Impact of traffic safety law amendments on fatal road traffic injuries in the Republic of Srpska: a before–after analysis

Abstract

Road traffic injuries remain a major contributor to premature mortality, especially in low- and middle-income countries. This study quantified the burden of premature mortality attributable to road traffic injuries in the Republic of Srpska by calculating Years of Life Lost (YLL) and Potential Years of Life Lost (PYLL), and assessed changes following the 2021 amendments to traffic safety legislation. A quasi-experimental before–after design compared the periods 2011–2020 and 2021–2024. Mortality data were sourced from official demographic statistics and analysed using descriptive and inferential statistical methods. The results indicate a substantial decline in premature mortality. The mean number of road traffic deaths decreased by 27.9%, while YLL and PYLL were reduced by approximately 70%. Reductions occurred across all age groups, with the most pronounced decline among individuals aged 15-24 years and among vulnerable road users, particularly pedestrians and bicyclists. The Haddon matrix was used as the primary analytical framework, organizing findings across pre-crash, crash, and post-crash phases. The observed changes were primarily associated with system-level interventions in the pre-crash phase, particularly legislative and enforcement measures. Improvements in crash and post-crash determinants also likely contributed to reduced mortality. In conclusion, the reduction in premature mortality observed after 2021 is temporally associated with legislative amendments and aligns with a broader system-based road safety framework rather than isolated policy measures. Further research is warranted to quantify the contribution of individual interventions and to assess long-term trends.