Fatal hyperthermia among children in school buses: Analysis of 47 cases in China.

The school bus is an important mode of transportation for school-age children, and safety-related issues are always the focus of public concern. Fatal hyperthermia occurring in school buses is an uncommon type of school bus-related injury. An internet search using Chinese internet search engines based on various combinations of keywords including 'vehicles', 'school bus', 'children or babies', 'hyperthermia or heat stroke' and 'death' was performed. Forty-seven cases of fatal hyperthermia in children which occurred in school buses were retrieved in the study. High ambient temperature, younger age and poor management were identified as risk factors. There is a lack of consensus regarding the legal nature and liability for fatal hyperthermia occurring in school buses. Pre-employment education should be focused on awareness of the dangers of leaving children alone in a school bus. Most importantly, the relevant legislation and regulations on school buses should be implemented. An internal alarm-raising system is recommended to avoid this kind of tragedy.