Estimating the drink driving attributable fraction of road traffic deaths in Mexico.

AIM: To estimate the Drink Driving Attributable Fraction (DDAF) of road traffic injury mortality in car occupants in Mexico during 2010-13. DESIGN: A case-control study was conducted to examine the presence of alcohol in analysed body fluids of car occupants killed in fatal crashes (cases) compared with car drivers tested in alcohol-testing checkpoints who were not involved in a fatal collision (controls). Two data sets were used for the period 2010-13: the forensic module of the Epidemiological Surveillance System on Addictions that included car occupants killed in a collision (cases) and a data set from alcohol-testing at police checkpoints available for matching municipalities (controls). SETTING: Mexico. PARTICIPANTS: The analysed study sample included 1718 car occupants killed in a traffic collision and 80 656 drivers tested at alcohol police checkpoints, all from 10 municipalities. MEASUREMENTS: Unadjusted and adjusted odds ratios (OR) of presence of alcohol in body fluids were obtained stratified by sex and age groups and the interaction with these two variables were assessed. The ORs were used to calculate the DDAF. FINDINGS: It was estimated that 19.5% of car occupants' deaths due to road traffic injuries were attributable to alcohol consumption [95% confidence interval (CI) = 19.1-19.9]. The adjusted OR of presence of alcohol was 6.84 (95% CI = 6.06-7.71) overall. For males it was 7.21 (95% CI = 6.35-8.18) and for females it was 4.45 (95% CI = 3.01-6.60). The ORs were similar across younger age bands (10-19 years: 9.61, 95% CI = 6.72-13.73; 20-29 years: 7.70, 95% CI = 6.28-9.4; and 30-49 years: 7.21, 95% CI = 5.98-8.70); and lower but still elevated among older people (50+ years: 3.19, 95% CI = 2.19-4.65). CONCLUSIONS: An estimated 19.5% of car occupant deaths in Mexico may have been caused by alcohol in 2010-13.

Attitude change in youths after being exposed to different road safety interventions in two Mexican cities.

OBJECTIVE: To assess the reach of three different types of road safety interventions (social marketing, education and law enforcement) implemented as part of the Iniciativa Mexicana de Seguridad Vial y Prevención de Lesiones en el Tránsito (Mexican Initiative for Road Safety and the Prevention of Road Traffic Injuries) among youth in two Mexican cities (Guadalajara-Zapopan, Jalisco and León, Guanajuato), and to examine students' self-reported attitude change after being exposed to these interventions. METHODS: A cross-sectional design was utilized to evaluate the reach of the city-wide interventions among a random sample of public and private high school and college students from October to December 2011. A total of 5,114 students completed a self-administered questionnaire. RESULTS: In both cities, students reported a greater exposure to social marketing (73% in Guadalajara-Zapopan and 64% in León) as compared to educational interventions (29.3% in León and 21.6% in Guadalajara-Zapopan) and law enforcement activities (~12% in both). Among respondents, self-reported attitude change was higher after being exposed to educational interventions than law enforcement. Social marketing yielded the lowest prevalence of self-reported attitude change. DISCUSSION: Our results show a potential moderate impact, measured as self-reported attitude change, resulting from the three intervention approaches under study. Future studies should address the intensity of exposure as well as the translation of attitude change into safer behaviors. Information generated by this study could be useful for local authorities in the intervention areas to inform their activities.