Simon Ntramah, Williams Ackaah, Nukhba Zia, Lamisa Ashraf, Yuan Shang, Francis Afukaar, Edmund K Debrah, Abdulgafoor M Bachani
{"title":"Seatbelt and child restraint use in Accra, Ghana: results from multi-round observational studies (2015-2020).","authors":"Simon Ntramah, Williams Ackaah, Nukhba Zia, Lamisa Ashraf, Yuan Shang, Francis Afukaar, Edmund K Debrah, Abdulgafoor M Bachani","doi":"10.1080/17457300.2026.2656209","DOIUrl":"10.1080/17457300.2026.2656209","url":null,"abstract":"<p><p>Seatbelt and child restraint use are cost-effective ways of reducing the severity of road traffic injuries among vehicle occupants and children, respectively. The study aimed to determine the prevalence and associated factors of seatbelt and child restraint use in Accra, Ghana, using a multi-round cross-sectional observation design spanning the period 2015 - 2020. Between 6 and 15 sites were randomly selected in areas where traffic slowed down considerably or completely stopped. Nine observational rounds were undertaken during the period with a gap of six months between each round. The overall seatbelt usage was 48.7% (<i>n</i> = 481,585), with a significant difference among drivers' (78.9%, <i>n</i> = 258,996), front-seat passengers' (14.4%, <i>n</i> = 206,578) and rear-seat passengers' use (2.2%, <i>n</i> = 16,011) (<i>p</i> < 0.001). Child seat usage was far lower at 5.9%. The observed driver seatbelt use, passenger seatbelt usage and child seat usage generally declined significantly between August 2015 and November 2020. Both seatbelt and child restraint use were lowest among males, truck vehicles, on weekends and in presence of camera enforcement, among other specific factors. Policy reforms should prohibit young children from occupying front seats and place clear legal responsibility on drivers to secure all passengers.</p>","PeriodicalId":47014,"journal":{"name":"International Journal of Injury Control and Safety Promotion","volume":" ","pages":"309-321"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zia Ur Rehman, Chenzhu Wang, Said M Easa, Chaozhe Jiang, Arshad Jamal
{"title":"Temporal and weather-specific analysis of injury severity in three-wheeled rickshaw crashes: a heterogeneity-aware modeling approach.","authors":"Zia Ur Rehman, Chenzhu Wang, Said M Easa, Chaozhe Jiang, Arshad Jamal","doi":"10.1080/17457300.2026.2637567","DOIUrl":"10.1080/17457300.2026.2637567","url":null,"abstract":"<p><p>Three-wheeled motorized rickshaws (3-WMRs) present serious safety risks in developing countries, yet the joint effects of weather and temporal changes on crash severity remain underexplored. Using six years of police-reported 3-WMR crash data from Rawalpindi, Pakistan (2017-2022), we estimate a partially constrained temporal random-parameters logit model with heterogeneity in means to capture unobserved factors and time-varying effects across weather types and biennial periods. Severe or fatal injuries are more likely in crashes involving motorcycles, pedestrians, or trucks; single-vehicle events; older drivers; peak-hour traffic; wrong U-turns; speeding; and distraction. Importantly, the magnitudes and directions of several effects vary by weather and over time. Rainy conditions elevate severity risk (e.g., reduced friction), whereas sunny weather is linked to riskier behaviors (e.g., speeding). The results support adaptive, weather-specific countermeasures, including stricter speed enforcement in rain, enhanced signing/markings for low visibility, and targeted training for high-risk groups such as older riders.</p>","PeriodicalId":47014,"journal":{"name":"International Journal of Injury Control and Safety Promotion","volume":" ","pages":"239-266"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Investigating the factors of three-wheeled autorickshaw (3W-AR) crash severity: comparison of explainable machine learning models.","authors":"Tefera Bahiru Ambo, Chuanyun Fu, Zhaoyou Lu, Betelihem Asfaw Ashamo, Simon Gebregziabher Hailemichael","doi":"10.1080/17457300.2026.2650749","DOIUrl":"10.1080/17457300.2026.2650749","url":null,"abstract":"<p><p>Three-wheeled autorickshaws (3W-ARs), locally called Bajaj, are a vital mode of public transport in Ethiopia. However, their crash involvement remains an overlooked critical mobility challenge. This study investigates the crash severity influence factors of 3W-ARs using five machine learning models: Random Forest (RF), Decision Tree (DT), Support Vector Machine (SVM), XGBoost, and LightGBM, along with the SHAP interpreter for explainability. Five-year crash record data (2019-2023) from Dire Dawa City were analysed. The results revealed that RF and DT outperformed the other three models with overall accuracies of 92.7% and 92.3%, respectively. Several attributes significantly contribute to the severity of 3W-AR injuries, including driving experience, rider educational level, pedestrian crossing behavior, and vehicle age. Notably, pedestrian-involved collisions particularly those resulting from unsafe pedestrian actions such as sudden road crossing or walking along traffic lanes emerged as one of the most dominant and consistent predictors of fatal and severe injury crashes. By integrating a machine learning model with explainable AI, this study advances data-driven approaches for enhancing 3W-AR safety and crash prevention measures. The findings provide critical insights for policymakers and transportation planners, enabling the development of targeted interventions suited to Ethiopian context.</p>","PeriodicalId":47014,"journal":{"name":"International Journal of Injury Control and Safety Promotion","volume":" ","pages":"282-298"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yejin Kim, Sihyeon Moon, Yoseph Lee, Jooyoung Lee, Ilsoo Yun
{"title":"A quantitative methodological framework for traffic accident risk estimation using the Swiss Cheese Model.","authors":"Yejin Kim, Sihyeon Moon, Yoseph Lee, Jooyoung Lee, Ilsoo Yun","doi":"10.1080/17457300.2026.2666222","DOIUrl":"10.1080/17457300.2026.2666222","url":null,"abstract":"<p><p>A quantitative framework for estimating traffic accident risk based on the Swiss Cheese Model is proposed. While the Swiss Cheese Model is widely recognized for explaining accident causation, its applications have remained qualitative and descriptive. To address this limitation, the proposed framework operationalizes Swiss Cheese Model deficiencies as measurable risk factors and models their multi-layered interactions in the form of system-level trajectories. The framework derives representative values under normal and hazardous conditions, constructs system-level trajectories, and estimates traffic accident risk using machine learning. An empirical analysis demonstrates the framework's ability to identify high-risk configurations. The highest-risk configuration was associated with increased predicted accident risk relative to baseline conditions. The findings indicate that the framework can advance the Swiss Cheese Model from a post-hoc explanatory tool to a system-level framework, providing a methodological foundation for data-driven identification of high-risk configurations to support proactive traffic safety management and policy development.</p>","PeriodicalId":47014,"journal":{"name":"International Journal of Injury Control and Safety Promotion","volume":" ","pages":"335-349"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A nation in motion, a people in mourning: a lamentation on Ghana's road carnage.","authors":"Enock Aninakwah, Isaac Aninakwah","doi":"10.1080/17457300.2026.2635100","DOIUrl":"10.1080/17457300.2026.2635100","url":null,"abstract":"<p><p>Ghana is losing too many lives on the road, and the numbers continue to rise. This study examined road traffic fatalities in Ghana from 1991 to 2024, identified their major causes and compared Ghana's situation with that of selected African countries. Data were obtained from credible sources, including the National Road Safety Authority, the World Health Organisation, the Ghana Highway Authority and relevant local studies. The findings show that more than 46,000 people died in road crashes between 1991 and 2018, with an additional 2,494 deaths recorded in 2024 alone. The leading causes were poor road infrastructure, driver error and vehicle defects. Comparative analysis revealed that Ghana's road fatality rate is higher than that of Rwanda and Nigeria, despite Ghana having a smaller vehicle population. Using a statistical projection based on historical trends, the study indicates that Ghana could record more than 2,800 road deaths in a single year by 2030 if current conditions persist. This trajectory suggests that the country is unlikely to achieve the Sustainable Development Goal target of halving road traffic deaths. These findings highlight a crisis that has become normalised in everyday life, where road travel is often perceived as a gamble. Urgent and coordinated action is therefore required, including improved road infrastructure, expansion of dual carriageways, stricter enforcement of traffic regulations and sustained public education. Road safety in Ghana has become a national public health and development priority rather than a transport issue alone.</p>","PeriodicalId":47014,"journal":{"name":"International Journal of Injury Control and Safety Promotion","volume":" ","pages":"230-238"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Restraints for young kids on motorcycles: potential harms likely outweigh the benefits.","authors":"","doi":"10.1080/17457300.2026.2635098","DOIUrl":"10.1080/17457300.2026.2635098","url":null,"abstract":"<p><p>The transport of young children on motorcycles is a concern in many low- and middle-income countries. A 2015 World Health Organization report speculated about the potential value of safety restraints (\"safety harness\") that strap the child to the adult rider and aim to prevent young children from slipping off motorcycles. Although the WHO report recommended that the concept should be evaluated before adoption, India recently became the first country to mandate the use of child safety harnesses. Epidemiological data from India show that children rarely slip off motorcycles. In contrast, crashes of motorcycles that are carrying young children are far more common. In a crash, a child who is tethered to an adult is likely to sustain more severe injuries because of the adult's mass and movement during impact. Therefore, the risks posed by harnesses to children may far exceed their benefits. Policies promoting these devices will likely create a false sense of safety among parents that could increase the transport of young children on motorcycles and in more risky conditions. India's policy mandating their use should be discontinued until more evidence is available. We call for urgent reconsideration and redirection of attention toward evidence-based strategies to protect children in traffic.</p>","PeriodicalId":47014,"journal":{"name":"International Journal of Injury Control and Safety Promotion","volume":" ","pages":"226-229"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Built environment characteristics and drowning mortality: a global satellite-based analysis of urbanisation, infrastructure, and water proximity.","authors":"Ryan Essex, Samsung Lim, Jagnoor Jagnoor","doi":"10.1080/17457300.2026.2678332","DOIUrl":"https://doi.org/10.1080/17457300.2026.2678332","url":null,"abstract":"<p><p>Drowning remains a major global public health challenge, yet how built environment characteristics shape population-level drowning risk remains poorly understood. This study linked satellite-derived built environment data to subnational drowning mortality estimates across 203 regions in 12 countries from 2006-2021. It found that built environment associations with drowning mortality are complex, non-linear, and shaped by development context. Urban extent was strongly protective, while built area near water showed protection overall but increased risk when combined with high population crowding. Almost all drowning mortality variance occurred between regions rather than within regions over time, indicating risk is predominantly determined by place-based characteristics. Income-stratified analyses revealed profound heterogeneity: crowding was protective in low- to middle-income settings, while near-water built area was protective mainly in middle-income settings. These findings highlight the importance of tailoring drowning prevention strategies to local built environment configurations and development contexts.</p>","PeriodicalId":47014,"journal":{"name":"International Journal of Injury Control and Safety Promotion","volume":" ","pages":"1-12"},"PeriodicalIF":2.0,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammed Alsabri, Shree Rath, Hamza Irfan, Amira A Aboali, Noha S Shaban, Akash Kumar, Lauren A Carr
{"title":"Outcomes and predictive factors in pediatric drowning: a systematic review and meta-analysis of prehospital predictors.","authors":"Mohammed Alsabri, Shree Rath, Hamza Irfan, Amira A Aboali, Noha S Shaban, Akash Kumar, Lauren A Carr","doi":"10.1080/17457300.2026.2678328","DOIUrl":"https://doi.org/10.1080/17457300.2026.2678328","url":null,"abstract":"<p><p><b>Purpose:</b> Drowning ranks as the third leading cause of injury-related death in children globally. This systematic review and meta-analysis aims to provide a comprehensive assessment of mortality rates, and resuscitation success rates in pediatric populations. <b>Methods</b>: A comprehensive literature search was conducted across four databases PubMed, Cochrane, Web of Science and Scopus for all original studies published till November 2024 with reported outcomes of drowning in the pediatric population. Outcomes evaluated include mortality, rate of discharge, neurological outcomes at discharge, and success rate of resuscitation. <b>Results</b>: Twenty-four studies encompassing 2,436 pediatric drowning cases were analyzed. The pooled mortality rate was 24% (95% CI [0.17, 0.34]), underscoring the critical fatality risk. The pooled discharge rate was 63% (95% CI [0.47, 0.76]), indicating favorable recovery for most cases. However, one-third of patients exhibited significant neurological deficits. Resuscitation success was achieved in 39% (95% CI [0.32, 0.48]), with bystander resuscitation demonstrating nearly double the success rates compared to emergency medical personnel or lifeguards. <b>Conclusion</b>: Despite favorable discharge rates, pediatric drowning remains a major public health challenge with high mortality and neurological impairment rates. Urgent action is required to develop standardized management protocols and prevention strategies, particularly in resource-limited settings.</p>","PeriodicalId":47014,"journal":{"name":"International Journal of Injury Control and Safety Promotion","volume":" ","pages":"1-13"},"PeriodicalIF":2.0,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel Gyaase, Margaret Peden, Julie Brown, Jagnoor Jagnoor
{"title":"Helmet use among motorcyclists in Tamale, Ghana: prevalence and associated factors.","authors":"Daniel Gyaase, Margaret Peden, Julie Brown, Jagnoor Jagnoor","doi":"10.1080/17457300.2026.2663856","DOIUrl":"https://doi.org/10.1080/17457300.2026.2663856","url":null,"abstract":"<p><p>Motorcycle use has become crucial in Ghana, as it is the predominant mode of transportation in some parts of the country. Ensuring their safety is crucial in reducing the exponential increase in related fatalities. This study assessed helmet-wearing rates among motorcyclists (riders and pillion riders), non-standard helmet use and improper helmet use, and identified demographic, spatial and behavioural factors influencing helmet wearing in Tamale, Ghana. We conducted an observational study among 10,127 motorcyclists (7,147 riders and 2,980 pillion riders) in Tamale. Motorcyclists were observed at intersections, traffic lights, and sections of the road where they usually slow down. The prevalence of helmet use was estimated as proportions and 95% confidence intervals. Log-binomial regression was used to identify factors associated with helmet use. The prevalence of helmet use was 24.4% (95% CI: 23.6% to 25.2%). Among riders, the prevalence was 31.7%; among pillions, 6.9%. The prevalence further declines to 15.0% (95% CI: 14.3% to 15.7%) when improper use and non-standard helmets are considered. Helmet use was higher among males, older motorcyclists, weekday commuters, those in the central business district, and on highways. Riders with pillion passengers were less likely to wear helmets, and helmet use among pillion riders declined as their number increased. Findings underscore the need for regulatory action on helmet standards, targeted enforcement and pillion safety.</p>","PeriodicalId":47014,"journal":{"name":"International Journal of Injury Control and Safety Promotion","volume":" ","pages":"1-10"},"PeriodicalIF":2.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Deotima Mukherjee, K Ramachandra Rao, Geetam Tiwari
{"title":"Pedestrian crash risk near bus stops in Delhi: development of safety performance functions.","authors":"Deotima Mukherjee, K Ramachandra Rao, Geetam Tiwari","doi":"10.1080/17457300.2026.2663852","DOIUrl":"https://doi.org/10.1080/17457300.2026.2663852","url":null,"abstract":"<p><p>The present study develops safety performance functions (SPFs) to identify key factors contributing to pedestrian crashes near high-risk bus stops in Delhi, India. Bus stops associated with fatal and non-fatal incidents were identified across multiple administrative districts. To capture temporal variation, the analysis was conducted separately for daytime and nighttime crashes based on reported crash timings. Video-graphic surveys and built-environment audits were undertaken to identify potential factors influencing pedestrian safety. Negative Binomial and Hurdle Negative Binomial models were estimated to analyse crash occurrence. The results indicate that various built-environment attributes-such as sidewalk condition, on-street parking, crossing type, and lighting conditions-significantly affect crash risk near bus stops. Additionally, higher bus commuter volumes were associated with increased crash frequency. The findings further suggest that Hurdle models outperform conventional count models for such data. Overall, the study highlights critical design and operational factors requiring targeted interventions to enhance pedestrian safety near bus stops.</p>","PeriodicalId":47014,"journal":{"name":"International Journal of Injury Control and Safety Promotion","volume":" ","pages":"1-15"},"PeriodicalIF":2.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}