Inadequate domestic insulation in Australia – an additional risk factor for lethal hypothermia

Abstract

Case report An 86-year-old woman was found deceased at her home address having not been seen for 4 days. The major findings at autopsy included a fractured neck of femur, recent pressure areas over her buttock, Wischnewski spots of the stomach and pancreatic necrosis. There were no significant underlying organic diseases and no other evidence of trauma. Minimum overnight temperatures around the time of death ranged from 8.0-14.6°C. Death was attributed to hypothermia complicating immobility from a fractured neck of femur. This case demonstrates that frail, elderly and socially-isolated individuals may be at risk of lethal hypothermia. Importantly, a subsequent scene investigation indicated additional risk factors. specifically the house, which was a pre-World War II brick bungalow, lacked double glazed windows, and had no wall or floor insulation, or underfloor heating. The external doors had gaps that would have been associated with significant air leakage. Discussion The evaluation of possible hypothermic deaths should, therefore, include not only measuring room and environmental temperatures, but also noting the type and quality of heating and insulation. As the population of Australia ages, and fuel and energy costs rise, more of these types of deaths may be expected to occur.