Research In Action
Research In Action
A 5-year-old boy in Texas. A 6-month-old girl in Maryland. A 1-year-old boy in California. These are just a few of the pediatric vehicular heatstroke (PVH) deaths that have occurred in the US over the past month where children were intentionally or unintentionally left behind in a hot vehicle. Annually, PVH claims the lives of an average of 37 US children.
While PVH is preventable, it is a complex issue that requires a multifaceted approach encompassing caregiver awareness, legislation, and technologies that function as detection, alert, and intervention systems. Prior CHOP research funded by the National Highway Traffic Safety Administration (NHTSA) evaluated products designed to prevent children 2 and under from being left behind in closed, parked vehicles, potentially leading to pediatric heatstroke. Results from this novel assessment in 2012 showed none of the three pediatric heatstroke devices tested to be completely reliable and consistent in their ability to detect children. Since then, there have been technological advancements developed by automotive manufacturers, child restraint manufacturers, and third-party developers to find an engineering solution to preventing PVH. But how effective would these technologies be if applied to real-world cases of PVH?
That was the question my co-authors and I aimed to answer in recently published research in the American Journal of Public Health. We systematically reviewed cases of children dying in hot vehicles from 2011–2019 to identify “exemplar” scenarios, or cases that were distinct from others in terms of circumstances, and whether the various technological interventions available would have prevented these deaths. Across 354 cases, we identified 10 distinct scenarios based on the age of the child, the location inside the vehicle where the child was found, the immediate surroundings of the vehicle, and the caregiver’s status.
We found that no single technology would have prevented all PVH events. Instead, a combination of indirect detection (e.g., sensing that a rear door has been opened and closed before a trip), direct detection (e.g., pressure sensors), alerting (e.g., visual, auditory, or haptic alerts), and intervention (e.g., the vehicle’s air conditioner turning on) features is needed. Within specific categories, some technologies were found to be more effective than others. For example, among alerting technologies, notifying a second-degree contact was the only technology that would have effectively brought intervention to every child, whether they were left behind intentionally or unintentionally by caregivers.
Beginning in 2025, all new passenger vehicles less than 10,000 pounds must be equipped with a child safety alert system. Our study, funded by CHOP and The Ohio State University’s Center for Child Injury Prevention Studies (CChIPS), shows variable effectiveness among the available technologies, indicating that minimum technology requirements for vehicles should be established in tandem with novel education efforts. Technology, while critically important, nearly always requires someone to take an action in order to save the child from PVH. So while these advancements are crucial, they do not replace education and awareness for caregivers. As temperatures continue to soar this summer, we should encourage caregivers to access heatstroke prevention tips from organizations like Safe Kids and the American Academy of Pediatrics.
