Estimate of the magnitude of risky and protective behaviors associated with road traffic injuries in capitals participating in the Life in Traffic Project of Brazil.

BACKGROUND: Brazil occupies the fifth position in the ranking of the highest mortality rates due to RTI in the world. With the objective of promoting traffic safety and consequently reducing deaths, Brazil created the Life in Traffic Project (LTP). The main goal of LTP is reducing 50% of RTI deaths, by promoting interventions to tackle risk factors, such as driving under the influence of alcohol and excessive and/or inappropriate speed. Thus, the aim of this study was to estimate the magnitude of risky and protective factors for RTI in capitals participating in the LTP in Brazil. We estimated these factors according to sociodemographic (age group, sex, education, race and, type of road user). METHODS: A total of 5,922 car drivers and motorcyclists from 14 Brazilian capitals participating in the LTP were interviewed. Data collection was carried out in sobriety checkpoints at night and consisted of the administration of an interview and a breathalyzer test. Risky and protective behaviors associated with RTI were investigated. Covariates of the study were: age, sex, education, race and, type of road user. Poisson multiple regression analysis was used to assess the relationship between variables of interest. RESULTS: The prevalence of individuals with positive blood alcohol concentration (BAC) was 6.3% and who reported driving after drinking alcohol in the last 30 days was 9.1%. The others risky behaviors reported were: driving at excessive speed on roads of 50 km/h, using a cell phone for calls while driving, using a cell phone to send or read calls while driving, running a red light. Use of seatbelts and helmets showed prevalence above 96,0% Use of seatbelts showed prevalence of 98.6% among car drivers, and helmet use was described by 96.6% of motorcycle drivers. Most risky behaviors were more prevalent in younger age groups (except BAC measurement higher in older participants), in males (except for cell phone use), in participants with higher education level and without a driver's license. CONCLUSION: Excessive speed and driving under the influence of alcohol, defined as priorities within the LTP, need more consistent interventions, as they still have considerable prevalence in the cities investigated. The factors described such as cell phone usage and passing red traffic lights should also need to be prioritized as a focus on promoting traffic safety.

The association between legalization of cannabis use and traffic deaths in Uruguay.

BACKGROUND AND AIMS: While cannabis use has been found to impair motor vehicle driving, the association between cannabis legalization and motor vehicle fatalities is unclear. In Uruguay in December 2013, cannabis for recreational purposes was legalized. This study assessed the association between implementation of this law and changes in traffic fatality rates. DESIGN: Interrupted time-series analysis of traffic fatality rates of light motor vehicle drivers and motorcyclists in urban and rural settings. Changes are reported as step and trend effects against modeled trends in the absence of legalization. SETTING: Uruguay, Montevideo and four rural provinces (Colonia, Florida, Río Negro and San José) from 1 January 2012 to 31 December 2017. Cases and measurement Weekly traffic fatalities of light motor vehicle drivers and motorcyclists per type of vehicle. Data were gathered from the National Road Safety Agency of Uruguay and the Ministry of Transport and Public Works, respectively. RESULTS: Cannabis legalization was associated with a 52.4% immediate increase [95% confidence interval (CI) = 11.6, 93.3, P = 0.012] in the light motor vehicle driver's fatality rate. However, no significant change in the motorcyclists' fatality rate was observed. In Montevideo the legislation was associated with an absolute increase in its light motor vehicle driver's fatality rate by 0.06 (95% CI = 0.01, 0.11, P = 0.025), but no significant associations were observed in rural settings. CONCLUSIONS: In Uruguay, the 2013 legislation legalizing recreational cannabis consumption may have been associated with an increase in fatal motor vehicle crashes, particularly in light motor-vehicle drivers and urban settings.

Variability in crash and near-crash risk among novice teenage drivers: a naturalistic study.

OBJECTIVE: Using video monitoring technologies, we investigated teenage driving risk variation during the first 18 months of independent driving. STUDY DESIGN: Driving data were collected on 42 teenagers whose vehicles were instrumented with sophisticated video and data recording devices. Surveys on demographic and personality characteristics were administered at baseline. Drivers were classified into 3 risk groups using a K-mean clustering method based on crash and near-crash (CNC) rate. The change in CNC rates over time was evaluated by mixed-effect Poisson models. RESULTS: Compared with the first 3 months after licensure (first quarter), the CNC rate for participants during the third, fourth, and fifth quarters decreased significantly to 59%, 62%, and 48%, respectively. Three distinct risk groups were identified with CNC rates of 21.8 (high-risk), 8.3 (moderate-risk), and 2.1 (low-risk) per 10 000 km traveled. High- and low-risk drivers showed no significant change in CNC rates throughout the 18-month study period. CNC rates for moderate-risk drivers decreased substantially from 8.8 per 10 000 km in the first quarter to 0.8 and 3.2 in the fourth and fifth quarters, respectively. The 3 groups were not distinguishable with respect to personality characteristics. CONCLUSION: Teenage CNC rates varied substantially, with distinct high-, moderate-, and low-risk groups. Risk declined over time only in the moderate-risk group. The high-risk drivers appeared to be insensitive to experience, with CNC rates consistently high throughout the 18-month study period, and the moderate-risk group appeared to learn from experience.