Associations between smoke-free vehicle legislation and childhood admissions to hospital for asthma in Scotland: an interrupted time-series analysis of whole-population data.

BACKGROUND: In Scotland, childhood admissions to hospital for asthma fell from March, 2006, after legislation was introduced to prohibit smoking in public places. In December, 2016, new Scottish legislation banned smoking in vehicles containing a child. We aimed to determine whether the introduction of this new legislation produced additional benefits. METHODS: We obtained data on all asthma emergency admissions to hospitals in Scotland between 2000 and 2018 for individuals younger than 16 years. We used interrupted time-series analyses to study changes in monthly incidence of asthma emergency admissions to hospital per 100 000 children after the introduction of smoke-free vehicle legislation, taking into account previous smoke-free interventions. We did subgroup analyses according to age and area deprivation, using the Scottish Index of Multiple Deprivation, and repeated the analyses for a control condition, gastroenteritis, and other respiratory conditions. FINDINGS: Of the 32 342 emergency admissions to hospital for asthma among children younger than 16 years over the 19-year study period (Jan 1, 2000, to Dec 31, 2018), 13 954 (43%) were among children younger than 5 years and 18 388 (57%) were among children aged 5-15 years. After the introduction of smoke-free vehicle legislation, there was a non-significant decline in the slope for monthly emergency admissions to hospital for asthma among children younger than 16 years (-1·21%, 95% CI -2·64 to 0·23) relative to the underlying trend in hospital admissions for childhood asthma. However, children younger than 5 years had a significant decline in the slope for monthly asthma admissions (-1·49%, -2·69 to -0·27) over and above the underlying trend among children in this age group (equivalent to six fewer hospitalisations per year), but no such decline was seen in children aged 5-15 years. Monthly admissions to hospital for asthma fell significantly among children living in the most affluent areas (-2·27%, -4·41 to -0·07) but not among those living in the most deprived areas. We found no change in admissions to hospital for gastroenteritis or other respiratory conditions after the introduction of the smoke-free vehicle legislation. INTERPRETATION: Although legislation banning smoking in vehicles did not affect hospital admissions for severe asthma among children overall or in the older age group, this legislation was associated with a reduction in severe asthma exacerbations requiring hospital admission among preschool children, over and above the underlying trend and previous interventions designed to reduce exposure to second-hand smoke. Similar legislation prohibiting smoking in vehicles that contain children should be adopted in other countries. FUNDING: None.

The impact of state laws on motor vehicle fatality rates, 1999-2015.

BACKGROUND: Motor vehicle crash (MVC) fatalities have been declining while states passed various legislation targeting driver behaviors. This study assesses the impact of state laws on MVC fatality rates to determine which laws were effective. METHODS: Publically available data were collected on driver-related motor vehicle laws, law strengths, enactment years, and numbers of verified-trauma centers. Prospective data on crash characteristics and MVC fatalities 16 years or older from Fatality Analysis Reporting System 1999 to 2015 (n = 850) were obtained. Generalize Linear Autoregressive Modeling was used to assess the relative contribution of state laws to the crude MVC fatality rate while controlling for other factors. RESULTS: Lowering the minimum blood alcohol content (BAC) was associated with largest declines for all ages, especially the older cohorts: 16 years to 20 years (B = 0.23; p < 0.001), 21 years to 55 years (B = 1.7; p < 0.001); 56 years to 65 years (B = 3.2; p < 0.001); older than 65 years (B = 4.1; p < 0.001). Other driving under the influence laws were also significant. Per se BAC laws accompanying a reduced BAC further contributed to declines in crude fatality rates: 21 years to 55 years (B = -0.13; p < 0.001); older than 65 years (B = -0.17; p < 0.05). Driving under the influence laws enhancing the penalties, making revocation automatic, or targeting social hosts had mixed effects by age. Increased enforcement, mandatory education, vehicle impoundment, interlock devices, and underage alcohol laws showed no association with declining mortality rates. Red light camera and seatbelt laws were associated with declines in mortality rates for all ages except for older than 65 years cohort, but speed camera laws had no effect. Graduated Driver License laws were associated with declines for 16 years to 21 years (B = -0.06; p < 0.001) only. Laws targeting specific risks (elderly, motorcycles, marijuana) showed no effect on declining MVC mortality rates during the study period. CONCLUSION: States have passed a wide variety of laws with varying effectiveness. A few key laws, specifically laws lowering allowable BAC, implementing red light cameras, and mandating seatbelt use significantly reduced MVC mortality rates from 1999 to 2015. Simply adding more laws/penalties may not equate directly to lives saved. Continued research on state laws will better inform policy makers to meet evolving public health needs in the management of MVC fatalities. LEVEL OF EVIDENCE: Epidemiological, Level III.

[Support to smoking regulation in private vehicles and public outdoor spaces]. / Apoyo a la regulación de fumar en el interior de vehículos privados y espacios públicos al aire libre.

OBJECTIVE: To know the support of tobacco regulation is a very important issue to advance in the tobacco control policies and reduce the passive exposure to tobacco. The aim of this study was to describe the attitudes towards forbidding smoking in private vehicles and public outdoor spaces. METHODS: This is a cross-sectional study of a representative sample (n=736) of the adult population (24+ years old) from Barcelona, Spain in 2013-2014. We calculated the percentages of individuals who had a favourable attitude towards smoking regulation in private vehicles and public outdoor spaces, their adjusted Odds ratios (aOR) and their 95% confidence intervals (95%CI) according to sex, age, educational level and smoking status through logistic regression. We used weighted data for all analyses in order to keep the representativeness of the population of Barcelona in 2013-2014. RESULTS: 61.7% of participants supported forbidding smoking in private vehicles and 89.5% supported forbidding it only in the presence of minors. The support to smoking regulation in public outdoor spaces varied from 42.5% to 84.7% in different settings. Smokers showed a less favourable attitude towards an extension of the smoking regulation to other settings: outdoor areas of university centres, outdoor areas of shopping centres and beaches and outdoor pools. CONCLUSIONS: A wide support exists to extend the smoking regulation to private vehicles, especially in the presence of children, and public outdoor spaces. This wide support could favour the extension of smoking regulation to these places to improve the population's health and to contribute to denormalise tobacco use among the population.

OBJETIVO: Conocer el apoyo a la regulación del consumo de tabaco es una pieza clave para avanzar en las políticas de control del tabaquismo y reducir la exposición pasiva al tabaco. El objetivo de este trabajo fue describir las actitudes hacia la prohibición de fumar en los vehículos privados y espacios públicos al aire libre. METODOS: studio transversal de una muestra representativa (n=736) de la población adulta (mayor de 24 años) de la ciudad de Barcelona, España, realizado en 2013-2014. Se calcularon el porcentaje de individuos que tenían una actitud favorable a la regulación del consumo de tabaco en el interior de vehículos privados y espacios públicos al aire libre, las Odds Ratio ajustadas (ORa) y sus intervalos de confianza al 95% (IC95%) según sexo, edad, nivel de estudios y estatus de consumo de tabaco mediante un modelo de regresión logística. Se utilizaron pesos de probabilidad inversa para mantener la representatividad de la población de Barcelona en 2013-2014. RESULTADOS: El 61,7% de los participantes estuvo a favor de la prohibición de fumar dentro de los vehículos privados y el 89,5% de prohibirlo sólo en presencia de menores. El apoyo a la regulación del consumo de tabaco en espacios exteriores varió entre 42,5% hasta 84,7% dependiendo del ambiente. Los fumadores mostraron una actitud menos favorable a la ampliación de la regulación a otros espacios: zonas exteriores de los centros universitarios, zonas exteriores de los centros comerciales y playas y piscinas descubiertas. CONCLUSIONES: Existe un amplio apoyo a la extensión de la regulación del consumo del tabaco en el interior de vehículos privados, especialmente en presencia de menores, y espacios públicos al aire libre. Este amplio apoyo podría favorecer la ampliación de la regulación del consumo de tabaco a estos espacios a fin de mejorar la salud de la población y al mismo tiempo contribuir a la desnormalización del consumo de tabaco entre la población.

Alternative Fuel Vehicle Adoption Increases Fleet Gasoline Consumption and Greenhouse Gas Emissions under United States Corporate Average Fuel Economy Policy and Greenhouse Gas Emissions Standards.

The United States Corporate Average Fuel Economy (CAFE) standards and Greenhouse Gas (GHG) Emission standards are designed to reduce petroleum consumption and GHG emissions from light-duty passenger vehicles. They do so by requiring automakers to meet aggregate criteria for fleet fuel efficiency and carbon dioxide (CO2) emission rates. Several incentives for manufacturers to sell alternative fuel vehicles (AFVs) have been introduced in recent updates of CAFE/GHG policy for vehicles sold from 2012 through 2025 to help encourage a fleet technology transition. These incentives allow automakers that sell AFVs to meet less-stringent fleet efficiency targets, resulting in increased fleet-wide gasoline consumption and emissions. We derive a closed-form expression to quantify these effects. We find that each time an AFV is sold in place of a conventional vehicle, fleet emissions increase by 0 to 60 t of CO2 and gasoline consumption increases by 0 to 7000 gallons (26,000 L), depending on the AFV and year of sale. Using projections for vehicles sold from 2012 to 2025 from the Energy Information Administration, we estimate that the CAFE/GHG AFV incentives lead to a cumulative increase of 30 to 70 million metric tons of CO2 and 3 to 8 billion gallons (11 to 30 billion liters) of gasoline consumed over the vehicles' lifetimes - the largest share of which is due to legacy GHG flex-fuel vehicle credits that expire in 2016. These effects may be 30-40% larger in practice than we estimate here due to optimistic laboratory vehicle efficiency tests used in policy compliance calculations.

Verifying emission reductions from heavy-duty diesel trucks operating on Southern California freeways.

Measurements on truck-dominated freeways in southern California have offered a unique opportunity to track emission changes that have occurred due to the implementation of local and state regulations affecting heavy-duty diesel trucks. These regulations have accelerated fleet turnover to cleaner and newer trucks. In this study, a mobile platform was used to measure nitrogen oxides (NOX), black carbon (BC), and ultrafine particles (UFPs) on diesel-dominated southern California freeways. Fleet-averaged fuel-based emission factors were calculated for diesel trucks and the results showed NOX and BC emissions were reduced by 40% or more between 2009 and 2011, but there were no statistically significant reductions for UFP. Technologies associated with these new trucks, mainly diesel particulate filters, have changed the physical characteristics of diesel particulate, shifting the size distribution of such particles to smaller modes (10-20 nm). In addition, integration of 2007 MY trucks into the fleet was also observed in on-road ratios of nitrogen dioxide (NO2) and NOX. NO2/NOX ratios steadily increased from 0.23 ± 0.06 in 2009 to 0.30 ± 0.03 in 2010 but plateaued and declined in 2011.

Hurto de automotores y estrategias contra el delito: una mirada desde la academia, el victimario y la Policía / Automobile theft and strategies against crime: a glance from the academy, the offender, and the Police / Roubo de veículos automotores e estratégias contra o crime: um olhada da academia, do vitimário e da Polícia

Se identifican las variables que deben abordarse en el estudio del hurto o robo de automotores y el diseño de estrategias contra este delito. Para tal propósito, se realizó una búsqueda sistemática en diferentes bases científicas de datos, se aplicó una entrevista semiestructurada a personas condenadas en Colombia por el delito de hurto de automotores y se contrastó con la evidencia empírica obtenida en diferentes análisis y trabajos de campo realizados por el OBSER-DIJIN. Se utilizó como marco teórico para el análisis la teoría de elección racional y la de la oportunidad. Como resultado, se identificaron once variables que intervienen en el fenómeno: a) rentabilidad, b) tecnología, c) facilidad de legalización, d) nivel organizativo de los delincuentes, e) seguridad, f) vigilancia informal, g) nodos de actividad, h) conducta espacial, i) penalidad, j) transnacionalidad y k) instrumentalización; se terminó por exponer una visión criminológica holística e integradora de los elementos vinculados al fenómeno, y la sugerencia de acciones de control surgidas del análisis multivariado del delito. Se concluye con recomendaciones que pueden ser usadas en la política criminal, en países o territorios con afectación de este tipo de criminalidad.

As variáveis que devem abordar-se no estudo do furto ou roubo de veículos automotores e o projeto das estratégias contra a este crime são identificados. Para tal propósito, uma busca sistemática foi feita em diferentes bancos de dados científicas, uma entrevista semi-estruturada foi feita a pessoas condenadas na Colômbia pelo crime do roubo de veículos automotores e foi contrastada com a evidência empírica obtida em análises diferentes e nos trabalhos do campo feitos pelo OBSER-DIJIN. A teoria da eleição racional e aquela da oportunidade foi usada como o enquadramento teórico para a análise. Como resultado, onze variáveis que intervêm no fenômeno foram identificadas: a) renda, b) tecnologia, c) facilidade do legalização, d) nível organizacional dos delinquentes, e) segurança, f) vigilância informal, g) nós da atividade, h) conduta espacial, i) penalidade, j) transnacionalidade, k) e instrumentalização; finalmente, expõe se uma visão holística criminológica e integradora dos elementos vinculados ao fenômeno, e a sugestão das ações do controle surgidas dos diferentes tipos de análise do crime. Em conclusão se apresentam recomendações que podem ser usadas na política criminal, nos países ou nos territórios com afetação deste tipo de criminalidade.

The variables that should be approached in the study of automobile theft or robbery are identified, as well as the strategies designed to fight against this crime. For such purpose, a systematic search was carried out through different scientific databases; a semi-structured interview was applied with people convicted in Colombia for automobile theft, and it was examined in contrast with the empirical evidence obtained through diverse analysis and field work carried out by the OBSER-DIJIN. The theory of rational choice and opportunity was used as a theoretical framework for the analysis. As a result, eleven variables involved in the occurrence were identified: a) profitability, b) technology, c) easy legalization, d) criminals’ organizational level, e) security, f) informal surveillance, g) activity nodes, h) special conduct, i) penalty, j) trans-nationality, and k) instrumentalization; a holistic criminological vision integrating the elements connected to the occurrence was finally exposed, along with control actions suggested as a result of the multivaried analysis of the crime. The article concludes with recommendations that may be used in criminal police in countries or territories affected with this kind of criminality.

Greenhouse gas implications of fleet electrification based on big data-informed individual travel patterns.

Environmental implications of fleet electrification highly depend on the adoption and utilization of electric vehicles at the individual level. Past research has been constrained by using aggregated data to assume all vehicles with the same travel pattern as the aggregated average. This neglects the inherent heterogeneity of individual travel behaviors and may lead to unrealistic estimation of environmental impacts of fleet electrification. Using "big data" mining techniques, this research examines real-time vehicle trajectory data for 10,375 taxis in Beijing in one week to characterize the travel patterns of individual taxis. We then evaluate the impact of adopting plug-in hybrid electric vehicles (PHEV) in the taxi fleet on life cycle greenhouse gas emissions based on the characterized individual travel patterns. The results indicate that 1) the largest gasoline displacement (1.1 million gallons per year) can be achieved by adopting PHEVs with modest electric range (approximately 80 miles) with current battery cost, limited public charging infrastructure, and no government subsidy; 2) reducing battery cost has the largest impact on increasing the electrification rate of vehicle mileage traveled (VMT), thus increasing gasoline displacement, followed by diversified charging opportunities; 3) government subsidies can be more effective to increase the VMT electrification rate and gasoline displacement if targeted to PHEVs with modest electric ranges (80 to 120 miles); and 4) while taxi fleet electrification can increase greenhouse gas emissions by up to 115 kiloton CO2-eq per year with the current grid in Beijing, emission reduction of up to 36.5 kiloton CO2-eq per year can be achieved if the fuel cycle emission factor of electricity can be reduced to 168.7 g/km. Although the results are based on a specific public fleet, this study demonstrates the benefit of using large-scale individual-based trajectory data (big data) to better understand environmental implications of fleet electrification and inform better decision making.

Road safety legislation in the Americas / Legislación sobre seguridad vial en las Américas

Legislating five of the main risk factors for road traffic injuries (RTIs), as much as enforcing the law, is essential in forging an integral culture of road safety. Analysis of the level of progression in law enforcement allows for an evaluation of the state of world regions. A secondary analysis of the 2009 Global status report on road safety: time for action survey was undertaken to evaluate legislation on five risk factors (speed management, drinking and driving, motorcycle helmet use, seatbelt use, and use of child restraints) in the Americas. Laws were classified depending on their level of progression: the existence of legislation, whether the legislation is adequate, a level of law enforcement > 6 (on a scale of 0-10), and whether the law is considered comprehensive. A descriptive analysis was performed. The totality of the countries has national or subnational legislation for at least one of the five risk factors. However, 63% have laws on the five risk factors studied, and none of them has comprehensive laws for all five. Seatbelt use appears to be the most extended enforced legislation, while speeding laws appear to be the least enforced. There are positive efforts that should be recognized in the region. However, the region stands in different stages of progression. Law enforcement remains the main issue to be tackled. Laws should be based on evidence about what is already known to be effective.

La legislación sobre cinco de los principales factores de riesgo de sufrir lesiones causadas por el tránsito, así como el cumplimiento de la ley, son esenciales para forjar una cultura integral de seguridad vial. El análisis del nivel de progresión en el cumplimiento de la ley permite evaluar el estado de las regiones del mundo. Se llevó a cabo un análisis secundario de la encuesta Informe sobre la situación mundial de la seguridad vial: es hora de pasar a la acción, de 2009, para evaluar la legislación sobre cinco factores de riesgo (control de la velocidad, conducir bajo la influencia del alcohol, uso del casco al conducir motocicletas, uso de cinturones de seguridad y uso de sistemas de retención para niños) en las Américas. Las leyes se clasificaron según su nivel de progresión: la existencia de legislación, si la legislación es adecuada, un nivel de cumplimiento de la ley > 6 (en una escala de 0-10) y si la ley se considera integral. Se realizó un análisis descriptivo. Todos los países tienen legislación nacional o subnacional al menos con respecto a uno de los cinco factores de riesgo; sin embargo, 63% tienen leyes sobre los cinco factores de riesgo estudiados, y ninguno de ellos tiene leyes integrales para los cinco. La legislación sobre uso de cinturones de seguridad parece ser la de mayor cumplimiento, mientras que las leyes de exceso de velocidad parecen ser las que menos se cumplen. En la región hay esfuerzos positivos que deben reconocerse; sin embargo, existen diferentes etapas de progresión. El cumplimiento de la ley sigue siendo el principal tema por abordar. Las leyes deben basarse en datos de eficacia reconocida.

Incorporating time-corrected life cycle greenhouse gas emissions in vehicle regulations.

Beginning with model year 2012, light-duty vehicles sold in the U.S. are subject to new rules that regulate tailpipe greenhouse gas (GHG) emissions based on grams of CO(2)-equivalent per mile (gCO(2)e/mi). However, improvements in vehicle technology, lower-carbon fuels, and improvements in GHG accounting practices which account for distortions related to emissions timing all contribute to shifting a greater portion of life cycle emissions away from the vehicle use phase and toward the vehicle production phase. This article proposes methods for calculating time-corrected life cycle emissions intensity on a gCO(2)e/mi basis and explores whether regulating only tailpipe CO(2) could lead to an undesirable regulatory outcome, where technologies and vehicle architectures with higher life cycle GHGs are favored over technologies with lower life cycle emissions but with higher tailpipe GHG emissions. Two life cycle GHG assessments for future vehicles are presented in addition to time correction factors for production and end-of-life GHG emissions. Results demonstrate that, based on the vehicle designs considered here, there is a potential for favoring vehicles with higher life cycle emissions if only tailpipe emissions are regulated; moreover, the application of time correction factors amplifies the importance of production emissions and the potential for a perverse outcome.

Es sostenible la reducción del hurto de automotores mediante atraco en Bogotá? / Can motor vehicle robbery hold-up be reduced in a sustainable manner in Bogota? / Quão sustentável é reduzir o roubo de carros por furto em Bogotá?

El atraco ha sido la segunda modalidad más frecuente de hurto de automotores en Colombia, y se ha concentrado en las principales ciudades del país. En Bogotá, los atracos se han dirigido a automóviles particulares, además de los taxis, y descendieron hasta un rango medio que se ha mantenido desde el año 2006. Con el artículo se pretende, en primer término, verificar y discutir correlaciones del atraco con factores de persistencia, identificados mediante revisión bibliográfica y entrevistas abiertas a funcionarios de policía judicial y del gremio asegurador. Los factores analizados son: precio relativo de los autos usados con respecto a los nuevos; precio absoluto de los nuevos; participación en las ventas de los autos nuevos o ventas relativas; salvamentos de las compañías aseguradoras; averías de los autos, y autorrobos presentados como atracos. Los más relevantes, estadísticamente, son las ventas relativas y los salvamentos. Las primeras reflejan la preferencia de los clientes por los autos nuevos, y la de los ladrones por los más comerciales. Los segundos son un factor de oferta en el mercado de piezas de autos, que emplean como cubierta los comercializadores de las hurtadas. En segundo término, se busca discutir el alcance del control policial sobre los hurtos. Se encontró una relación directa y significativa, contraria a lo esperado, con los hurtos, y en particular con la modalidad del atraco, reincidencia de los ladrones y continuidad en su modus operandi. De ahí que, al final, se expongan sugerencias de incorporación de los factores de persistencia en la estrategia de intervención policial

In Colombia, holdups have been the second more frequent method used in motor vehicle thefts, particularly in major cities in the country. In Bogota, stick-ups generally aimed at stealing private cars, apart from taxis, have shown a reduction down to a stable middle range since 2006. This article is firstly intended to discuss and verify hold-up correlations with persistence factors identified by means of a bibliographical review and open interviews made to judicial police and insurance officers. Factors analyzed include: the relative price of used cars with respect to new vehicles; the absolute price of new cars; the new car share in sales, or relative sales; insurance companies’ salvages; car averages, and fake robberies presented as hold-ups. Most relevant in statistical terms are relative sales and salvages. Relative sales reflect clients’ favoritism for new cars, and robbers’ preference for more commercial vehicles. The later are a good supply factor at the spare-part market used as a cover by stolen-parts merchandisers. An unexpected direct and significant relationship was found with robberies and, particularly, with hold-ups, and the recidivism and continuity of robbers in their modus operandi. Hence the suggestions exposed at the end with respect to incorporating the persistence factors in police-intervention strategy

O furto foi a segunda forma mais comum de roubo de veículos na Colômbia, e está concentrado nas principais cidades do país. Em Bogotá, os furtos se voltaram para carros particulares, assim como táxis, e caíram até uma faixa média que ocupa desde 2006. Com o artigo pretende-se, primeiro, verificar e discutir as correlações do furto com fatores de persistência identificados a partir da revisão da literatura e entrevistas abertas aos agentes de polícia judiciária e do grêmio de seguros. Os fatores analisados são: o preço relativo dos carros usados em relação ao preço dos novos, o preço absoluto dos novos, a participação nas vendas de carros novos ou vendas relacionadas, o salvamento das companhias de seguros, danos nos carros, e roubos falsos apresentados como furtos. Os mais relevantes, estatisticamente, são as vendas relativas e os salvamentos. As primeiras refletem a preferência dos clientes por novos carros, e aquela dos ladrões pelos mais comerciais. Os últimos são um fator de oferta no mercado de peças de carros, que os negociantes utilizam como fachada das peças roubadas. Em segundo lugar, visa discutir o alcance do controle da polícia nos roubos. Encontrou-se uma relação direta e significativa, ao contrário das expectativas, com os roubos, e em particular a modalidade de furto, a reincidência dos ladrões e a continuidade no seu modus operandi. Assim, no final, vão se expor as sugestões da incorporação dos fatores de persistência na estratégia de intervenção da polícia

Relationship between vehicle emissions laws and incidence of suicide by motor vehicle exhaust gas in Australia, 2001-06: an ecological analysis.

BACKGROUND: Globally, suicide accounts for 5.2% of deaths among persons aged 15 to 44 years and its incidence is rising. In Australia, suicide rates peaked in 1997 and have been declining since. A substantial part of that decline stems from a plunge in suicides by one particular method: asphyxiation by motor vehicle exhaust gas (MVEG). Although MVEG remains the second most common method of suicide in Australia, its incidence decreased by nearly 70% in the decade to 2006. The extent to which this phenomenon has been driven by national laws in 1986 and 1999 that lowered permissible levels of carbon monoxide (CO) emissions is unknown. The objective of this ecological study was to test the relationship by investigating whether areas of Australia with fewer noxious vehicles per capita experienced lower rates of MVEG suicide. METHODS AND FINDINGS: We merged data on MVEG suicides in Australia (2001-06) with data on the number and age of vehicles in the national fleet, as well as socio-demographic data from the national census. Poisson regression was used to analyse the relationship between the incidence of suicide within two levels of geographical area--postcodes and statistical subdivisions (SSDs)--and the population density of pre-1986 and pre-1999 passenger vehicles in those areas. (There was a mean population of 8,302 persons per postcode in the study dataset and 87,413 persons per SSD.) The annual incidence of MVEG suicides nationwide decreased by 57% (from 2.6 per 100,000 in 2001 to 1.1 in 2006) during the study period; the population density of pre-1986 and pre-1999 vehicles decreased by 55% (from 14.2 per 100 persons in 2001 to 6.4 in 2006) and 26% (from 44.5 per 100 persons in 2001 to 32.9 in 2006), respectively. Area-level regression analysis showed that the suicide rates were significantly and positively correlated with the presence of older vehicles. A percentage point decrease in the population density of pre-1986 vehicles was associated with a 6% decrease (rate ratio [RR] = 1.06; 95% confidence interval [CI] 1.05-1.08) in the incidence of MVEG suicide within postcode areas; a percentage point decrease in the population density of pre-1999 vehicles was associated with a 3% decrease (RR = 1.03; 95% CI 1.02-1.04) in the incidence of MVEG suicide. CONCLUSIONS: Areas of Australia with fewer vehicles predating stringent CO emission laws experience lower rates of MVEG suicide. Although those emission laws were introduced primarily for environmental reasons, countries that lack them may miss the benefits of a serendipitous suicide prevention strategy. Please see later in the article for the Editors' Summary.

Performance-based regulation: enterprise responsibility for reducing death, injury, and disease caused by consumer products.

This article offers a bold new idea for confronting the staggering level of death, injury, and disease caused by five consumer products: cigarettes, alcohol, guns, junk food, and motor vehicles. Business leaders try to frame these negative outcomes as "collateral damage" that is someone else's problem. That framing not only is morally objectionable but also overlooks the possibility that, with proper prodding, industry could substantially lessen these public health disasters. I seek to reframe the public perception of who is responsible and propose to deploy a promising approach called "performance-based regulation" to combat the problem. Performance-based regulation would impose on manufacturers a legal obligation to reduce the negative social costs of their products. Rather than involving them in litigation or forcing them to operate differently (as "command-and-control" regimes do), performance-based regulation allows the firms to determine how best to decrease bad public health consequences. Like other public health strategies, performance-based regulation focuses on those who are far more likely than individual consumers to achieve real gains. Analogous to a tax on causing harm that exceeds a threshold level, performance-based regulation seeks to harness private initiative in pursuit of the public good.

[Guidelines on prophylactic medical examinations of drivers]. / Wskazówki do przeprowadzania badan profilaktycznych kierowców.

The performance of workers' prophylactic medical examinations is regulated by the Labor Code and relevant executive regulations. There are also other regulations that concern particular groups of workers, e.g., drivers. The range and frequency of medical examinations are determined by the physician responsible for their performance on the basis of the "Guidelines on prophylactic medical examinations of workers" The Guidelines do not focus on particular jobs, but on occupational exposure to physical, chemical, biological, and psychosocial hazards. Driving is a kind of job that requires total psychomotor efficiency. This article presents standards of prophylactic medical examinations of drivers who are engaged in the commercial "road transport", i.e., drivers who do not come under the provisions of the "Road Transportation Act", as well as of other persons who use their driving rights for occupational purposes.

The public health approach to motor vehicles, tobacco, and alcohol, with applications to firearms policy.

The public health approach that has been used to reduce problems caused by motor vehicles, tobacco and alcohol is applied to firearms policy. Manufacturers try to focus prevention efforts on the user rather than the product, and promote education and law enforcement policies directed toward the consumer. Public health efforts emphasize the systematic collection of data, scientific inquiry, and a multi-faceted policy approach that includes modifying the product and the environment. The endeavor to reduce gun violence is part of the general and continuing public health struggle to reduce harms caused by consumer products.