Transport Research International Documentation (TRID)

PREVENTing Pilot murder-suicide: A policy-oriented review

Mon, 01 Jun 2026 09:02:34 GMT

Pilot murder-suicides represent a critical and under-addressed challenge at the intersection of human factors, safety management, and intelligent transportation systems. Recent high-profile incidents–such as Mozambique Airlines Flight 470 (2013), Germanwings Flight 9525 (2015), China Eastern Airlines Flight 5735 (2022), and preliminary discussions around Air India Flight 171 (2025)–have underscored the urgent need for evidence-based prevention strategies that align with the evolving landscape of smart and automated aviation. While substantial primary research exists, the field lacks a comprehensive, policy-oriented synthesis that bridges psychological, operational, and technological dimensions. To address this gap, we consolidate the extant literature and introduce the PREVENT framework, a multidimensional, data-driven approach to mitigating pilot murder-suicide risks. The framework spans seven prevention domains, offering actionable insights for integrating mental health support, real-time risk monitoring, and human-centered design into next-generation aviation systems. By synthesizing empirical evidence and case studies, this review provides a roadmap for policymakers, transport authorities, and industry practitioners to enhance safety in intelligent aviation environments. We identify conceptual and empirical gaps to guide future research, emphasizing the need for interdisciplinary collaboration between behavioral science, engineering, and public policy to ensure safe, resilient, and human-focused smart transportation systems.

Preventing Real-World Pediatric Vehicular Heatstroke Events With Technology

Mon, 24 Nov 2025 10:19:56 GMT

In this article, the authors explore the use of technology as a strategy to prevent pediatric vehicular heatstroke events. The authors reviewed cases of children dying in hot vehicles to identify scenarios that might be classified as “exemplar;” these ten cases were further defined as cases that were different from the norm based on characteristics of the child, caregiver, and the setting or context in which the event occurred. In each of these 10 special cases, the authors considered whether currently-available detection, alerting, and intervention technologies would have prevented the heatstroke event. They found that the effectiveness of different technologies varied widely; no single technology by itself could have prevented all deaths. The authors conclude with a discussion of the Hot Cars Act (2021) which mandates that vehicles have child safety alert systems in all models starting in 2025. However, this Act does not provide any specific guidelines to manufacturers about which technologies should be used. The authors stress the need for using multiple features in tandem in order to prevent pediatric heatstroke events.

A mixed-methods study characterizing US caregivers’ attitudes toward pediatric vehicular heatstroke interventions

Wed, 19 Nov 2025 17:09:39 GMT

Several behavioral and technological approaches have been proposed to help prevent pediatric vehicular heatstroke (PVH), or children overheating in cars. While studies have examined technologies’ efficacy in controlled settings, it remains unclear how end-users feel about adopting behavioral/technological interventions for use in the real-world. Thus, this study’s objective was to characterize caregivers’ attitudes toward available PVH interventions. We conducted a national survey and focus groups with caregivers of children less than 5 years old. Both studies gathered caregivers’ demographics, as well as their opinions about adopting/using broad and specific types of behavioral and technological interventions for PVH. Surveys were analyzed with descriptive statistics; focus groups were analyzed using a grounded theory approach to qualitative data. There were 1,500 survey respondents and 4 focus groups (16 participants total). Participants across studies shared similar interests in and generally positive opinions toward behavioral and technological PVH interventions, with caveats. A selection of survey findings include: (1) 90% of respondents were Somewhat or Extremely Willing to use technology that would remind them/warn them if they had left a child, (2) 58-64% would use Vehicle-based warning systems (e.g., occupant detection sensor + horn), Car seat-based warning systems (e.g., child detection sensor + siren), or Vehicle-based reminder technology (e.g., trip-based message or chime), and (3) 11% would not use any technology. Focus groups agreed generally with respondents in the survey, expanding results to state more caregivers should be aware of behavioral interventions and to raise concerns about some interventions’ ease of use, amount of effort required, risk of malfunction or lack of effectiveness, maintenance, and potential cost. For example, caregivers with rear-seat check reminders believed that chimes and dash messages may be ineffective in the long-term. The knowledge gained from this study can help to prioritize future PVH intervention efforts and enhance effectiveness among emerging approaches, along with informing how stakeholders may improve consumer awareness, adoption, and rates of correct usages. Based on our findings, this paper will inform ways to bolster caregivers’ engagement with behavioral approaches and simultaneous use of effective and accessible technological interventions.

Characterizing caregiver attitudes to optimize pediatric vehicular heatstroke campaigns

Mon, 19 May 2025 09:11:29 GMT

Since 1998; approximately 1,000 US children have died due to pediatric vehicular heatstroke (PVH; i.e., children overheating in vehicles). As the frequency of cases have largely remained unchanged over time, there is a need for novel research that can inform effective PVH prevention efforts, such as awareness campaigns. The objective of this project was to characterize caregivers’ opinions about existing PVH campaigns and thoughts about what future campaigns should look like. The authors conducted 4 virtual focus groups (16 participants total). Groups discussed broad childhood injury topics, as well as PVH. Groups also viewed existing communication campaigns for a variety of injury topics and provided their perspectives on what future campaigns focused on PVH should contain. All focus groups were recorded, transcribed, and de-identified. Two independent coders reviewed and coded transcripts, which were developed and applied using a directed-content approach. The authors then created code summaries, which were used to develop themes. Themes were: (1) PVH differs from other injuries, (2) Campaigns should be short, educational, practical, and include diverse populations/subjects, and (3) Campaigns should be placed where caregivers are with their children. Caregivers acknowledged they were misinformed about their PVH risk; providing them with real-world statistics changed their views about if they should adopt preventative actions. Participants voiced communicating this risk to caregivers with actions they can take to reduce their risk in future campaigns is important to promote widespread adoption of preventative measures. Based on results, the authors recommend future campaigns consider the IDEA framework when developing novel PVH campaigns.

Experimental and numerical investigation of thermal environment of the child trapped in a parked vehicle

Fri, 19 Apr 2024 16:25:04 GMT

Pediatric vehicular hyperthermia (PVH) has aroused wide public concern recently. High temperatures in closed vehicles with full sun exposure and no ventilation in summer seriously endanger children's lives. Aiming at this practical problem, this study first took the temperature of child’s core body as a standard, and divided the hyperthermia into three stages: un-compensable heating (Tc > 37ºC), heat stroke (Tc > 40ºC) and critical thermal maximum (Tc > 42ºC). On this basis, two weeks of outdoor parking experiments during 10:00-18:00, using an equivalent size dummy were conducted to explore the influence of ambient temperature and solar irradiation on cabin temperature, humidity, and child’s core body temperature. According to the experimental results, at an ambient temperature of 32.4ºC, the child in the cabin developed un-compensable heating within 72min, suffered heat stroke within 129min, and reached the critical thermal maximum within 151min. Considering the limitations of the experiment, a numerical study was conducted to analyze the effects of ambient temperature, solar irradiation, and window radiation characteristics on cabin temperature and flow fields comprehensively. Simulation results were in good agreement with the experiments: even at low ambient temperature Ta = 23ºC or weak solar irradiation (ts = 18:00) condition, the temperature in a closed compartment could reach the "hazardous" level. This study can provide guidance for public to increase security and prevention awareness, and promote the development of relevant policies and technologies.

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

Thu, 18 Apr 2024 17:08:06 GMT

ObjectivesTo 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.MethodsData 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.ResultsMost 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.ConclusionsThe 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.

Deliberate fatal crashes involving a motor vehicle and a cyclist or pedestrian

Fri, 26 May 2023 08:51:06 GMT

Deliberate crashes are caused by road users engaging in insurance fraud, attempting suicide, or “punishing” other road users. In this study, the authors investigated deliberate crashes that resulted in the deaths of “vulnerable” road users (cyclists and pedestrians).The authors used in-depth road crash investigation data from the Finnish Crash Data Institute and court decisions for a selected number of cases in which the deceased had not been the main originator of the crash. In 1997–2018, 96 pedestrians and five cyclists died in 101 deliberately caused crashes involving a motor vehicle. The majority of these crashes were caused by suicides (94/96 pedestrian and 3/5 cyclist crashes). Most of suicide crashes (79%) involved a heavy vehicle. Eighty percent of the victims were male. Previous suicidal thoughts and attempts, and a history of mental disorders/illness was prevalent around two thirds of the originators of the crashes. Four cases were caused by motor vehicle drivers. According to court rulings, the drivers in two of these cases were convicted of manslaughter. The authors provide some possible reasons for this relatively high number of road suicides in Finland and discuss the legal implications of deliberately hitting pedestrians or cyclists with a motor vehicle.

Death rates for motor-vehicle-traffic injuries, suicide, and homicide among adolescents and young adults aged 15-24 years - United States, 1999 - 2019

Fri, 11 Feb 2022 14:24:06 GMT

Mortality rates for adolescents and young adults aged 15-24 years for deaths from motor-vehicle-traffic injury, suicide, and homicide remained relatively stable during 1999-2006 and then exhibited different patterns through 2019. In 1999, the rate for motor-vehicle-traffic deaths was 25.6 per 100,000 population and declined to 13.7 in 2019. The suicide rate was 10.1 in 1999 and increased to 14.5 in 2018 before declining to 13.9 in 2019. The homicide rate was 12.9 in 1999 and declined to 9.5 in 2014 before increasing to 11.2 in 2019. In 2019, the death rates for motor-vehicle-traffic injury and suicide were similar; both rates were higher than the homicide rate. Source: National Center for Health Statistics, National Vital Statistics System, Mortality Data, 2009-2019. https://www.cdc.gov/nchs/nvss/deaths.htm Rates are per 100,000 population aged 15-24 years. Deaths from motor-vehicle-traffic injuries are identified with International Classification of Diseases, Tenth Edition (ICD-10) codes V02-V04[.1-.9], V09.2, V12-V14[.3-.9], V19[.4-.6], V20-V28[.3-.9], V29-V79[.4-.9], V80[.3-.5], V81.1, V82.1, V83-V86[.0-.3], V87[.0-.8], V89.2. All motor-vehicle-traffic injuries are unintended. Suicides are identified with ICD-10 codes U03, X60-X84, and Y87.0, and homicides with codes U01-U02, X85-Y09, and Y87.1.

Impact of COVID-19 lockdown policy on homicide, suicide, and motor vehicle deaths in Peru

Mon, 11 Jan 2021 11:08:08 GMT

Although lockdown measures to stop COVID-19 have direct effects on disease transmission, their impact on violent and accidental deaths remains unknown. The study aims to assess the early impact of COVID-19 lockdown on violent and accidental deaths in Peru. Based on data from the Peruvian National Death Information System, an interrupted time series analysis was performed to assess the immediate impact and change in the trend of COVID-19 lockdown on external causes of death including homicide, suicide, and traffic accidents. The analysis was stratified by sex and the time unit was every 15 days. All forms of deaths examined presented a sudden drop after the lockdown. The biggest drop was in deaths related to traffic accidents, with a reduction of 12.22 deaths per million men per month (95% CI: −14.45, −9.98) and 3.55 deaths per million women per month (95% CI:-4.81, −2.30). Homicide and suicide presented similar level drop in women, while the homicide reduction was 2.5 the size of the suicide reduction in men. The slope in homicide in men during the lock-down period increased by 6.66 deaths per million men per year (95% CI:3.18, 10.15). External deaths presented a sudden drop after the lockdown was implemented and an increase in homicide in men was observed. Falls in mobility have a natural impact on traffic accidents, however, the patterns for suicide and homicide are less intuitive and reveal important characteristics of these events, although the authors expect all of these changes to be transient.

Metal Against Marchers: An Analysis of Recent Incidents Involving Vehicle Assaults at U.S. Political Protests and Rallies

Thu, 03 Dec 2020 10:10:12 GMT

The protests against racism and police conduct taking place throughout cities and towns across the United States have been mostly peaceful, but a few of them have led to violent confrontations between protesters, counterprotesters, and police, and in a number of incidents, vehicles were driven into protesters. This Mineta Transportation Institute (MTI) Security Perspective examines the spate of reported vehicle assaults and other vehicle-related events that have occurred since the protests began in late May 2020. It describes the varied circumstances of the events and the apparent motivations of the drivers, and it offers preliminary (and tentative) judgments about where these incidents fall on a spectrum of hostility and premeditation. Finally, it compares and contrasts the current events with the incidents discussed in the authors' previous study, “Smashing into Crowds”—An Analysis of Vehicle Ramming Attacks."

The deterrent effect of “Vehicular Homicide Laws”: Microeconometric evidence from Italy

Thu, 17 Sep 2020 17:51:34 GMT

The authors empirically measure the short-run marginal deterrent effect of the Italian “Vehicular Homicide Law” (VHL), introduced in Italy in 2016. They exploit micro-data on the entire universe of road accidents in Italy in the period before and after the VHL. The authors find no systematic variation of the number of deaths per accident, after controlling for an array of driver and vehicle characteristics, road and weather conditions, province-level effects and time effects absorbing country-level variation in traffic volumes and enforcement devices. The authors argue that the short-run marginal deterrent effect of the Italian VHL was negligible. They also document a number of correlations between several driver, vehicle and road characteristics and both the occurrence and the severity of fatal accidents. The authors' results may help improving policy initiatives aimed at curbing dangerous driving on Italian roads.

Foul play ruled in Sage Sagittarius deaths : NYK insists it is promoting a safe working environment following a report of onboard fatalities

Fri, 28 Aug 2020 18:40:53 GMT

Testing the Impact of Road Network Connectivity on Criminal Lethality

Tue, 19 Nov 2019 14:09:57 GMT

It has been shown that there is a link between increased road network connectivity and more positive outcomes among all health outcomes. However, there has not yet been testing done that specifically associates criminal lethality and road network connectivity. This study is looking at road network connectivity in order to incorporate it as an explanatory variable for criminal lethality. Data collection from 190 cities consisted of data on Road Network Connectivity and Criminal Lethality. The National Incident-Based Reporting System (NIBRS), 2010 Census, 2010 American Community Survey, Google Earth, and Census Topologically Integrated Geographic Encoding and Referencing (TIGER) files comprised the data sources. The relationship between decreases in the rates of lethality among assaults and a city's road network connectivity is demonstrated by the data. There is a discussion of the significance of this finding.

Effectiveness of Taxicab Security Equipment in Reducing Driver Homicide Rates

Fri, 21 Sep 2018 09:32:23 GMT

Taxicab drivers historically have had one of the highest work-related homicide rates of any occupation. In 2010 the taxicab driver homicide rate was 7.4 per 100,000 drivers, compared to the overall rate of 0.37 per 100,000 workers. This study evaluated the effectiveness of taxicab security cameras and partitions on citywide taxicab driver homicide rates. Taxicab driver homicide rates were compared in 26 major cities in the U.S. licensing taxicabs with security cameras (n=8); bullet-resistant partitions (n=7); and cities where taxicabs were not equipped with either security cameras or partitions (n=11). News clippings of taxicab driver homicides and the number of licensed taxicabs by city were used to construct taxicab driver homicide rates spanning 15 years (1996–2010). Generalized estimating equations were constructed to model the Poisson-distributed homicide rates on city-specific safety equipment installation status, controlling for city homicide rate and the concurrent decline of homicide rates over time. Data were analyzed in 2012. Cities with cameras experienced a threefold reduction in taxicab driver homicides compared with control cities (RR=0.27; 95% CI=0.12, 0.61; p=0.002). There was no difference in homicide rates for cities with partitions compared with control cities (RR=1.15; 95% CI=0.80, 1.64; p=0.575). Municipal ordinances and company policies mandating security cameras appear to be highly effective in reducing taxicab driver deaths due to workplace violence.

The System Theoretic Accident Modelling and Process (STAMP) of Medical Pilot Knock-Out Events: Pilot Incapacitation and Homicide-Suicide

Fri, 21 Sep 2018 09:32:21 GMT

After the Germanwings flight 4U9525, mental health issues of pilots have been raised as a hazard to flight safety. Pilot homicide-suicide, as a special subtype of pilot incapacitation, can be examined at different levels of commercial aviation. The authors extended the System Theoretic Process Analysis (STPA), based on the System Theoretic Accident Modelling and Process (STAMP), to pilot behavior to investigate how these knock-out events may be encountered in the whole system. Several safety actions have been identified to prevent hazardous pilot behavior caused by medical incapacitation and homicidal-suicidal behavior at different levels of the system. Pilot incapacitation is already handled very well in practice with respect to the regulations and procedures in current usage. In contrast, the prevention of pilot homicide-suicide is currently managed by aeromedical decision-making regulations and pilot support programs. The design of the flight deck compartment door and the balancing of privacy laws and public safety remain trade-offs amid a medical risk.