Impact of the demerit point system on road traffic accident mortality in Spain

Pulido, José; Lardelli, Pablo; Fuente, Luís de la; Flores, Víctor; Vallejo, Fernando; Regidor, Enrique

doi:10.1136/jech.2008.082461

Cited by 36 publications

(21 citation statements)

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“…Finally, the number of traffic injuries in Spain had already decreased substantially after the prioritization of road safety there in 2004. 13 In Spain, a previous study had observed a 14.5% reduction in overall fatalities on nonurban roads, 9 a reduction similar to the10% and 12% reductions, respectively, in the numbers of men and women killed or seriously injured, as observed in the present study.…”

Section: Comparison With Previous Studiessupporting

confidence: 73%

“…In Spain, the effectiveness of the PPS has been assessed only for overall numbers of fatalities on nonurban roads. 9 In addition, none of those studies have analyzed changes in risk among drivers, who are the main target of the PPS. Our objective was to assess the effectiveness of the PPS in reducing the number of drivers involved in injury collisions (i.e., traffic collisions resulting in injury) and the number of people injured in traffic collisions in Spain.…”

mentioning

confidence: 99%

“…Although 20 of the 27 EU member states had adopted a PPS by 2007, to date, few countries have published studies assessing its effectiveness in terms of road safety. [4][5][6][7][8][9] The few studies that have been published are generally simple before-after analyses, with the exception of those by Zambon et al 4 and Pulido et al 9 In addition, most studies have assessed only the impact of PPS on the overall number of people injured or killed, and have not considered gender, type of road user, and other variables that could help to identify in which road user profiles the PPS is effective and in which profiles it is ineffective. In Spain, the effectiveness of the PPS has been assessed only for overall numbers of fatalities on nonurban roads.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Impact of the Penalty Points System on Road Traffic Injuries in Spain: A Time–Series Study

Novoa¹,

Pérez²,

Santamariña-Rubio³

et al. 2010

Am J Public Health

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Objectives. We assessed the effectiveness of the penalty points system (PPS) introduced in Spain in July 2006 in reducing traffic injuries. Methods. We performed an evaluation study with an interrupted time–series design. We stratified dependent variables—numbers of drivers involved in injury collisions and people injured in traffic collisions in Spain from 2000 to 2007 (police data)—by age, injury severity, type of road user, road type, and time of collision, and analyzed variables separately by gender. The explanatory variable (the PPS) compared the postintervention period (July 2006 to December 2007) with the preintervention period (January 2000 to June 2006). We used quasi-Poisson regression, controlling for time trend and seasonality. Results. Among men, we observed a significant risk reduction in the postintervention period for seriously injured drivers (relative risk [RR] = 0.89) and seriously injured people (RR = 0.89). The RRs among women were 0.91 (P = .095) and 0.88 (P < .05), respectively. Risk reduction was greater among male drivers, moped riders, and on urban roads. Conclusions. The PPS was associated with reduced numbers of drivers involved in injury collisions and people injured by traffic collisions in Spain.

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Section: Comparison With Previous Studiessupporting

confidence: 73%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Impact of the Penalty Points System on Road Traffic Injuries in Spain: A Time–Series Study

Novoa¹,

Pérez²,

Santamariña-Rubio³

et al. 2010

Am J Public Health

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“…The fact that DDTI joinpoints match with the introduction of relevant traffic safety regulations might suggest, although never prove, a causal link, which could be further investigated with an adequate methodology. In any case, our results for global DDTI rates are consistent with previous analytical studies (Novoa et al, 2010a(Novoa et al, , 2011Pulido et al, 2010). An analytic approach could have been adopted, establishing previous causal hypotheses about the positive effects of a specific regulation or intervention and looking to see if a joinpoint appears shortly before or coincident with its introduction.…”

Section: Discussionsupporting

confidence: 93%

“…Previous studies suggest that some specific interventions, mainly focused on preventing reckless behaviours such as excessive speeding, alcohol-impaired driving (AID), or driving without helmets or seatbelts, have been effective (Brady et al, 2009;Castillo-Manzano et al, 2011;Elvik and Vaa, 2004;Fell and Voas, 2006;Goss et al, 2008;Ker and Chinnock, 2008;Liu et al, 2008;McMillan and Lapham, 2006;Novoa et al, 2009;Shults et al, 2004Shults et al, , 2009Wilson et al, 2006). Single pre-/post intervention studies -e.g., interrupted time series -are perhaps the most common designs used for this purpose (Killoran et al, 2010;Novoa et al, 2010aNovoa et al, ,b, 2011Pulido et al, 2010;Wilson et al, 2010). However, it is difficult to assess the effectiveness of specific interventions due to the intrinsic complexity of the relationship between traffic injuries, risk factors, and policies, as well as the limitations of surveillance systems (Peden et al, 2004).…”

Section: Introductionmentioning

confidence: 96%

An example of the usefulness of joinpoint trend analysis for assessing changes in traffic safety policies

Barrio

Pulido

Bravo

et al. 2015

Accident Analysis & Prevention

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Effectiveness of road safety interventions: An evidence and gap map

Goel,

Tiwari,

Varghese

et al. 2024

Campbell Systematic Reviews

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BackgroundRoad Traffic injuries (RTI) are among the top ten leading causes of death in the world resulting in 1.35 million deaths every year, about 93% of which occur in low‐ and middle‐income countries (LMICs). Despite several global resolutions to reduce traffic injuries, they have continued to grow in many countries. Many high‐income countries have successfully reduced RTI by using a public health approach and implementing evidence‐based interventions. As many LMICs develop their highway infrastructure, adopting a similar scientific approach towards road safety is crucial. The evidence also needs to be evaluated to assess external validity because measures that have worked in high‐income countries may not translate equally well to other contexts. An evidence gap map for RTI is the first step towards understanding what evidence is available, from where, and the key gaps in knowledge.ObjectivesThe objective of this evidence gap map (EGM) is to identify existing evidence from all effectiveness studies and systematic reviews related to road safety interventions. In addition, the EGM identifies gaps in evidence where new primary studies and systematic reviews could add value. This will help direct future research and discussions based on systematic evidence towards the approaches and interventions which are most effective in the road safety sector. This could enable the generation of evidence for informing policy at global, regional or national levels.Search MethodsThe EGM includes systematic reviews and impact evaluations assessing the effect of interventions for RTI reported in academic databases, organization websites, and grey literature sources. The studies were searched up to December 2019.Selection CriteriaThe interventions were divided into five broad categories: (a) human factors (e.g., enforcement or road user education), (b) road design, infrastructure and traffic control, (c) legal and institutional framework, (d) post‐crash pre‐hospital care, and (e) vehicle factors (except car design for occupant protection) and protective devices. Included studies reported two primary outcomes: fatal crashes and non‐fatal injury crashes; and four intermediate outcomes: change in use of seat belts, change in use of helmets, change in speed, and change in alcohol/drug use. Studies were excluded if they did not report injury or fatality as one of the outcomes.Data Collection and AnalysisThe EGM is presented in the form of a matrix with two primary dimensions: interventions (rows) and outcomes (columns). Additional dimensions are country income groups, region, quality level for systematic reviews, type of study design used (e.g., case‐control), type of road user studied (e.g., pedestrian, cyclists), age groups, and road type. The EGM is available online where the matrix of interventions and outcomes can be filtered by one or more dimensions. The webpage includes a bibliography of the selected studies and titles and abstracts available for preview. Quality appraisal for systematic reviews was conducted using a critical appraisal tool for systematic reviews, AMSTAR 2.Main ResultsThe EGM identified 1859 studies of which 322 were systematic reviews, 7 were protocol studies and 1530 were impact evaluations. Some studies included more than one intervention, outcome, study method, or study region. The studies were distributed among intervention categories as: human factors (n = 771), road design, infrastructure and traffic control (n = 661), legal and institutional framework (n = 424), post‐crash pre‐hospital care (n = 118) and vehicle factors and protective devices (n = 111). Fatal crashes as outcomes were reported in 1414 records and non‐fatal injury crashes in 1252 records. Among the four intermediate outcomes, speed was most commonly reported (n = 298) followed by alcohol (n = 206), use of seatbelts (n = 167), and use of helmets (n = 66). Ninety‐six percent of the studies were reported from high‐income countries (HIC), 4.5% from upper‐middle‐income countries, and only 1.4% from lower‐middle and low‐income countries. There were 25 systematic reviews of high quality, 4 of moderate quality, and 293 of low quality.Authors' ConclusionsThe EGM shows that the distribution of available road safety evidence is skewed across the world. A vast majority of the literature is from HICs. In contrast, only a small fraction of the literature reports on the many LMICs that are fast expanding their road infrastructure, experiencing rapid changes in traffic patterns, and witnessing growth in road injuries. This bias in literature explains why many interventions that are of high importance in the context of LMICs remain poorly studied. Besides, many interventions that have been tested only in HICs may not work equally effectively in LMICs. Another important finding was that a large majority of systematic reviews are of low quality. The scarcity of evidence on many important interventions and lack of good quality evidence‐synthesis have significant implications for future road safety research and practice in LMICs. The EGM presented here will help identify priority areas for researchers, while directing practitioners and policy makers towards proven interventions.

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Impact of the demerit point system on road traffic accident mortality in Spain

Abstract: Implementation of the DPS in Spain has led to a significant reduction in the number of traffic accident deaths in the context of a downward trend after the implementation of the 2004 measures.

Cited by 36 publications

References 6 publications

Impact of the Penalty Points System on Road Traffic Injuries in Spain: A Time–Series Study

Impact of the Penalty Points System on Road Traffic Injuries in Spain: A Time–Series Study

An example of the usefulness of joinpoint trend analysis for assessing changes in traffic safety policies

Effectiveness of road safety interventions: An evidence and gap map

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