Pediatric vehicular heatstroke: An analysis of 296 cases from the National Fatality Review Case Reporting System

Abstract

Objectives

To explore the National Fatality Review Case Reporting System (NFR-CRS) as a new data source to (1) characterize pediatric vehicular heatstroke (PVH) deaths among children <15 years of age reviewed by Child Death Review teams, and (2) identify factors independently associated with common PVH scenarios and incident locations.

Methods

Data for 2005–2019 were used to characterize 296 PVH deaths. Frequencies and percentages were calculated to describe child, supervisor, and incident characteristics. Multiple logistic regression with and without imputation were carried out to identify factors associated with the two outcomes of interest: PVH scenario (left in vehicle vs. gained access) and incident place (supervisor workplace vs. other locations). Odds ratios and 95% confidence intervals (OR, 95% CI) were calculated.

Results

Most children had been left unattended in vehicles (N = 225, 76.0%) and 13.5% (N = 40) had gained access independently. Children were most often male (N = 168, 56.8%), non-Hispanic White (N = 131, 44.3%), and <2 years of age (N = 172, 58.1%). Disability or chronic illness was noted for 4.7% (N = 14), 13.9% (N = 41) had a history of maltreatment, and 6.1% (N = 18) an open CPS case at the time of incident. Children left unattended were more likely to be <2 years of age (adjusted imputed OR 26.7, CI 7.3–97.2) and less likely to have an open CPS case (0.2, 0.0–0.4) and for the incident to occur at home (0.2, 0.1–0.9) compared to children who gained access. PVH deaths occurring at the supervisor’s workplace were more likely to be <2 years of age (6.2, 2.4–15.8), to have occurred on a weekday (5.9, 1.7–20.9), and to have been supervised by their parent at the incident time (2.7, 1.1–6.7) compared to other locations.

Conclusions

The results align with previous PVH findings and added new information on child race/ethnicity, CPS action, disability/chronic illness, and maltreatment. With the exception of parents being more likely to be the supervisor in incidents occurring at home, which was expected, neither supervisor characteristics nor child race/ethnicity or sex were independently significant in multiple regression, suggesting that PVH is pervasive and that education campaigns should be similarly broad.

Keywords:

• Pediatric vehicular heatstroke
• heatstroke
• hyperthermia
• non-crash
• non-traffic

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The National Center for Fatality Review and Prevention is funded in part by Cooperative Agreement Number UG7MC28482 from the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB) as part of an award totaling $5,149,996 annually with 0% financed with non-governmental sources. These contents are solely the responsibility of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.