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Little literature addresses the burden of injury in Botswana, including trauma from motor-vehicle crashes (MVCs). In response, the University of Botswana and the Botswana Ministry of Health and Wellness are collaborating with the University of Pennsylvania to enhance injury and trauma research capacity in Botswana. Here we describe this training program and a research exercise to identify opportunities to prevent, through future research and countermeasures, MVCs specifically in Botswana. We initiated a mixed-methods study during a training module during the first two years of the program. The module introduced the Haddon matrix as a conceptual framework, and asked trainees to identify host, vector, and physical/social environment risk factors for MVCs that, if targeted, may lead to primary, secondary, or tertiary prevention. We conducted 10 photovoice elicitation interviews; results were thematically analyzed to further elucidate the context of MVCs in Botswana and potential countermeasures. Our process identified a range of ideas as barriers or facilitators to MVC prevention. The most commonly cited barriers were animals on the road, drunk or reckless driving, poor road quality, lack of road signs/traffic signals to orient drivers, and poor visibility (e.g., no street lighting; poor lighting on vehicles). Regarding primary prevention, participants identified features prior to the crash, across all matrix levels, as influencers of crashes in Botswana. Among these, several human factors (i.e., over-speeding; drunk driving) and environmental factors (i.e., livestock on road) were commonly mentioned as contributors to MVCs, as were cattle gates and traffic calming measures for prevention. Results of the Haddon matrix exercise proved useful for training burgeoning Batswana researchers to think conceptually about the occurrence of MVCs in Botswana and think creatively about targeting countermeasures for prevention. The exercise resulted in potential research questions for the trainees to pursue in mentored research of their own. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the epidemiology of patients admitted with finger amputations in the U.S., as well as to evaluate and propose prevention strategies. The National Electronic Injury Surveillance System was queried to obtain data on patients that presented to, and were admitted from US emergency departments for treatment of traumatic finger amputations during the period of 2002–2016. The Haddon Matrix, a framework that can be used to analyze the host, agent, and environmental factors of an injury relative to its timing, was then used to evaluate possible contributing factors of amputation events, and thereby explore plausible prevention interventions. From 2002 to 2016, approximately 348,719 people were admitted from the ED for traumatic amputations. The majority were Caucasian and were male. The mean age was 42.3 years old. This was significantly older than those who were not admitted. The top five products responsible for amputations in admitted patients were power saws (40.9% of cases), doors (10.3%), lawn mowers (7.4%), snow blowers (4.3%), and bicycles (2.4%). This list included a higher proportion of powered tools than those with finger amputations who were discharged from the ED with a finger amputation. Patients admitted with finger amputations from the ED were older, more likely to be male, and more likely to be victims of powered tools than those that were discharged. Table saws are responsible for a high proportion of the finger amputations that result in hospital admissions. The Haddon Matrix helps us identify factors (host, agent, physical environment, and social environment) to be addressed in prevention strategies. Such approaches might include championing education campaigns, policy measures, and equipment safety features. The effectiveness of such strategies warrants further investigation. [ABSTRACT FROM AUTHOR]

Introduction: Oil tanker truck disasters have been reported worldwide; however, the circumstances, causes, and health effects of these disasters have not been described. To address this gap, we performed a systematic review using PRISMA criteria to better understand this public health problem and identify prevention targets.Methods: The academic and lay literatures were systematically searched for terms related to oil tanker truck disasters. Reports about civilian oil tanker truck disasters that occurred from 1997-2017 were included. Details about the disasters were summarized, including circumstances, identifiable causes, and health effects.Results: The search yielded 4713 Nexis Uni articles, 199 Google results, and one PubMed article; 951 records met inclusion criteria, describing 224 oil tanker truck explosions or fires. At least 2909 people died as a result of these disasters, and 3038 additional people were hospitalized. Almost all deaths (94%) occurred in low- and low-middle-income countries (LMIC). This may largely be due to scooping - the practice of collecting spilled oil from disabled tanker trucks for use or resale. Using the Haddon matrix, potential targets for future disaster prevention were identified.Conclusions: These data highlight the circumstances, causes, and health burden related to oil tanker truck disasters. Most began as collisions or rollovers, but nearly half of the fatalities involved scooping. The findings suggest opportunities to promote road safety, improve scene safety and security protocols used by drivers and first responders, and promote public understanding of the dangers of scooping to prevent mass casualty disasters from disabled tanker trucks, particularly in LMIC. [ABSTRACT FROM AUTHOR]

Floods are one of the most common and severe natural disasters attributed to climate change that affect the globe, especially in the less-resourced countries in the global south, including those in Eastern Africa (E.A). They have been increasingly reported to occur in the past decades in E.A, and it is crucial to understand their underlying risk factors before planning their relevant mitigation interventions. In this case, drawing on the results of a rapid review conducted a priori, this study used the Haddon matrix (HM) to explore and analyze the anthropogenic drivers of floods in ten partner countries of the Belt and Road Initiative (BRI) in E.A, including Burundi, Djibouti, the Democratic Republic of the Congo, Ethiopia, Kenya, Rwanda, Somalia, Sudan, Tanzania, and Uganda between 1990 and 2021. Accordingly, this study notes that the anthropogenic drivers that previously contributed to floods in the 10 partner countries of BRI in E.A were diverse, multifaceted, interrelated, and revolved around challenges of environmental degradation and encroachment on biodiversity and ecosystems, infrastructural and drainage systems, urbanization and physical planning, and socioeconomic development and the livelihood of the population. Efforts to tackle these challenges ought to be aligned with the implementation of the BRI agenda. In particular, this should draw on various opportunities contained in the BRI, as well as the Chinese success and vast experience in poverty alleviation and DRR. To the best of our knowledge, this is the first study to apply the HM in exploring the anthropogenic drivers of floods in the context of the BRI partner countries in the E.A and should act as a reference for further research on a similar subject matter. [ABSTRACT FROM AUTHOR]

Recognizing the need for a more comprehensive approach to preventing child homicides that result from family violence, the authors applied Haddon's three methods of injury prevention to the context of family violence: modification of the agent of injury; identification of control strategies to intervene in the process of injury; and application of the comprehensive Haddon matrix to explore pre-event, event, and post-event strategies addressing the child, parent, and the environment. Examples of evidence-based strategies were identified to support this approach, and innovative strategies were suggested which build on existing approaches applied to other contexts. Recommendations and implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Sudden cardiac arrest remains an important health care problem. If survival rates of all regions would equal those of the best performers, literally thousands of lives would be saved. Similar to injury, there is a need for an epidemiology-based approach for planning and execution of countermeasures. In this policy paper, we present the Haddon Matrix as an all-inclusive conceptual framework to assist in this. We advocate for a more community-centred ‘public health’ approach, with a crucial role for policy-level executives. There is a large potential gain in outcome by implementing ‘passive’ – not requiring individual action – measures. As happened for injury, ‘Cardiac Arrest Academies’ should be created to facilitate and coordinate this process. [Copyright &y& Elsevier]

Abstract: Driver, vehicle, public road, and farm enterprise characteristics were examined for their combined association with farm vehicle public road crash group membership. North Carolina farms experiencing a public road crash from 1992 to 2003 (n =200) were compared with a non-crash control group (n =185) for a 1:1 case:control ratio. Five characteristics were associated with increased odds of crash group membership in the combined model (likelihood ratio=175.95; d.f.=15; p <.001): use of non-English speaking drivers (OR=3.71); use of non-family hired help drivers (OR=4.25); types of non-farm vehicle public road use (OR=1.39); farm injury history (OR=1.33); and, use of younger farm vehicle drivers (OR=1.02). Farms reporting older farm vehicle drivers (OR=0.97), and low farm income (OR=0.29) were less likely crash group members. Recommendations are discussed for incorporating findings into farm vehicle crash prevention research and interventions. [Copyright &y& Elsevier]

Abstract: Accident investigations influence public perceptions and safety management strategies by determining the amount and type of information learned about the accident. To examine the factors considered in investigations, this study used a content analysis of 100 consecutive media reports of amusement ride accidents from an online media archive. Fatalities were overrepresented in the media dataset compared with U.S. national estimates. For analysis of reports, a modified “Haddon matrix” was developed using human-factors categories. This approach was useful to show differences between the proportions and types of factors considered in the different accident stages and between employee and rider accidents. Employee injury accounts primarily referred to the employee''s task and to the employee. Rider injury reports were primarily related to the ride device itself and rarely referred to the rider''s “task”, social influences, or the rider''s own actions, and only some reference to their characteristics. Qualitatively, it was evident that more human factors analysis is required to augment scant pre-failure information about the task, social environment, and the person, to make that information available for prevention of amusement ride accidents. By design, this study reflected information reported by the media. Future work will use the same techniques with official reports. [Copyright &y& Elsevier]

• Video observation and interviews can identify risks and obstacles in traffic environment. • The degree of accessibility affects the degree of risk taking in traffic environment. • Identified risks were due to deficiencies in built environment and poor maintenance. • Other risks were related to interaction with other road users and poor visibility • Negative impacts of coldness, precipitation and poor snow clearing. According to the European Union, fatal road accidents involving Vulnerable Road Users (VRUs) are equal in proportion to fatal car road accidents (46%). VRUs include individuals with mobility challenges such as the elderly and Powered Wheelchair (PWC) users. The aim of this interdisciplinary qualitative study was to identify obstacles and risks for PWC users by exploring their behaviour and experiences in traffic environments. Videos and in-depth interviews with 13 PWC users aged 20–66 were analysed for this study. The interviews and videos, which include real-life outdoor observations, originate from a qualitative study exploring experiences of PWC use on a daily basis in Sweden. Underlying causal factors to identified risks and obstacles were identified, based on human, vehicle (PWC) and environmental factors in accordance with the Haddon Matrix. The results show significant potential for improvement within all three perspectives of the Haddon Matrix used in the analysis. Participants faced and dealt with various obstacles and risks in order to reach their destination. For example, this includes uneven surfaces, differences in ground levels, steep slopes, as well as interactions with other road users and the influence of weather conditions, resulting in PWC users constantly accommodating and coping with the shortcomings of the vehicle and the environment. There are still major challenges with regard to preventing obstacles and risks in the traffic environment for PWC users. To discern PWC users in traffic accident and injury data bases, a start would be to register type of aid used for persons involved in an accident. Furthermore, to emphasise PWC users' role as VRUs, it may also be advantageous to describe them as drivers rather than users when navigating the traffic environment. Given the limited sample, further research covering more data from a broader perspective would be beneficial. By incorporating emerging knowledge of PWC users' prerequisites and needs, and including them in research and traffic planning, the society will grow safer and more inclusive, and become better prepared for meeting future demands on accessibility from an aging population. [ABSTRACT FROM AUTHOR]