Driving Performance Under Heat Exposure: A Systematic Review and Meta-Analysis of Experimental Studies

ObjectiveThis systematic review and meta-analysis (SRMA) aimed to synthesize and critically appraise existing experimental evidence regarding the impact of heat exposure on driving performance.BackgroundClimate change, characterized by rising temperatures, has been linked to more road accidents and related injuries. Nonetheless, no comprehensive systematic review or meta-analysis has examined the direct effects of increased ambient temperature on driving performance.MethodRegistered in PROSPERO (#CRD42024584269), this SRMA searched major databases and grey literature from their inception to October 2024 and appraised the quality and confidence of the evidence via an established research methodology. A final pool of 7 studies, totaling approximately 207 participants, met the inclusion criteria.ResultsOf the five coded dependent variables, only reaction time (RT) had a sufficient number of studies to support a meta-analysis. There was moderate confidence that heat exposure impairs drivers' RT (SMD = 0.72, 95% CI: 0.32-1.12, p = 0.0004, I² = 65%, p = 0.02). On the other hand, insufficient evidence precluded a definitive assessment of heat's impact on other driving performance metrics, including lateral control, longitudinal control, signal detection, and driving violations, owing to inconsistent findings, limited data and heterogeneity of performance criteria.ConclusionThis synthesis confirms that heat is likely to impair RT, yet evidence concerning other performance aspects remains insufficient. The current study serves as a foundational step in systematically documenting a critical evidence gap in a topic of mounting public health relevance.ApplicationThis paper provides insights for technological and infrastructural adaptations to enhance road safety in the context of rising global temperatures.