potential buyers think they would never forget a child - especially their own child - in a motor vehicle or anywhere else. The most common equipment is the following:
 
   .Simple ‘reminders’ to remind the driver that a child is on the backseat of the vehicle when he/she leaves: these are either physical lines between the driver and child, or tags attached to the key ring, too bulky to fit into a pocket. 
 
 
 
 
 
  
 
Line connecting the child seat to the car key                                                   Tag on car key-ring
 
The first system is not recommended. The child may grab the line, wrap it around its neck and strangle; there is an aggravated risk in case of collision or sudden braking.
 
   .Warning devices with a weight and movement sensor, such as the Cars-N-Kids Car Seat that has a built-in sound device, which plays a lullaby when the child is in its car seat, when the vehicle comes to a full stop for more than five seconds and when the child unfastens its restraints or gets out of its seat.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    .‘Distance’ sensor warning devices: a sensor is attached to the baby or booster seat. Several sophisticated models automatically detect whether the child is on the seat (weight sensor) and turn on automatically; others also warn of excessive ambient heat (temperature probe), whether the adult has moved away or not.  However, as a rule, users must deliberately turn on the devices every time they transport a child and keep them on. The adult carries a receiver emitting a signal when bearer moves beyond critical distance (3 to 5 meters) from the transmission base located near the child. Numerous patents and systems of this kind are marketed in the United States, including the one engineered by NASA in 2000 that never found an outside partner for mass marketing.
It is called the Child Presence Sensor  (http://videos.howstuffworks.com/nasa/2174-how-child-safety-sensors- work-video.htm).
 
 
 
                                                                            
 
  
 
 
 
 
Baby Minder: an emitting buckle                       Transmitter cushion placed under the
that is attached to the baby seat belt               child and a warning signal receiver
 
            .Drown prevention alarms belong to the same product category. They are also ‘distance’ alarms that usually operate as toddler supervision aides. Object (keys, phones, and ID) loss or theft prevention alarms can also be classed in the same group.
In this case, the receptor triggers the baby-forgotten alarm when bearer moves away from the transmitter.
 
   
 
 
 
 
       
  
 
Drown and distance prevention pool alarm     Distance prevention alarm        Object loss or anti-theft alarm
 
c.       Special Risk Prevention Devices
 
 
For children accidentally locked in vehicles fitted with super-lock mechanisms or dead bolt locks, car makers say that having to push the car remote twice to trigger the system is the primary safety step.
In the United States where super-lock doors are widespread, car makers suggest leaving a spare remote key in the trunk to prevent someone being entrapped in the car. They also offer the optional feature of door release buttons installed in hidden places on the car.
For children who are entrapped in car trunks, they also offer the optional feature of an inside trunk handle (Emergency trunk release handle).
 
 
 
 
    
 
 
 
  
 
Door release button installed in glove compartment                   Phosphorescent trunk release handle
 
 
2.      Feasible Technical Devices (see Appendix 4)
 
 
 
Several devices and technologies analysing various car environment parameters, including biometric parameters, may provide appropriate solutions, or even warn the driver and third parties (camera assisted parking aide and distance sensor, hypovigilance warning based on pupil analysis and eyelid blinks, customised infrared sensor air-conditioning, emergency call in case of accident) already exist as standard or optional features on numerous motor vehicles sold on the European market. 
 
According to the consulted experts, five systems could be adapted and become prevention systems against the leaving of a child in a motor vehicle:
 
    - The Personal Car Communicator: installed on some VOLVO vehicles; the system operates with a pocketsize remote control. A heartbeat sensor is activated if there is an occupant in the passenger compartment. It is exclusively sold as a warning device against car intrusion. If the warning were automatic, it could conceivably warn of the presence of a child in the vehicle when the driver moves away.
 
    - Seatbelt sensors:  the system detects a passenger or driver whose belt is not buckled when the cars starts or is moving. Similarly, it could warn the driver that a seat belt is still buckled when he/she leaves the car and locks the doors. The device would operate with the child restraint systems (baby and booster seat) using seat belts. However, it would have to be connected to a weight sensor to forestall false alarms if the restraint system is installed permanently in the car. For systems with ISOFIX[18] fastenings, the child seat would have to be fitted with a seatbelt-buckled sensor.
 
   -  Image Recognition: several upscale cars are already fitted with cameras. Aimed outside, the cameras recognize speed limit signs and detect pedestrians in the path of the car. Thermal and/or semi-infrared imaging cameras aimed at the back seat and connected to an image recognition programme could detect a child and trigger an alarm if the driver leaves the car leaving the child behind. Other functions could be added to make the system cost-effective (adaptive deployment of airbags and seatbelt tighteners, headlight adjustment, and so on).
 
   -  Door Opening Sequence Analyser: this would detect a person on the backseat by analysing car door opening. Before taking the car, it is locked; the back door is opened to install a child and then closed. The driver’s door is opened and closed, and the driver starts the car. When the car stops, the engine is off and the driver’s door opened and closed, a sequence analyser would expect the back door to open. If the door has not been opened and car lock has been initiated, the system would assume that a person seated in the back may have been forgotten, and would alert the driver.[19] On two-door vehicles, the system could operate when a front seat is pushed down.
 
    -  Airbag Deactivation Warning: deactivating the airbags in the front of a car to install a child seat could trigger a warning if the driver leaves the vehicles and locks it without reactivating the airbags. The system would only work for the front seats.
 
 
3.      The Limits of Technical Devices
 
 
 
The first limit is system acceptability. As it is complicated to make their installation mandatory, the systems could only be offered as optional features on motor vehicles. Regardless of performance, their purchase assumes that the responsible adult is aware of the risk of forgetting a child in a motor vehicle.
 
Each different system has its limits. All the systems hardwired to a vehicle can only ensure the child’s safety if it is aboard a vehicle fitted with the systems, and not during occasional trips in a third-party’s car. Stand-alone systems have to be installed and turned on each time the child seat is moved from one vehicle to the next. Most systems have to be turned on deliberately when a child is aboard the vehicle. This operation may also be forgotten, thus rendering the device inoperative. Usually, the systems are only functional if the driver or one of the adult passengers is near or around the vehicle.
 
However, the asset of technical devices triggering parents’ attention should not be neglected, although no warning system can replace adults’ requisite vigilance in the event of an unpredictable lapse of forgetting a child in a motor vehicle requiring immediate response.
 
However, these aides must be used appropriately, i.e., they must not cause adults to feel less responsible, or relax their supervision due to a feeling of false safety. With or without alarms, some behavioural principles still stand. A child riding in a motor vehicle must be supervised at all times and be regularly given fluids. It should never be left alone in a motor vehicle, even for a short while. System activation and operations must be checked before each trip and regularly maintained.
 
Forgetfulness is still a complex phenomenon. According to some experts, forgetfulness forestalled by a warning system during car transportation may shift to other – equally dangerous – everyday actions, or may affect the child in other ways and circumstances (forgetting the child in the bath, at the shopping centre, or failing to switch on the warning system). Adults must pay attention to any signs of fatigue, stress, or minor memory lapses, which may cause tragedies. At the first sign of these symptoms, adults should immediately take the requisite measures (rest, reorganise daily tasks and use reminders). 
 
 
BASED ON THIS DATA
 
 
 
Whereas the data collected by the Commission shows that leaving a child unattended in a motor vehicle, intentionally or unintentionally is not a rare event and, because of the incurred risks, warrants the enactment of measures to limit its occurrence;
 
Whereas, according to the information provided to the Commission, the next review of UNECE Regulation no. 44 in Geneva will make it mandatory to transport children in a ‘rear-facing position’ in appropriate child restraint systems until the age of eighteen months, which might aggravate the risk of forgetting young children in the back of the car;
 
Whereas, despite the fact they are not widespread in France, there is the danger of door super-lock mechanisms that make it impossible to open car doors and windows, even from the inside;
 
Whereas there is a lack of experimental and epidemiological data on the extent of child protection of children in the event of a road accident when the child seat is in front next to the driver;
 
Whereas the temperature inside motor vehicles parked in the sun rises quickly and young children are particularly vulnerable to the risk of hyperthermia, a risk aggravated by their confinement in a car seat;
 
Whereas informing adults and building their awareness of the risk of forgetting a child in a motor vehicle and the dangers of leaving it unattended are essential prerequisites to any other legal or technical measure serving to limit the resulting accidents;
 
Whereas, for preventive purposes, leaving a child unattended in a vehicle intentionally should be distinguished from forgetting it in the car (both having admittedly the same consequences), but forgetting a child is typically random, unexpected and unpredictable;
 
Whereas third parties finding a child left unattended in a motor vehicle are currently reluctant to intervene due to their respect of property and privacy;
 
Whereas the psychological mechanisms underlying the action of forgetting a child in a motor vehicle are complex and there is no fully effective preventive technical solution to the problem;
 
Whereas technical warning devices meeting minimum safety requirements do exist and could help prevent adults’ lax attention when driving young children in their motor vehicles;
 
Whereas making the said devices mandatory in international automotive regulations is hard to do;
 
Whereas the devices will never dispense adults exerting their vigilance in all circumstances from being the primary guardians responsible for the safety of the children in their charge;
 
 
Issues the following recommandation :
 
 
The Commission recommandes that :
 
 
1.      The Public Authorities
   
 
. Improve the knowledge of the cases of children forgotten, or left unattended in motor vehicles, and of the consequences of such actions, through ad hoc and periodic surveys of law enforcement and emergency services
 
    . Allocate resources for the funding of information campaigns addressed to future parents, parents, health professionals and childcare providers:
   - On the risk of forgetting a child in a motor vehicle and on preventive measures
 
   - On the dangers of leaving a child unattended in a motor vehicle
 
    . Inform health professionals and childcare providers on the risk and danger of forgetting a child in a motor vehicle and on the need to build parents and future parents’ awareness of this issue
 
    . Encourage childcare providers and teachers to contact immediately the persons responsible for the child in case of an unexpected absence to find out the reasons for the absence
 
   .  Conduct tests and epidemiological studies detailing the extent of child protection in the event of a road accident when the child seat is in the front next to the driver
 
   . Include information on the temperature rise in motor vehicles parked in the sun and on the dangers to its occupants in the theoretical curricula for the driver’s licence test
 
 
2.      Car makers
 
 
 .  Study the possibility of fitting motor vehicles with technical warning devices against the risk of forgetting a child on the backseat
 
   . Warn future buyers and owners of a vehicle fitted with a door super-lock mechanism of the dangers of the device that, once triggered, makes it impossible to open the doors and windows by hand, including from inside the car
 
   .  Include information on the above-mentioned danger, the rise of temperature in motor vehicles parked in the sun and on the ensuing dangers for its occupants, in car user manuals
 
   .  Roll out or participate in information campaigns on the risk of forgetting a child in a motor vehicle and on the danger of leaving it unattended
 
 
3.      Manufacturers and Retailers of Childcare Products, Alarms or Car Accessories
    
 
.  In coordination with car makers, include in their product range technical warning devices that could limit the risk of forgetting a young child in a vehicle
 
    .  Roll out or participate in information campaigns on the risk of forgetting a child in a motor vehicle and on the danger of leaving it unattended
 
 
4.      Mutual Societies and Insurance Companies
  
 
  .  Inform their members on temperatures inside motor vehicles parked in the sun and on the ensuing dangers for its occupants
 
    .  Roll out or participate in information campaigns on the risk of forgetting a child in a motor vehicle and on the danger of leaving it unattended
 
 
5.      Parents and Early Childhood Professionals
   
 
    . Not leave a young child unattended in a stopped or parked motor vehicle, anywhere or in any circumstances
 
    .  Not underestimate the risk of forgetting a child in a motor vehicle, and for the purpose of limiting the said risk:
 
 − Generally speaking:
 
   .  Pay attention to signs of fatigue, stress, or any ensuing minor lapses: the warning signs that should make them aware of the risks to themselves and to others; rest immediately and implement the required organisational measures to remedy the situation
 
   . After all their car trips, get into the habit of inspecting the entire passenger compartment, especially the backseats, before leaving the vehicle, day and night
 
   .  Ask that childcare providers or teachers contact them immediately once they realise that a child that should be in their care is absent
 
 − As a precautionary measure, when transporting a child occasionally or regularly:
 
   .  Put together personal ‘reminders’ to prevent them from forgetting a child on the backseat of the vehicle (place essential personal belongings next to the child, or place the child’s belongings next to the adult, programme a warning on one’s personal electronic equipment)
 
   .  Or acquire technical warning devices used as ‘reminders’, check that they are turned on and operating properly before any trip, and maintain them regularly
 
   .  Before purchasing or activating the devices, measure the risks inherent to using the door super-lock system on vehicles that may have them
 
 
6.      The Public
  
 .  Immediately intervene when they find a young child left unattended in a motor vehicle and warn the authorities, the nearest security or emergency services 
 
 
 
7.      Employers, department store or shopping centre managers, and car park operators
   
 
. At the entrance to their car parks, install billboards urging drivers to check that they have not left anyone in their vehicle and reminding them of the risks due to a temperature rise in vehicles parked in the sun
 
   .   Have parking spaces making it safe and easy to install and remove young children from a motor vehicle
 
   .   Roll out or participate in information campaigns on the risk of forgetting a child in a motor vehicle and on the danger of leaving it unattended.  
 
 
ADOPTED AT THE SESSION OF 10 DECEMBER 2009
 
 
BASED ON THE REPORT BY MR. JEAN-LUC GUERQUIN-KERN
 
 
Assisted by Mrs. Michèle HENRY and Mrs. Muriel GRISOT, Commission Technical Advisors, in accordance with Article R. 224-4 of the Consumer Code
 
 
 

Appendix 1
Children Forgotten or Left in Motor Vehicles
Collection of Press Articles from June 2007 to August 2009
 
Victim
Age
Date
Place
Author
Circumstances
Consequences
Adult’s Behaviour
1
2
06/08/2009
Clermont-Ferrand
Mother
Little girl left at the car park of a supermarket by her mother who had gone shopping. After being alerted by passers-by, the security guard broke the car window and removed the little girl from the passenger compartment. According to the investigation, she spent 20 min in the car
 
 
 
None
 
The mother had gone shopping; she was unaware that she had endangered her daughter’s life.
1
?
29/07/2009
L’Ilse d’Abeau
Father
Baby left in a vehicle by its father.  alerted emergency services. The firefighters were immediately met by the mother.
 
None
 
The father stated that he had only left his child “a few seconds”.
1
15 months
28/07/2099
Bormes Les Mimosas
Both parents
 
After a trip lasting several hours, a couple of Dutch nationals realized their little girl was unusually quiet.
 
 
?
A physician on the scene took care of the severely dehydrated child that had gone into convulsions. A helicopter evacuated her to hospital.
1
3
06/07/2009
Les Avenières
Man
Child left unattended mid-afternoon in a vehicle parked at the car park of the Walibi theme park in Avenières. Visitors alerted the authorities and car park employees broke a window to remove the child from the car. The child had been locked in the car for about twenty minutes – the child did not sustain any serious physical injuries
 
 
 
 
None
 
 
 
The responsible male adult showed up after the child had been removed from the vehicle.
1
6 months
26/06/09
Ajaccio
Grandmother
Little girl left 7 hours at a parking space in town. Her grandmother was supposed to drive her to day-care centre. Discovered by a passer-by who alerted the firefighters
 
 
None
 
No notification by day-care centre
1
11 months
22/06/2009
Louvain
Father
Little girl left all day at the car park of her father’s company. He was supposed to drop her off at the day-care centre that morning. Discovered by the mother who had come to recover the baby seat so she could retrieve her daughter at day-care centre.
 
Death
 
No notification by day-care centre
1
4
15/05/2009
Lourdes
Driver
Little boy left two hours in the school bus that should have taken hum to nursery school. Van parked near a road and a train station.
 
None
 
The child had fallen asleep and the driver had not checked that the van was empty. The childcare employees assumed that the child had not been sent to school.
1
5 months
25/03/2009
Toulouse
Mother
Little girl forgotten for more than 8 hours in a vehicle parked at the company car park. Her mother forgot her in the car because she thought she had taken her to day-care centre.
Slight dehydration
A ‘blank’ in the morning routine for a 30 year-old mother. No notification by day-care centre
1
1
11/02/2009
Nouméa
Father
Child forgotten at a car park. The father thought he had dropped it off at day-care centre.
Death
No notification by day-care centre
1
10 months
0801/2009
Paris
Childcare provider
Child forgotten in a car in -10°C weather. Rescued by the police.
None
Forgot the keys and the child in the car
1
15 months
19/09/2008
Nogent sur Marne
Childcare provider
A little 15 month-old boy left in a car by a childcare provider who said she was ‘in a hurry’ and then admitted to having left another little girl the same age at home. Both children were rescued by the police.
 
 
None
 
Recklessness or unfit for the job of childcare provider
1
14 months
15/0/2008
Genlis (21)
Father
Child forgotten in a vehicle parked at the company car park. The father should have dropped it off at the childcare provider’s at 8:30 am. At 12:45 pm, passers-by released the child.
Early signs of dehydration, hyperthermia and tachycardia
Very preoccupied by his job, overworked, stress, worry – No notification by childcare provider.
1
10 months
17/08/2008
Béziers
Mother
Child left intentionally in a parked vehicle during the night of the Béziers Fair. Child recovered after a passer-by intervened.
None
Unaware of the actual risks
1
6
08/08/2008
Cannes
Father
At about 6 pm, child found locked in a car parked in the city centre. Passers-by alerted the firefighters who broke a window and pulled out the child. It was not dehydrated as clouds had abated the sun’s heat.
 
 
None
The father arrived at about 6:55 pm, stating he had only been gone a few minutes, that he had left a window cracked, and that his son was not an infant.
1
13
12/08/2008
Guadeloupe (97)
Father and mother
Child forgotten in a 4X4. Parents came home very late from a party. Teenager fell asleep in the vehicle. Super lock mechanism of the vehicle made it impossible to open the doors from the inside. Anti-theft windows
Death
Father had mistakenly thought that the child had gotten out of the vehicle
1
2
07/08/2008
Chatou (78)
Father
Child left in the car. The firefighters alerted by passers-by took a half hour to remove the child from the car. The drunken father was asleep at home.
None
Recklessness due to drunkenness
2
3 months and 3
06/08/2008
Cernay (68)
Mother
Children rescued after having been left at a sunny car park of a supermarket
None
Unaware of actual risks
1
6
06/08/2008
Lorgues (83)
Aunt
Child left in a vehicle while its aunt was at an Internet café. Child rescued by passers-by
None
Unaware of actual risks
1
2 and a half
04/08/2008
Morières lès Avignon
Grandfather
Child left 30 min in a vehicle at a supermarket car park. Intervention by passers-by who removed the child from the vehicle
None
Unaware of actual risks
1
2
30/07/2008
Dijon (21)
?
Child left in a car at supermarket car park. Security guard removed the child. 45°C temperature in the passenger compartment
None
Unaware of actual risks
1
3
22/07/2008
Saint-Marcel (71)
Father
Child forgotten from 8:30 am to 5 pm in a car at his father’s company car park. He was supposed to drop the child off at the childcare provider’s
Death
Blank, complete memory lapse – No  notification by childcare provider
1
2 and a half
15/07/2008
Pont-de-Chéruy (38)
Father
Child forgotten in a vehicle parked at a car park in the bright sun at about 2:30 pm. The father forgot to drop the child off at its maternal grandparents’ who were to mind it – Father ‘distracted’ by a traffic accident. The child was found at about 5 pm, could not be resuscitated
Death
‘Disruption’ in the daily routine – No reaction from grandparents
1
8 months
 
Belgium
Mother
Baby left in a car by the mother who was “dragged into a discotheque by a friend.”
None
Unaware of actual risks
1
19 months
20/06/2007
Béziers
Father
Little girl forgotten in a vehicle at company car park. The father had forgotten to drop her off at day-care centre
Death
Mind was a total blank. No notification by day-care centre
1
5 months
21/05/2007
Hal (Belgium)
Mother
Child left all day at a car park whereas the mother thought she had left it at the childcare provider’s
Death
Mother of three ‘blanked out’ during the daily routine – No notification by the childcare provider
26
 
 
 
 
 
 
 
 
 
 

Appendix 2
 
Two Examples of Typical Accidents
 
Early afternoon one Tuesday, a man parked his car at the downtown car park in Pont-de-Chéruy (Isère). He left his two and half year-old son in the car.  Hours go by. At about 5 pm, a passer-by glanced in the window and saw a baby who seemed to be doing poorly. He called the emergency services that break the pane. Despite a cardiac massage, they could not resuscitate the baby. It died of dehydration. According to the firefighters, the temperature in the passenger compartment was over 40°C.
 
The father had parked the car at one of the car parks on rue de la République in Pont-de-Chéruy. He had gone to work at his pharmacy. “Visibly upset, the father told the emergency services that he had forgotten that he had left his son in the car,” stated the Public Prosecutor of Vienne.
 
At the hearing Wednesday afternoon, the father provided more ample explanation. “Before the ‘event’, he had witnessed a hit-and-run traffic accident. He had written down the hit-and-run licence plate number to give to the accident victim. These are the circumstances explaining why he had forgotten that his son was in the car,” explained Public Prosecutor Franck Rastoul. “He then went to work at (his) pharmacy.” According to the preliminary investigation, the father, who was supposed to drop the child off at relatives so they could mind him, was not used to driving with the child in the afternoon.
 
"I know him well. He’s a customer,” the owner of the bakery next to the pharmacy told the Post. “He was very kind.” “Everybody’s talking about it. Everybody has an opinion,” he added. “Some wonder why he left the child, others say that he’s separating from his wife. They couldn’t have children for a long time. They finally had one… What he really needs is our support.”
 
Sources: AFP, Le Post, Europe 1, RTL, Le Dauphiné Libéré and France 2
___________
 
Another death of a child forgotten in a car
 
This is the second tragedy to occur in a week. After a little 2 year-old boy died in Isère this July 15, a little three year-old girl called Zoé was forgotten by her father in his car in the sun. She died yesterday afternoon in Saint-Marcel (Saône-et-Loire).
 
For unknown reasons, the 38 year-old father, an AREVA executive who was on his way to work, left the child in his vehicle at his company car park in the blazing sun. When he returned to his car at about 3:30-4 pm, he didn’t immediately realize that his little girl was dead on the backseat. It was only when he went to retrieve his other child at day-care centre that he realized the tragedy. He rushed off to the firefighters, but it was too late.
 
The father (who is in custody) and the mother were hospitalised in a state of shock. There will be an autopsy today.
 
Lieutenant-Colonel Alain Diry of the Saône et Loire firefighters said that, “At about 5:30-5:45 pm, firefighters who were training at the  Saint-Marcel fire station saw a car drive into the station courtyard. Holding a child, a man - the child’s father -  got out of the car and rushed over. They performed every feasible emergency procedure with the equipment in vain, unfortunately. The child was probably already dead. The father collapsed and was taken with the mother to the Chalon-sur Saône hospital centre by the firefighters.”
 
What happened?
 
Deputy Public Prosecutor Thierry Bas of Chalon-sur-Saône spoke about the preliminary investigation into the facts, “Like every other morning, the father put his children, a little 5 year-old boy and a little 3 year-old girl, into his car. He dropped off his son at the day nursery and forgot to leave his little girl at the childcare provider’s. He went to work, leaving his car at a sunny car park. At the end of his day’s work, at 4:30 pm, he got into his car and drove to the day nursery to retrieve his son. When he opened the door to put his son on the backseat, he saw that his daughter was doing poorly. He immediately drove to the fire station where the little girl could not be resuscitated. He was in such a state of shock that we couldn’t interrogate him.”
 
“It could happen to anyone.”
 
Jean-Michel Muller, a paediatrician and President of the Nice Côte d’Azur Paediatrician’s Association, believes that “It could happen to anyone because people are often very busy, they’re doing something. If you ask people to whom this has happened, they know that a child should not be left unattended, but they had other things on their mind, and what happened at that time was not deliberate.  It’s a tragedy. One knows that a child should not unsupervised at the poolside, but  even so, the door stays open. It’s carelessness. The stories with cars probably happened to people who were in trouble or who were very busy, they had something to do for several hours, and at the last minute they forget that they had left the child in the car.”
 
Source: radio Monte-Carlo, 23/07/2008

Appendix 3
 
Preventive Technical Devices against Leaving a Child Unattended in a Motor Vehicle
(non-exhaustive list)
 
Name of Device
Manufacturer
Detection Principle
Warning Principle
Advantages
Inconveniences
Baby safety line
Sisters of Invention
Physical line between the driver and child
A line is connected to the car seat (or child) and the other end is connected to the ignition key
Reliability
The line can only be attached to the key after the key has been inserted into the ignition. Risk of forgetting
Child reminder system
Baby Bee Safe
No detection: tag that acts as reminder for the driver
No alarm. A large tag has to be attached to the car keys after the child has been placed on the backseat
Easy-to-install – Works for children of all ages
No visual alarm or buzzer – It has to be attached to the car’s ignition key
Car seat monitor
Cars-N-Kids
Movement and weight sensor
 
 
 
Child minder
Baby Alert
Distance sensor
Un alarm goes off on a receiver carried by the driver if he/she moves more than 3 meters away from the child strapped into the seat
Easy-to-install – The system fits onto the child seat belt and is attached at the same time
Only works with a baby car seat
No name yet
Think Baby
Distance sensor
An alarm goes off on a receiver carried by the driver if he/she moves away from the child strapped into the seat
Easy-to-install – Only product engineered by a French company. It will be marketed at the end of 2009 in France.
Only works with a baby car seat
Child presence sensor
NASA
Distance sensor
 
 
 
Halo Child Seat Safety System
Sisters of Invention
Distance sensor plus ambient temperature sensor
If the driver moves away or the heat climbs, an alarm sounds on a pod. If the driver does not respond after a predetermined amount of time, an alarm sounds on the child seat.
Easy-to-install (sensor pad placed under the baby or booster seat). The child’s weight automatically activates the system, which switches off automatically when the child is picked up. No risk of false alarms or parasites.
Cost ($149.00) Marketing scheduled for late 2009 in the United States
Tomy Alarm / Safety Angel / Securyploof / Call me: Kid Alarm / Conrad alarm, and others
Various
Distance and drown prevention alarms for children or animals
Distance measured between a transmitter worn by the child and a receiver worn by the responsible adult + humidity sensor
Alarm sounds on the receiver
Does not require any installation on motor vehicles
 
 
 
 

Appendix 4
 
Adjustable Technical Devices to Prevent Leaving a Child Unattended in a Motor Vehicle
(non-exhaustive list)
 
 
Name of Device
Manufacturer
Detection Principle
Warning Principle
Advantages
Inconveniences
Personal Car Computer
VOLVO
Heart beat detection
Visual and sound alarm transmitted by receiver carried by the driver
Already operational system
Limited sensor sensitivity for individuals weighing less than 40kg – Problems detecting several people in the passenger compartment – Risk of confusion with an animal – Range limited to 300 meters around the vehicle – Only works if driver queries the device
Safety belt buckled sensor
Various
Sensor on seat belt buckle
Alarm sounds in the car
No need to trigger the system for each trip with the child – Is operational for baby car seats, booster seats and any person seated in the back
Requires modifying the programming of the system that must trigger an alarm if a belt is buckled when the key is taken out and the doors locked – Risk of false alarms – Doesn’t work on seats fitted with ISOFIX fastenings
Image determination
To engineer
Image recognition and infrared detectors
Triggers an alarm if a person is still on the backseat when the driver leaves the vehicle
Detection reliability – Can detect any person at the back of the car – Automatic system
High Cost
Door opening analysis
To engineer
Analysis of the opening sequences of rear passenger doors
Alarm sounds in the vehicle if the rear passenger doors, that are opened before the vehicle starts, are not opened before the doors are locked when the car stops
Low cost (all the doors are equipped with contactors)
Risk of false alarms – Only works on two-door cars or if the driver doesn’t lock the car
Airbag deactivation alarm
To engineer
Analysis of airbag activation
Visual or sound alarm on the vehicle
Uses airbag control tests
Only operational for children seated in front
 
 
 
 
 
 


* French Institute for Public Health Surveillance, National Institute for Prevention and Health Education, National Interministerial Road Safety Observatory, National Institute for Research on Transports and their Safety.
[1] The European Child Safety Alliance is a non-governmental organisation member of the European Consumer Safety Association (ECOSA), which conducts studies on child behaviours, accidentology, standards and regulations. It issues recommendations to the public authorities, to improve child safety in European countries.
[2] Austria, the Czech Republic, Denmark, Finland, Germany, Great Britain, Hungary, Iceland, Italy, Lithuania, the Netherlands, Spain, and Switzerland.
[3] This is especially true in Sweden where parental leave lasts 480 days. Both parents are entitled to the leave and may share it. It may be postponed or taken in batches. Therefore, children are seldom entrusted to childcare providers before they are 2 years old.
[4] Psychiatrist Serge HEFEZ formulated the hypotheses in an article published on the website www.20minutes.fr, on 23 June 2008 (http://www.20minutes.fr/article/242672/France-Enfants-oublies-dans-une-voiture-Le-fait-que-cela-soit-arrive-a-deux-peres-pose-question.php).
[5] A 1998 National Highway Traffic Safety Administration (NHTSA) study found 24 heat related deaths in vehicles, 23 to children under 5.
[6] Compared to the number of drivers and based on the data collected by Commission, the risk occurrence is higher in France than in the United States, with a ratio of 1.2 fatalities per 120 million drivers in France (40 million motor vehicles) compared to 0.72 fatalities in the United States (250 million motor vehicles).
 
 
 
 
 
[7] The Sun Belt has sunny, but not always hot weather. In winter, it snows on the Sierra Nevada and Rocky Mountains. Several deserts are in the southwestern area.
[8] Hypermnesia, characterized by an abnormally sharp memory and vivid recall, is a pathology that impedes the power of reasoning and reflection. It requires deliberate efforts to forget.
[9] Specialists now perceive memory as a set of subsystems: episodic or retrospective memory (of events), semantic memory (of knowledge and concepts), procedural memory (of skills and routines), prospective memory (tasks to perform), implicit memory (knowledge fostering new learning skills).
[10] Article in the 27 February 2009 issue of the Washington Post.
 
[11] The parents and generally any adult responsible for the child.
[12] As case in point is a commercial for mineral water showing infants dancing on roller-blades, copycatting teenage attitudes.
[13] In France, the Institut national de prévention et d’éducation pour la santé (INPES) organises these initiatives. Every year the Institute rolls out an information campaign on the risks incurred by exposure to the sun, and specifically to ultra-violet rays  (www.prevention-soleil.fr), and a campaign on the risk of dehydration during heat waves.
 
[14] Obligations listed in the Public Health Code (specifically Articles R. 4127-9; R. 4127- 205; R. 4127-315 and R. 4312-6).
[15] Specifically “Kids and Cars” in the United States
[16] In the United States, a Bill on the prevention of accidents to children in parked cars was passed in February 2008. It drew on the Cameron Gulbransen Kids Transportation Safety Act. Advocates of the bill had to abandon the request for alarm systems detecting an unattended child in a motor vehicle because of automakers’ blatant opposition.
[17] UNECE works to stimulate sustainable economic growth within its 56 member States. To do so, the EEC provides a forum for communication between the States, offers a negotiating framework for international legal instruments on trade, transport and the environment, and communicates statistics and economic and environmental analyses. The Commission helps increase the United Nations’ efficiency through the regional implementation of the results of world conferences and UN summits.
 
[18] Isofix is a standardised fastening system for child seats for children ages 0+ to 1 (from 0 to 18kg). Two ‘straps’ anchored into vehicle body attach the seat. A third fastening prevents the seat from rotating when there is a lateral shock. 
[19] The system would work if an object were on the backseat. A deactivation option could be installed.