Abstract
In September 2003, Mexico City introduced “Conduce sin Alcohol” (CSA)-drive without alcohol-a program that monitors breath alcohol concentration limits among drivers to reduce road traffic crashes. To our knowledge, no study has evaluated the impact of this program on mortality. We estimated the effect of CSA on the monthly rate of traffic-related deaths (deaths per one million people) in Mexico City. We applied interrupted time series analyses (ITSA) using monthly data from 1998 to 2016, adjusting for number of people covered by a public health insurance, monthly number of public health care facilities in the city, monthly average rain precipitation in milliliters, and number of vehicles registered. Our results show a statistically significant average reduction in the monthly trend of traffic-related deaths of 0.08 per 1 million people/per month after the program was implemented relative to the pre-intervention trend. The relative difference comparing pre- and post-intervention predicted values from the ITSA model shows that there was a 23.2% reduction in the fatality rate. Findings from this study can be used to scale up programs to monitor alcohol concentration limits among drivers in cities with high alcohol-related crashes and deaths where the program has not been implemented.
Similar content being viewed by others
References
Andreuccetti, G., Carvalho, H. B., Cherpitel, C. J., Ye, Y., Ponce, J. C., Kahn, T., & Leyton, V. (2011). Reducing the legal blood alcohol concentration limit for driving in developing countries: a time for change? Results and implications derived from a time-series analysis (2001-10) conducted in Brazil: Reducing blood alcohol limits for driving. Addiction, 106, 2124–2131. https://doi.org/10.1111/j.1360-0443.2011.03521.x.
Bergel-Hayat, R., Debbarh, M., Antoniou, C., & Yannis, G. (2013). Explaining the road accident risk: Weather effects. Accident Analysis & Prevention, 60, 456–465. https://doi.org/10.1016/j.aap.2013.03.006.
Bhalla, K., Harrison, J. E., Shahraz, S., & Fingerhut, L. A. (2010). Availability and quality of cause-of-death data for estimating the global burden of injuries. Bulletin of the World Health Organization, 88, 831–838C. https://doi.org/10.2471/BLT.09.068809.
Castillo-Manzano, J. I., Castro-Nuño, M., & Fageda, X. (2014). Can health public expenditure reduce the tragic consequences of road traffic accidents? The EU-27 experience. The European Journal of Health Economics, 15, 645–652. https://doi.org/10.1007/s10198-013-0512-1.
Centro Nacional para la Prevención de Accidentes. (2010). Programa Nacional de Alcoholimetría, Centro Nacional para la Prevención de Accidentes. (2010). Programa Nacional de Alcoholimetría, http://conapra.salud.gob.mx/Interior/Documentos/Manuales/Programa_Nacional_Alcoholimetria.pdf. Accessed 10 Feb 2020
Consejo Nacional de Población. (2019). Proyecciones de la Población 2010–2050. https://datos.gob.mx/busca/dataset/proyecciones-de-la-poblacion-de-mexico-y-de-las-entidades-federativas-2016-2050
Dirección General de Información en Salud. (2019a). Población: Cubos dinámicos. http://www.dgis.salud.gob.mx/contenidos/basesdedatos/bdc_poblacion_gobmx.html
Dirección General de Información en Salud. (2019b). Recursos en salud: cubos dinámicos. http://www.dgis.salud.gob.mx/contenidos/basesdedatos/bdc_recursos_gobmx.html
Eisenberg, D. (2004). The mixed effects of precipitation on traffic crashes. Accident Analysis & Prevention, 36, 637–647. https://doi.org/10.1016/S0001-4575(03)00085-X.
Erke, A., Goldenbeld, C., & Vaa, T. (2009). The effects of drink-driving checkpoints on crashes—a meta-analysis. Accident Analysis & Prevention, 41, 914–923. https://doi.org/10.1016/j.aap.2009.05.005.
Fell, J. C., & Scherer, M. (2017). Estimation of the potential effectiveness of lowering the blood alcohol concentration (BAC) limit for driving from 0.08 to 0.05 grams per deciliter in the United States. Alcoholism: Clinical and Experimental Research, 41, 2128–2139. https://doi.org/10.1111/acer.13501.
Ferris, J., Mazerolle, L., King, M., Bates, L., Bennett, S., & Devaney, M. (2013). Random breath testing in Queensland and Western Australia: Examination of how the random breath testing rate influences alcohol related traffic crash rates. Accident Analysis & Prevention, 60, 181–188. https://doi.org/10.1016/j.aap.2013.08.018.
Gómez-García, L., Pérez-Núñez, A., & Hidalgo-Solórzano, E. (2014). Impacto de la reforma en la legislación sobre consumo de alcohol y conducción en Guadalajara y Zapopan, Jalisco, México: una mirada en el corto plazo. Cadernos de Saúde Publica, 30, 1281–1292.
Hadland, S. E., Xuan, Z., Sarda, V., Blanchette, J., Swahn, M. H., Heeren, T. C., et al. (2017). Alcohol policies and alcohol-related motor vehicle crash fatalities among young people in the US. Pediatrics, 139, e20163037. https://doi.org/10.1542/peds.2016-3037.
Haghpanahan, H., Lewsey, J., Mackay, D. F., McIntosh, E., Pell, J., Jones, A., et al. (2019). An evaluation of the effects of lowering blood alcohol concentration limits for drivers on the rates of road traffic accidents and alcohol consumption: A natural experiment. The Lancet, 393, 321–329. https://doi.org/10.1016/S0140-6736(18)32850-2.
Horwood, L. J., & Fergusson, D. M. (2000). Drink driving and traffic accidents in young people. Accident Analysis & Prevention, 32, 805–814. https://doi.org/10.1016/S0001-4575(00)00005-1.
Instituto Nacional de Estadística y Geografía. (2016). Síntesis metodológica de la estadística de accidentes de tránsito terrestre en zonas urbanas y suburbanas. http://internet.contenidos.inegi.org.mx/contenidos/Productos/prod_serv/contenidos/espanol/bvinegi/productos/nueva_estruc/702825087999.pdf.
Instituto Nacional de Estadística y Geografía. (2019a). Parque vehicular. https://www.inegi.org.mx/temas/vehiculos/.
Instituto Nacional de Estadística y Geografía (2019b). Accidentes de tránsito terrestre en zonas urbanas y suburbanas. https://www.inegi.org.mx/programas/accidentes/.
Instituto Nacional de Estadística y Geografía. (2019c). Mortalidad. Registros administrativos. Vitales. Natalidad. Matrimonios. Instituto Nacional de Estadística y Geografía. INEGI. https://www.inegi.org.mx/temas/mortalidad/.
Instituto Nacional de Estadística y Geografía. (2019d). Encuesta Nacional sobre Disponibilidad y Uso de Tecnologías de la Información en los Hogares (ENDUTIH). https://www.inegi.org.mx/programas/dutih/2019/.
Lenk, K. M., Nelson, T. F., Toomey, T. L., Jones-Webb, R., & Erickson, D. J. (2016). Sobriety checkpoint and open container laws in the United States: Associations with reported drinking-driving. Traffic Injury Prevention, 17, 782–787. https://doi.org/10.1080/15389588.2016.1161759.
Li, Q., He, H., Duan, L., Wang, Y., Bishai, D. M., & Hyder, A. A. (2017). Prevalence of drink driving and speeding in China: A time series analysis from two cities. Public Health, 144, S15–S22. https://doi.org/10.1016/j.puhe.2016.11.024.
Linden, A., & Arbor, A. (2015). Conducting interrupted time-series analysis for single- and multiple-group comparisons. The Stata Journal, 15, 480–500.
Mendis, S., & World Health Organization. (2014). Global status report on noncommunicable diseases 2014. https://apps.who.int/iris/bitstream/10665/148114/1/9789241564854_eng.pdf?ua=1
Nagata, T., Setoguchi, S., Hemenway, D., & Perry, M. J. (2008). Effectiveness of a law to reduce alcohol-impaired driving in Japan. Injury Prevention, 14, 19–23. https://doi.org/10.1136/ip.2007.015719.
Nakahara, S., Katanoda, K., & Ichikawa, M. (2013). Onset of a declining trend in fatal motor vehicle crashes involving drunk-driving in Japan. Journal of Epidemiology, 23, 195–204. https://doi.org/10.2188/jea.JE20120134.
Peek-Asa, C. (1999). The effect of random alcohol screening in reducing motor vehicle crash injuries. American Journal of Preventive Medicine, 16, 57–67. https://doi.org/10.1016/S0749-3797(98)00116-0.
Pérez-Núñez, R., Hidalgo-Solórzano, E., Vera-López, J. D., Lunnen, J. C., Chandran, A., Híjar, M., & Hyder, A. A. (2014a). The prevalence of mobile phone use among motorcyclists in three Mexican cities. Traffic Injury Prevention, 15, 148–150. https://doi.org/10.1080/15389588.2013.802776.
Pérez-Núñez, R., Híjar, M., Celis, A., & Hidalgo-Solórzano, E. (2014b). El estado de las lesiones causadas por el tránsito en México: Evidencias para fortalecer la estrategia mexicana de seguridad vial. Cadernos de Saúde Pública, 30, 911–925. https://doi.org/10.1590/0102-311X00026113.
Programa_Nacional_Alcoholimetria.pdf. (n.d.). http://conapra.salud.gob.mx/Interior/Documentos/Manuales/Programa_Nacional_Alcoholimetria.pdf.. Accessed 10 Feb 2020.
Santoyo-Castillo, D., Pérez-Núñez, R., Borges, G., & Híjar, M. (2018). Estimating the drink driving attributable fraction of road traffic deaths in Mexico: Drink driving attributable fraction in Mexico. Addiction, 113, 828–835. https://doi.org/10.1111/add.14153.
Secretaría de Seguridad Pública. (2019). Programa conduce sin alcohol. Secretaría de Seguridad Pública. http://www.ssp.df.gob.mx/programas.html
Servicio Meteorológico Nacional. (2019). Resúmenes mensuales de temperatura y lluvias. https://smn.cna.gob.mx/es/climatologia/temperaturas-y-lluvias/resumenes-mensuales-de-temperaturas-y-lluvias
Síntesis metodológica de la estadística de accidentes de tránsito terrestre en zonas urbanas y suburbanas 2016. (2016), 23.
Vera-López, J. D., Pérez-Núñez, R., Híjar, M., Hidalgo-Solórzano, E., Lunnen, J. C., Chandran, A., & Hyder, A. A. (2013). Distracted driving: Mobile phone use while driving in three Mexican cities. Injury Prevention, 19, 276–279. https://doi.org/10.1136/injuryprev-2012-040496.
Watson, B., & Freeman, J. (2007). Perceptions and experiences of random breath testing in Queensland and the self-reported deterrent impact on drunk driving. Traffic Injury Prevention, 8, 11–19. https://doi.org/10.1080/15389580601027360.
World Health Organization. (2000). International guide for monitoring alcohol consumption and related harm. World Health Organization http://apps.who.int/iris/bitstream/10665/66529/1/WHO_MSD_MSB_00.4.pdf.
World Health Organization (Ed.). (2010). Global strategy to reduce the harmful use of alcohol. Geneva: World Health Organization.
World Health Organization. (2015). Global status report on road safety 2015.
World Health Organization. (2017). Preventing noncommunicable diseases (NCDs) by reducing environmental risk factors. Geneve: World Health Organization http://apps.who.int/iris/bitstream/10665/258796/1/WHO-FWC-EPE-17.01-eng.pdf?ua=1.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Source of Funding
There was no funding for this study.
Data Sources
All data used in the study comes from publicly available information, as cited in the paper.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic Supplementary Material
ESM 1
(DOCX 30 kb)
Rights and permissions
About this article
Cite this article
Colchero, M.A., Guerrero-López, C.M., Quiroz-Reyes, J.A. et al. Did “Conduce Sin Alcohol” a Program that Monitors Breath Alcohol Concentration Limits for Driving in Mexico City Have an Effect on Traffic-Related Deaths?. Prev Sci 21, 979–984 (2020). https://doi.org/10.1007/s11121-020-01133-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11121-020-01133-3