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Introducción: Anualmente se pierden 1,35 millones de vidas por causa de siniestros viales; su ocurrencia se ha relacionado, además de factores comportamentales, con desigualdades sociales. Objetivo: Analizar las desigualdades sociales urbano-rurales en la mortalidad por siniestros viales en Colombia para el periodo 1998-2019. Materiales y métodos: Estudio ecológico a partir del análisis de las tasas de mortalidad ajustadas de los grupos poblacionales urbanos y rurales estratificados por sexo. Se hicieron análisis con regresión de Joinpoint y se calcularon medidas de desigualdad simple absoluta y relativa. Resultados: Se registraron 139 323 muertes por siniestros viales, en Colombia la tasa de mortalidad por esta causa se ha venido reduciendo. En contraste con las áreas rurales, en las áreas urbanas esta reducción es más significativa. Existen desigualdades en la mortalidad entre las áreas urbanas y rurales que han venido estrechándose. No obstante, en el caso de hombres y mujeres ha venido incrementándose. Discusión: La reducción de la tasa de mortalidad por siniestros viales sugiere que las intervenciones en seguridad vial han sido efectivas. La mayor mortalidad en hombres puede explicarse a partir de factores comportamentales. Las desigualdades urbano-rurales pueden estar relacionadas con las dinámicas de desarrollo. Conclusiones: Se registra una reducción en la tasa de mortalidad por siniestros viales, la cual es más significativa en áreas urbanas. Existen desigualdades urbano-rurales en la mortalidad por esta causa. Las políticas de seguridad vial deben partir de un enfoque integrador vinculado con otras agendas políticas.
Introduction: Annually, 1,35 million lives are lost due to road accidents; their occurrence has been related, in addition to behavioral factors, to social inequalities. Objective: To analyze urban-rural social inequalities in mortality from traffic accidents in Colombia from 1998-2019. Methods and materials: Ecological study based on the analysis of standardized mortality rates adjusted for age and sex of urban and rural population groups stratified by sex. Joinpoint regression analyses were performed, and absolute and relative simple inequality measures were calculated. Results: There were 139.323 deaths from road accidents; in Colombia mortality rates from this cause has been decreasing. In urban areas, the reduction is more significant than in rural areas. Disparities in mortality between urban and rural areas have been narrowing, however, in the case of men and women, they have been increasing. Discussion: Reducing the mortality rate from road accidents suggests that road safety interventions have been effective. Behavioral factors can explain the higher mortality in men. Urban-rural inequalities can be related to development dynamics. Conclusions: There is a significant reduction in the mortality rate due to road accidents in urban areas. There are urban-rural inequalities in mortality from this cause. Road safety policies must be based on an integrative approach linked to other political agendas.
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OBJECTIVE: In this study, we aim to identify social typologies of pedestrian crashes considering demographics, health impacts, involved vehicle, temporality of the collision, and place of impact in Hermosillo, Mexico. METHODS: A socio-spatial analysis was performed by using local urban planning information and vehicles-pedestrian crashes records collected by the police department (N = 950) between 2014 and 2017. Multiple Correspondence Analysis and Hierarchical Cluster Analysis were used to determine typologies. Geographical distribution of typologies was obtained with spatial analysis techniques. RESULTS: The results suggest there are four typologies, which portray the physical vulnerability of pedestrians, which reflect the vulnerability to collisions associated to the variables age, gender, and street speed limits. Findings show that children are more likely to be injured during weekends in residential zones (Typology 1), while older females are more likely to be injured during the first three days of the week (Monday - Wednesday) in the downtown area (Typology 2). Injured males during the afternoon in arterial streets represented the most frequent cluster (Typology 3). Also, males were likely to be severely injured by heavy trucks during nighttime in peri-urban areas (Typology 4). These findings indicate that vulnerability and risk exposure vary according to the type of pedestrian involved in the crash, which are linked to the types of places they visit. CONCLUSIONS: The design of the built environment plays a major role in the number of pedestrian injuries particularly when it favors motor vehicles over pedestrians or non-motorized vehicles. Because traffic crashes are considered preventable events, cities must embrace a diversity of mobility modes and incorporate the appropriate infrastructures that safeguard the lives of all their travelers, especially pedestrians.
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Pedestres , Ferimentos e Lesões , Masculino , Criança , Feminino , Humanos , Acidentes de Trânsito , Cidades , México/epidemiologia , Veículos Automotores , Ferimentos e Lesões/epidemiologiaRESUMO
The article aims to investigate the influence of risk exposure factors on the frequency of road crashes from January to August 2020 in Ciudad Juarez, Mexico. It is a longitudinal study with four data sets: road crashes, population and housing census, location of economic activities, and road network information. Specifically, this study investigates the relationship between exposure factors - demographics, main roads and land use - and road crashes. A mixed method analysis was employed, (1) spatial analysis using GIS techniques; and (2) a negative binomial spatial regression model. The results showed a strong spatial dependence (0.274; p-value 0.00) of road crashes in the census tracts, and this effect was statistically significant (0.007) in the spatial regression model. In the model, a high probability (<0.05) of road crashes in the census tracts was found with the population aged 15 to 65 years, the length of main roads and the level of road coverage (Engel index), land uses with economic activities of an industrial and commercial character. The findings of this study successfully capture the social, economic, and urban conditions during the January-August 2020 period in the context of the COVID-19 pandemic. This new knowledge could help create preventive plans and policies to address the frequency of road crashes.
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Acidentes de Trânsito , COVID-19 , Humanos , Acidentes de Trânsito/prevenção & controle , Regressão Espacial , México/epidemiologia , Estudos Longitudinais , Pandemias , COVID-19/epidemiologiaRESUMO
OBJECTIVE: Examine the driving impairment effects of alcohol alone and of alcohol combined with texting. METHODS: Fifteen drivers (nine male, six female; mean age: 31.1 ± 6.9 years, range: 23 to 43 years) with similar drinking habit (i.e., social drinkers) completed a lap in a closed-course section in six different situations: (I) sober; (II) sober and while texting; (III) 30 minutes after ingesting a moderate dose of ethanol (0.50 g/kg); (IV) 30 minutes after drinking and while texting; (V) 60 minutes after drinking, (VI) 60 minutes after drinking and while texting. Driving performance was analyzed by means of maximum and mean speed, braking time and braking distance; and ability to control the car (i.e., evaluating if the drivers hit a traffic cone or exceeded the boundaries of the course). P values of < 0.05 were considered significant. RESULTS: Pre and post-alcohol consumption results show a significant increase concerning the drivers' mean and maximum speed after drinking (p < 3.2x10-8). However, neither alcohol nor texting had significant effects on braking parameters (p > 0.05). Traffic cones were knocked down only in texting experiments. In addition, when using the cell phone drivers tended to reduce the speed, and to accelerate abruptly right after they finish texting. CONCLUSION: Our findings strengthen the hypothesis that even moderate alcohol doses may significantly impair the driving performance. Additionally, alcohol and texting have complementary effects on driving impairment, and their combination represents a significant risk factor for crashes.
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Condução de Veículo , Telefone Celular , Envio de Mensagens de Texto , Acidentes de Trânsito , Adulto , Consumo de Bebidas Alcoólicas , Etanol/farmacologia , Feminino , Humanos , Masculino , Adulto JovemRESUMO
OBJECTIVE: The objective of the study was to examine child deaths in motor vehicle crashes by rurality, restraint use, and state child passenger restraint laws. STUDY DESIGN: 2015-2019 Fatality Analysis Reporting System data were analyzed to determine deaths and rates by passenger and crash characteristics. Optimal restraint use was defined using age and the type of the restraint according to child passenger safety recommendations. RESULTS: Death rates per 100â000 population were highest for non-Hispanic Black (1.96; [1.84, 2.07]) and American Indian or Alaska Native children (2.67; [2.14, 3.20]) and lowest for Asian or Pacific Islander children (0.57; [0.47, 0.67]). Death rates increased with rurality with the lowest rate (0.88; [0.84, 0.92]) in the most urban counties and the highest rate (4.47; [3.88, 5.06]) in the most rural counties. Children who were not optimally restrained had higher deaths rates than optimally restrained children (0.84; [0.81, 0.87] vs 0.44; [0.42, 0.46], respectively). The death rate was higher in counties where states only required child passenger restraint use for passengers aged ≤6 years (1.64; [1.50, 1.78]) than that in those requiring child passenger restraint use for passengers aged ≤7 or ≤8 years (1.06; [1.01, 1.12]). CONCLUSIONS: Proper restraint use and extending the ages covered by child passenger restraint laws reduce the risk for child crash deaths. Additionally, racial and geographic disparities in crash deaths were identified, especially among Black and Hispanic children in rural areas. Decision makers can consider extending the ages covered by child passenger restraint laws until at least age 9 to increase proper child restraint use and reduce crash injuries and deaths.
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Acidentes de Trânsito , População Rural , Humanos , Criança , Estados Unidos/epidemiologia , Lactente , Grupos Raciais , Família , Veículos AutomotoresRESUMO
Road traffic accidents result in injury or even death of passengers. One potential cause of these accidents is mechanical failures due to a lack of vehicle maintenance. In the quest to identify these mechanical failures, this paper aims to set up the procedure to identify the mechanical failures that contribute to traffic accidents in cities located in developing countries, including the city of Cuenca-Ecuador. For present research, a database provided by the entity responsible for the Vehicle Technical Inspection, the Empresa Pública Municipal de Movilidad, Tránsito y Transporte and for the ones responsible of managing traffic accident data, Oficina de Investigación de Accidentes de Tránsito and Sección de Investigación de Accidentes de Tránsito was used. The vehicle subcategories M1 and M3 (bus type) and N1, so named according to Ecuadorian technical standards, were considered the most relevant regarding accident rates. The database was analysed with descriptive statistics, a Pareto chart and time series with the quadratic trend. From this analysis, the most significant failures found in the VTI in all three subcategories were the alignment of the driver headlight, both horizontal and vertical, braking imbalance on the 2nd axle, insufficient tire tread and parking brake effectiveness. All these failures showed a decreasing trend over time and in the forecast at a maximum of two to three years. The most relevant causes of road accidents recorded during the period 2009-2018 related to mechanical failures were the braking system (65.5%) and the steering system (17.2%) for subcategory M1.
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Acidentes de Trânsito , Cidades , Equador/epidemiologia , Fatores de TempoRESUMO
According to the World Health Organization, in 2016, Colombia obtained the tenth position worldwide, the third in the continent and the second in South America, according to the accident rate of 9.7 motorcycle fatalities per 100,000 populations. Between 2012 and 2021, the number of deceased and injured motorcyclists among all road users was 50%, with an annual average of 3140 fatal victims and 20,800 injured victims. Bogotá, Cali, and Medellín were the cities with the most accidents. In Bogota in 2017, the deaths of motorcyclists on the roads were around 32% of the road actors. This data article presents the dataset used to analyze and predict the severity of motorcyclist road accidents in Bogota in the article entitled "Extraction of decision rules using genetic algorithms and simulated annealing for prediction of severity of traffic accidents by motorcyclists" [1]. The data set was consolidated from the registration of 175,245 traffic accidents and the report of 337,828 road actors involved in crashes in Bogotá between January 2013 and February 2018. The data was compiled, processed, and enriched with additional information about infrastructure and weather conditions. The data corresponds to 35,693 motorcyclist traffic accidents, represented by 28 variables, and classified into five categories: road actors, motorcyclists and individuals involved, weather conditions and timing, road conditions and location and characteristics of the accident. The data on motorcyclist traffic accidents opens up a scenario to deepen and compare road safety in Latin America, where studies on vulnerable road users are limited. According to severity, the data on motorcycle traffic accidents recorded 28% with material damage, 69% with injured and 3% with fatal victims.
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INTRODUCTION: Alcohol and illicit drugs impair cognitive and psychomotor skills and may thereby increase the risk of involvement in a road traffic crash and other types of injuries. However, the knowledge on the use of psychoactive substances among injured patients presenting to emergency departments in low and middle-income countries remains limited. AIMS: To estimate the prevalence of alcohol and illicit drug use among patients with traumatic injuries admitted to an emergency department in Sao Paulo, Brazil. METHODS: Blood samples from injured patients requiring hospitalization for more than 24 h due to road traffic crashes, falls, or violence, were collected from July 2018 to June 2019. The samples were analyzed for alcohol and illicit drugs. RESULTS: A total of 376 patients were included in this study; the median age was 36 years and 80% of patients were male. The majority (56%) of injuries resulted from road traffic crashes, with approximately half of them being motorcyclists. Alcohol, drugs, or both were detected in 32% of samples. The proportion that tested positive was highest for males (35%), for the age group 18-39 years (41%), for singles (43%), and for patients injured at nighttime (44%). Patients injured due to violence had the highest prevalence of alcohol or drugs in their blood samples (44%). Alcohol was most prevalent (23%), followed by cocaine (12%) and cannabis (5%). CONCLUSION: The use of alcohol and illicit drugs was common among injured patients in Sao Paulo; it was likely a contributing factor in a third of the injurious accidents. Alcohol was the most prevalent substance followed by cocaine and cannabis.
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Acidentes de Trânsito , Consumo de Bebidas Alcoólicas/epidemiologia , Drogas Ilícitas , Transtornos Relacionados ao Uso de Substâncias , Ferimentos e Lesões , Adolescente , Adulto , Brasil/epidemiologia , Feminino , Humanos , Masculino , Psicotrópicos , Detecção do Abuso de Substâncias , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Ferimentos e Lesões/epidemiologia , Adulto JovemRESUMO
Objective: Traffic crashes are a significant cause of health expenditure, mainly considering disability and death. Driving skills are key when it comes to traffic crashes, and older drivers may be unfit to drive. The statistics of traffic crashes involving older drivers can contribute to planning actions that reduce accidents. This study aimed to present statistical data on traffic crashes among older adults in a Brazilian state. Methods: This is an epidemiological study performed with data from the Traffic Accident Information System of the Federal District Traffic Department, Brazil, ranging from 2008 to 2017 and comparing the incidence of injury crashes between older drivers and adult drivers. Results: Although the system recorded 60 705 drivers involved in injury crashes, a 24% reduction was seen in the overall crash incidence during the studied period (2008 2017); within the older drivers group, this reduction was two times smaller (12%). Despite the smaller drop in incidence, older car drivers presented around three times less risk of crashes when compared to adult drivers, along with a lower risk of accidents on urban, low-speed streets, and were mostly involved in collisions during the day. Conclusion: We found that the risk of older drivers being involved in injury crashes was three times smaller than that of adult drivers. The behavior of older drivers can influence the occurrence of accidents.
Objetivo: Os acidentes de trânsito são causa significativa de gasto em saúde com incapacidades e mortes. Habilidades de condução veicular são elementos-chave para a ocorrência de acidentes de trânsito, e o motorista idoso pode ser incapaz para dirigir. As estatísticas de acidentes de trânsito com motoristas idosos podem contribuir para o planejamento de ações que reduzam os acidentes. Este estudo teve como objetivo apresentar dados estatísticos sobre acidentes de trânsito entre idosos em um estado brasileiro. Metodologia: Estudo epidemiológico com dados do Sistema de Informações de Acidentes de Trânsito do Departamento de Trânsito do Distrito Federal, Brasil, no período de 2008 a 2017, comparando a incidência de acidentes com vitima entre motoristas de automóveis idosos e não idosos. Resultados: De 2008 a 2017, apesar de o sistema contabilizar 60 705 motoristas envolvidos em acidentes de automóveis com vítimas, houve uma redução de 24% na incidência geral nos anos avaliados, sendo essa redução duas vezes menor no grupo de motoristas idosos (12%). A despeito da menor queda na incidência, os motoristas idosos condutores de automóveis tiveram cerca de três vezes menos risco de acidentes comparados a motoristas não idosos; menor risco para acidentes em vias urbanas, as de velocidade mais baixa; e maior predominância de acidentes tipo colisão no período diurno. Conclusões: Encontrou-se risco três vezes menor de motoristas idosos se envolverem em acidentes de automóveis com vitima quando comparados a não idosos. O comportamento dos motoristas idosos pode influenciar na ocorrência de acidentes.
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Humanos , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Acidentes de Trânsito/estatística & dados numéricos , Brasil/epidemiologia , Incidência , Fatores EtáriosRESUMO
BACKGROUND AND AIMS: Debates regarding lowering the blood alcohol concentration (BAC) limit for drivers are intensifying in the United States and other countries, and the World Health Organization recommends that the limit for adults should be 0.05%. In January 2016, Uruguay implemented a law setting a zero BAC limit for all drivers. This study aimed to assess the effect of this policy on the frequency of moderate/severe injury and fatal traffic crashes. DESIGN: A quasi-experimental study in which a synthetic control model was used with controls consisting of local areas in Chile as the counterfactual for outcomes in Uruguay, matched across population counts and pre-intervention period outcomes. Sensitivity analyses were also conducted. SETTING: Uruguay and Chile. CASES: Panel data with crash counts by outcome per locality-month (2013-2017). INTERVENTION AND COMPARATOR: A zero blood alcohol concentration law implemented on 9 January 2016 in Uruguay, alongside a continued 0.03 g/dl BAC threshold in Chile. MEASUREMENTS: Per-capita moderate/severe injury (i.e. moderate or severe), severe injury and fatal crashes (2013-2017). FINDINGS: Our base synthetic control model results suggested a reduction in fatal crashes at 12 months [20.9%; P-value = 0.018, 95% confidence interval (CI) = -0.340, -0.061]. Moderate/severe injury crashes did not decrease significantly (10.2%, P = 0.312, 95% CI = -0.282, 0.075). The estimated effect at 24 months was smaller and with larger confidence intervals for fatal crashes (14%; P = 0.048, 95% CI = -0.246, -0.026) and largely unchanged for moderate/severe injury crashes (-9.4%, P = 0.302, 95% CI = -0.248, 0.058). Difference-in-differences analyses yielded similar results. As a sensitivity test, a synthetic control model relying on an inferior treatment-control match pre-intervention (measured by mean squared error) yielded similar-sized differences that were not statistically significant. CONCLUSIONS: Implementation of a law setting a zero blood alcohol concentration threshold for all drivers in Uruguay appears to have resulted in a reduction in fatal crashes during the following 12 and 24 months.
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Condução de Veículo , Concentração Alcoólica no Sangue , Acidentes de Trânsito/prevenção & controle , Adulto , Consumo de Bebidas Alcoólicas , Chile , Humanos , Estados Unidos , UruguaiRESUMO
Although motor vehicle collisions (MVCs) are a worldwide public health concern due to their high injury, mortality, and fatality rates, few studies have addressed the epidemiologic behavior of MVCs in Latin American youth. Thus, this study was aimed at describing and comparing the characteristics of MVCs involving 0 to 14-year-olds in Costa Rica, Guatemala, and Panama. A secondary aim was to estimate the crude MVC-related injury, fatality, and mortality rates and their trends over time. We conducted a descriptive, retrospective study using publicly available data for Costa Rica, Panama, and Guatemala between 2012 and 2015. We examined the reported MVC cases and calculated the crude injury, fatality, and mortality rates and their trends over time (α = 0.05). Publicly available data reported 12,020 MVC-related injuries and 431 MVC-related deaths involving 0 to 14-year-olds. The most frequent mechanisms involved 0 to 14-year-olds as passengers or pedestrians in MVCs (>85% of all cases). The highest crude MVC-related injury and mortality rates were reported for Panama (119.35 and 2.14 per 100,000 population, respectively, in 0 to 14-years-olds), while Guatemala had the highest median MVC-related fatality rate (8.84 per 100,000 events; χ2 [2] = 377.8; p < 0.001) with a statistically significant trend increasing over time (r = 0.947; p = 0.027). Although several factors play a role in the prevention of MVCs among 0 to 14-year-olds, we found that Costa Rica was the only country that implemented a policy on child restraint systems resulting in the lowest rates of MVC-related injury, mortality, and fatality. These results could be used by decision makers from the aforementioned Central American countries to develop adequate policies addressing MVC preventative strategies to protect Central American infants and children.
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Acidentes de Trânsito/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adolescente , Criança , Pré-Escolar , Costa Rica/epidemiologia , Guatemala/epidemiologia , Humanos , Lactente , Recém-Nascido , Panamá/epidemiologia , Estudos RetrospectivosRESUMO
In 2016, Colombia's position regarding motorcyclist fatalities per 100,000 inhabitants was tenth worldwide and second in South America. In the seven years from 2012-2018, the proportion of deceased and injured motorcyclists among all road users was 50%. To analyse the significant aspects of the accident rate of motorcyclists in Colombia from 2016 to 2018 and estimate cost social value of motorcycle-related deaths. The global numbers of fatalities and injuries were compared to the Colombian context. Descriptive and inferential statistics were conducted to explore the association of fatal trauma and motorcycle accidents. P values and odds ratios were calculated. Bogotá, Cali, and Medellín were the cities with the most accidents. The month, day, time, age of the victims, and climatic conditions had a statistically significant association with the fatal trauma. Most victims were between the ages of 20-29 years. Motorcycles were involved in more than 60% of accidents. The social cost of a life lost in a motorcycle accident was estimated at $2,418 million Colombian pesos (725,400 USD) per year. The establishment of countermeasures for the road safety of vulnerable users should focus on associated causal factors in order to develop strategies to effectively reduce the number of accidents.
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Acidentes de Trânsito , Motocicletas , Ferimentos e Lesões/epidemiologia , Acidentes de Trânsito/economia , Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Colômbia/epidemiologia , Bases de Dados Factuais , Feminino , Humanos , Lactente , Internacionalidade , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Adulto JovemRESUMO
Objective: Road traffic crashes (RTCs) are responsible for a large number of deaths worldwide, but low- and middle-income countries frequently present higher rates of deaths; for example, Norway, a high-income country, has a rate of 2.0 drivers killed per 100,000 inhabitants, whereas Brazil, a middle-income country, has a rate of 18.4. A significant fraction of RTCs are related to use of psychoactive substances, especially alcohol, due to its availability, legality, and relatively low price. The aim of the present study was to evaluate differences in alcohol-related fatal RTCs in Sao Paulo, the largest city in Brazil, and Norway during an 11-year period (2005-2015). Methods: The authors compared databases of drivers killed in RTCs in Sao Paulo and in Norway, a country renowned for its success in reducing traffic fatalities and keeping them at a low level. Results: In total, 772 victims from Norway (11 years, 2005 to 2015) and 584 victims from Sao Paulo (2 years, 2005 and 2015) were analyzed. Sao Paulo presented higher proportions of motorcycle drivers, men involved in RTCs, and blood alcohol concentration (BAC)-positive cases. The mean BAC for alcohol-positive cases was similar in both sites. For both regions, the percentage of alcohol-positive cases decreased during the study period (from 45.6% to 35.3% in Sao Paulo and from 24.4% to 15.8% in Norway) but remained higher for Sao Paulo. Conclusions: The study shows a different profile of RTC victims and higher alcohol consumption among drivers in Sao Paulo. The differences between the sites can possibly be attributed to public policies regarding traffic safety and alcohol control, which could be further improved by following the Norwegian model in Sao Paulo.
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Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/estatística & dados numéricos , Concentração Alcoólica no Sangue , Dirigir sob a Influência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: To describe the temporal relationship between the road traffic mortality rate and gross domestic product (GDP) per capita in Brazil, and make an annual prediction of the evolution of both indicators until 2020, the end of the Sustainable Development Goals (SDGs) monitoring period. METHODS: Brazilian road traffic mortality rate official data were described from 2000 to 2015, while the GDP per capita official data were described from 2000 to 2013. GDP per capita and traffic mortality rate predictions were performed until 2020 using fractional polynomial analysis. Correlations were assessed using Pearson's correlation coefficient. RESULTS: From 2000 to 2015, there were over 446 000 road crashes fatal victims in Brazil. The road traffic mortality rate was positively related to the Brazilian GDP per capita, with a strong correlation (r=0.89; p<0.001) from 2000 to 2013 and a mild correlation (r=0.55; p<0.001) considering the whole period (2000-2020). The predictions show a reduction on the road traffic mortality rates in Brazil; however, if this same reduction pace continues, we estimate that the country will reach 12.4 road crash deaths per 100 000 inhabitants in 2020, a reduction of only 13.4% compared with 2015. CONCLUSION: If the same mortality reduction pace continues in Brazil, the country will not reach the proposed SDG, which is to reduce by half the number of deaths per 100 000 inhabitants. In addition, an intertwined conciliation between economical growth, sustainable development and public policies is needed in order to meet such an overwhelming goal.
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Acidentes de Trânsito/tendências , Produto Interno Bruto/tendências , Política Pública , Desenvolvimento Sustentável/tendências , Ferimentos e Lesões/mortalidade , Adolescente , Adulto , Brasil/epidemiologia , Desenvolvimento Econômico , Feminino , Objetivos , Inquéritos Epidemiológicos , Humanos , Masculino , Ferimentos e Lesões/prevenção & controle , Adulto JovemRESUMO
This study aimed at identifying and comparing subjective risk perception regarding two different violent situations in urban roads: traffic accidents (i.e. crashes) and robberies. A robbery consists of subtracting something from someone, while seriously threatening the victim, or using violence. Robberies can be perpetrated either with or without the use of a weapon. This study was carried out in the city of Uberlândia, a medium size city in the state of Minas Gerais, south-east Brazil. A total of 383 people was interviewed at home in two boroughs of Uberlândia, using a questionnaire divided in five parts: a) personal information; b) description of crash involvement; c) description of robbery involvement; d) the chance of being involved in a crash and in a robbery within the next three years; e) willingness to pay for more safety in traffic or for more security against robberies; f) what causes more damage or harm to society, crashes or robberies. Descriptive figures are shown for the sample which reported 1.44 crashes/person. More than half of those involved in crashes (56%) were injured and 75% of these needed hospital care. There were 1.15 robberies/person. Only 7% of those involved in robberies were injured, none of them hospitalized. During robberies, 57.3% of the respondents were threatened with weapons. Car drivers were more subject to crashes (40%) and pedestrians were more subject to robberies (78%). Risk perception of being involved in a robbery within the next three years and when on the streets of the local borough is higher than crash risk perception. Respondents thought of dying in 25.5% of the crashes and in 46.3% of the robberies. A large group (63.7% of the sample) declared the willingness to pay for more personal security rather than for more traffic safety. Statistical analysis is presented in an attempt to study the relationship between variables. As expected, the respondents' subjective risk perception appears to contradict objective risk. Instinctively, interviewees might perceive robberies as a greater threat than crashes, perhaps reflecting lightly on the latter. In countries with high crash and violent incident statistics such results could be used to orientate traffic safety policies, education and campaigns, concentrating on the outcomes of crashes.
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Acidentes de Trânsito , Atitude , Condução de Veículo , Pedestres , Roubo , Violência , Ferimentos e Lesões/etiologia , Adulto , Brasil , Crime , Meio Ambiente , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Medição de Risco , Fatores de Risco , Inquéritos e Questionários , ArmasRESUMO
OBJECTIVE: The overrepresentation of young drivers in poor road safety outcomes has long been recognized as a global road safety issue. In addition, the overrepresentation of males in crash statistics has been recognized as a pervasive young driver problem. Though progress in road safety evidenced as a stabilization and/or reduction in poor road safety outcomes has been made in developed nations, less-developed nations contribute the greatest road safety trauma, and developing nations such as Colombia continue to experience increasing trends in fatality rates. The aim of the research was to explore sex differences in self-reported risky driving behaviors of young drivers, including the associations with crash involvement, in a sample of young drivers attending university in Colombia. METHODS: The Spanish version of the Behaviour of Young Novice Drivers Scale (BYNDS-Sp) was applied in an online survey to a sample of 392 students (225 males) aged 16-24 years attending a major university. Appropriate comparative statistics and logistic regression modeling were used when analyzing the data. RESULTS: Males reported consistently more risky driving behaviors, with approximately one quarter of all participants reporting risky driving exposure. Males reported greater crash involvement, with violations such as speeding associated with crash involvement for both males and females. CONCLUSION: Young drivers in Colombia appear to engage in the same risky driving behaviors as young drivers in developed nations. In addition, young male drivers in Colombia reported greater engagement in risky driving behaviors than young female drivers, a finding consistent with the behaviors of young male drivers in developed nations. As such, the research findings suggest that general interventions such as education, engineering, and enforcement should target transient rule violations such as speeding and using a handheld mobile phone while driving for young drivers in Colombia. Future research should investigate how these interventions could be tailored specifically for the Colombian cultural context, including how their effects can be evaluated, prior to implementation.
Assuntos
Condução de Veículo/psicologia , Assunção de Riscos , Fatores Sexuais , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Colômbia , Feminino , Humanos , Masculino , Autorrelato , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Universidades , Adulto JovemRESUMO
OBJECTIVE: To examine geographic variation in motor vehicle crash (MVC)-related pediatric mortality and identify state-level predictors of mortality. STUDY DESIGN: Using the 2010-2014 Fatality Analysis Reporting System, we identified passengers <15 years of age involved in fatal MVCs, defined as crashes on US public roads with ≥1 death (adult or pediatric) within 30 days. We assessed passenger, driver, vehicle, crash, and state policy characteristics as factors potentially associated with MVC-related pediatric mortality. Our outcomes were age-adjusted, MVC-related mortality rate per 100 000 children and percentage of children who died of those in fatal MVCs. Unit of analysis was US state. We used multivariable linear regression to define state characteristics associated with higher levels of each outcome. RESULTS: Of 18 116 children in fatal MVCs, 15.9% died. The age-adjusted, MVC-related mortality rate per 100 000 children varied from 0.25 in Massachusetts to 3.23 in Mississippi (mean national rate of 0.94). Predictors of greater age-adjusted, MVC-related mortality rate per 100 000 children included greater percentage of children who were unrestrained or inappropriately restrained (P < .001) and greater percentage of crashes on rural roads (P = .016). Additionally, greater percentages of children died in states without red light camera legislation (P < .001). For 10% absolute improvement in appropriate child restraint use nationally, our risk-adjusted model predicted >1100 pediatric deaths averted over 5 years. CONCLUSIONS: MVC-related pediatric mortality varied by state and was associated with restraint nonuse or misuse, rural roads, vehicle type, and red light camera policy. Revising state regulations and improving enforcement around these factors may prevent substantial pediatric mortality.
Assuntos
Acidentes de Trânsito/mortalidade , Mortalidade da Criança , Sistemas de Proteção para Crianças/estatística & dados numéricos , Veículos Automotores/estatística & dados numéricos , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Fatores de Risco , Estados UnidosRESUMO
OBJECTIVES: The objective of this study was to identify the characteristics related to crash and victim, as well as the after-effects/disabilities and consequences arising from traffic crashes occurring in the city of Rio Branco-Acre. METHODS: This is an analytical descriptive cross-sectional study conducted in the City of Rio Branco-Acre. The study population consisted of 405 residents of the city who were victims of traffic crashes, of all age groups and genders, who were hospitalized for the first time as a result of the crash in public hospitals and the health system network, as recorded in the Hospital Information System, and who were discharged between January 1 and December 31, 2010. The data sources included hospital record consultations and active searches for the victims. Hierarchical logistic regression was performed to evaluate the factors associated with the after-effects. RESULTS: The majority of the study population was motorcycle victims (68.6%), male, and young (20-39 years). Concerning the after-effects, the following were significantly associated: factors related to the presence of a postcrash activity limitation (odds ratio [OR] = 2.39; 95% confidence interval [CI], 2.39-6.76), length of hospital stay in days (OR = 1 03; 95% CI, 1.01-1.06), and surgical treatment (OR = 1.82; 95% CI, 1.03-3.21). Those who suffered damage to soft tissue and nerves or facial injury showed an odds ratio of 2 to 4 times of having an after-effect/disability, independent of the victim's personal attributes. CONCLUSION: The mechanism, such as the origin of the pattern of injuries, explains the exposure factors shown by each attribute of the victim and their characteristics. Many of the injuries were precursors to after-effects/disabilities, which, due to their nature and extent, result in the modification of the apparently healthy living standards of young victims who are routinely injured in traffic crashes. Therefore, public policies for prevention should be formulated, reformulated, and implemented, taking into account each attribute of the victims and their social conditions, because these are closely related to their habits and customs. This is a starting point for promoting changes to the current reality that traffic crashes present in the morbidity and mortality of the population.
Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Pessoas com Deficiência , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Criança , Cidades , Estudos Transversais , Traumatismos Faciais/epidemiologia , Traumatismos Faciais/mortalidade , Traumatismos Faciais/patologia , Feminino , Humanos , Escala de Gravidade do Ferimento , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Motocicletas , Razão de Chances , Fatores de Risco , Ferimentos e Lesões/mortalidade , Ferimentos e Lesões/patologia , Adulto JovemRESUMO
BACKGROUND: Substance use disorders are associated with the increased risk of driving under the influence (DUI), but little is known about crack-cocaine and its relationship with road traffic crashes (RTC). METHOD: A multicenter sample of 765 crack-cocaine users was recruited in six Brazilian capitals in order to estimate the prevalence of DUI and RTC involvement. Legal, psychiatric, and drug-use aspects related with traffic safety were evaluated using the Addiction Severity Index - 6th version (ASI-6) and the Mini International Neuropsychiatric Interview. RESULTS: Seventy-six (28.3%) current drivers reported accident involvement following crack-cocaine use. Among drivers (n=269), 45.7% and 30.5% reported DUIs in the past 6 months and 30 days, respectively. Drivers reporting DUI's in the past month (n=82) had higher scores in the "psychiatric", "legal", and "family problems" subscales from the ASI-6, and lower scores in the "family social support" subscale in comparison to those without a history of DUIs (n=187). An overall high prevalence of psychiatric comorbidity and substance consumption was observed. Participants with 5+ years of crack-cocaine use were more likely to have been in a RTC (RR=1.52, 95%IC: 1.02-2.75), independently of marijuana use, binge drinking and psychiatric comorbidities. CONCLUSION: The high prevalence of RTC and DUI involvement among crack-using drivers supports the idea that they are at a high risk group regarding traffic safety. Years of crack consumption seem to be associated with RTC involvement. Also, the presence of psychiatric comorbidities, poly-drug use, and cognitive impairment usually associated with crack addiction could yield additional risk of accidents.
Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Condução de Veículo/psicologia , Transtornos Relacionados ao Uso de Cocaína/psicologia , Cocaína Crack , Dirigir sob a Influência/estatística & dados numéricos , Acidentes de Trânsito/psicologia , Adulto , Brasil/epidemiologia , Estudos Transversais , Dirigir sob a Influência/psicologia , Feminino , Humanos , Masculino , PrevalênciaRESUMO
Trends in the use of alcohol and drugs among motor vehicle drivers in Australia, Brazil, Norway, Spain, and the United States have been reviewed. Laws, regulations, enforcement, and studies on alcohol and drugs in biological samples from motor vehicle drivers in general road traffic and fatal road traffic crashes (RTCs) are discussed. Roadside surveys showed a reduction of drunk driving over time in the studied countries; however, the pattern varied within and between different countries. The reduction of alcohol use may be related to changes in road traffic laws, public information campaigns, and enforcement, including implementation of random breath testing or sobriety checkpoints. For non-alcohol drugs, the trend in general road traffic is an increase in use. However, drugs were not included in older studies; it is therefore impossible to assess the trends over longer time periods. Data from the studied countries, except Brazil, have shown a significant decrease in fatal RTCs per 100,000 inhabitants over the last decades; from 18.6 to 4.9 in Australia, 14.5 to 2.9 in Norway, 11.1 to 3.6 in Spain, and 19.3 to 10.3 in the United States. The number of alcohol-related fatal RTCs also decreased during the same time period. The proportion of fatal RTCs related to non-alcohol drugs increased, particularly for cannabis and stimulants. A general challenge when comparing alcohol and drug findings in biological samples from several countries is connected to differences in study design, particularly the time period for performing roadside surveys, biological matrix types, drugs included in the analytical program, and the cutoff limits used for evaluation of results. For RTC fatalities, the cases included are based on the police requests for legal autopsy or drug testing, which may introduce a significant selection bias. General comparisons between high-income countries and low- and middle-income countries as well as a discussion of possible future trends are included.