Increases in fines and driver licence withdrawal have effectively reduced immediate deaths from trauma on Brazilian roads: first-year report on the new traffic code
Introduction
Motor vehicle crashes and accidents involving pedestrians and vehicles account for much disability and loss of life in Brazil. Second to gunshot wounds, they are the most common causes of death among our population between 15 and 39 years of age and are the third cause of death between the ages of 10 and 49 years [1], [2]. Several reports from developed countries show that the rates of fatal and non-fatal injuries from motor vehicle crashes have declined over the years, largely associated with compliance to mandatory seat-belt and helmet use [2], [3], [4], [5], [6], [7]. Compliance to the same laws is a fact in Brazil; but motor vehicle crashes continue to kill, with death rates increasing steadily for years. It has been estimated that 90% of these crashes are caused by human error, while 6% are caused by road defects and 4% by mechanical failures [2].
On 21 January 1998, a new National Traffic Code began to be enforced in Brazil, in an attempt to reduce the number of deaths on the roads. This new code replaces a 33-year-old code and seeks to produce short-term changes in driver behaviour through stricter enforcement and higher penalties. The main changes were a large increase in fines, in some cases ten-fold, and a rigid penalty scoring system that leads to driver licence withdrawal. Speed limits were actually raised on many highways, but adherence to the rules has been more closely and effectively monitored.
Our purpose now is to analyse the impact in its first year of this new traffic code, which has punishment as its most striking feature, on the number of accidents, injured patients and immediate deaths on Brazilian interstate highways. Additionally, emergency room admissions to a level I trauma centre in downtown São Paulo were evaluated to show the impact of the new code on the incidence of injury from accidents occurring within an urban area.
Section snippets
Methods
The incidence of accidents, injured patients and immediate deaths on Brazilian interstate highways between 21 January 1998 and 20 January 1999 was compared with the corresponding data obtained between 21 January 1997 and 20 January 1998. Data were collected and published by the Departamento Nacional de Trânsito, the National Traffic Agency of the Brazilian Government, and made widely available through the lay press. Only eight out of 26 Brazilian states (Tocantins, Acre, Amazonas, Amapá, Goias,
Results
The new Brazilian Traffic Code was associated with a 21.3% reduction in the number of accidents occurring on interstate highways, from 327 640 in 1997 to 257 866 in 1998. More importantly, there was a 24.7% reduction in immediate deaths, saving 5962 lives (Fig. 1). There was also a marked decrease in tickets issued on the highway, which fell from 601 977 to 304 785, a 49.5% reduction.
A similar pattern was observed in downtown São Paulo, where there was a 33.2% reduction in motor vehicle-related
Discussion
Expensive tickets and threatened driver licences have proved to be an effective means of decreasing the first-peak, trauma-related, immediate deaths on Brazilian roads and the emergency room admissions from motor vehicle accidents in an urban area. Although the impact of the new code on the second- and the third-peak mortality could not be estimated, it is likely that morbidity and hospital mortality were reduced.
The social and economic impact of these findings is dramatic. Trauma is an
Acknowledgements
This study was supported by Fundação de Amparo a Pesquisa do Estado de São Paulo, grant FAPESP – 98/15658-0.
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Putting a lid on injury costs: the economic impact of the California motorcycle helmet law
J. Trauma
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