http://www.thelancet.com/journal/vol361/iss9376/full/llan.361.9376.ori
ginal_research.26229.1
The Lancet, Volume 361, Number 9376 28 June 2003
Traffic-law enforcement and risk of death from motor-vehicle crashes:
case-crossover study
Donald A Redelmeier, Robert J Tibshirani, Leonard Evans
Department of Medicine, University of Toronto, Clinical Epidemiology
and Health Care Research Program, Sunnybrook and Women's College
Health Sciences Centre, and Institute for Clinical Evaluative
Sciences in Ontario, Toronto, ON, Canada (Prof D A Redelmeier MD);
Departments of Statistics and of Health Research and Policy, Stanford
University, Stanford, CA, USA (Prof R J Tibshirani PhD); and Science
Serving Society, Bloomfield Hills, MI, USA (L Evans DPhil)
Correspondence to: Prof Donald A Redelmeier, Sunnybrook and Women's
College Health Sciences Centre, G-151, 2075 Bayview Avenue, Toronto,
ON, Canada M4N 3M5 (e-mail:[EMAIL PROTECTED])
Summary
Introduction
Methods
Results
Discussion
References
Summary
Background Driving offences and traffic deaths are common in
countries with high rates of motor-vehicle use. We tested whether
traffic convictions, because of their direct effect on the recipient,
might be associated with a reduced risk of fatal motor-vehicle
crashes.
Methods We identified licensed drivers in Ontario, Canada, who had
been involved in fatal crashes in the past 11 years. We used the
case-crossover design to analyse the protective effect of recent
convictions on individual drivers.
Findings 8975 licensed drivers had fatal crashes during the study
period. 21 501 driving convictions were recorded for all drivers from
the date of obtaining a full licence to the date of fatal crash,
equivalent to about one conviction per driver every 5 years. The risk
of a fatal crash in the month after a conviction was about 35% lower
than in a comparable month with no conviction for the same driver
(95% CI 20-45, p=0á0002). The benefit lessened substantially by 2
months and was not significant by 3-4 months. The benefit was not
altered by age, previous convictions, and other personal
characteristics; was greater for speeding violations with penalty
points than speeding violations without points; was no different for
crashes of differing severity; and was not seen in drivers whose
licences were suspended.
Interpretation Traffic-law enforcement effectively reduces the
frequency of fatal motor-vehicle crashes in countries with high rates
of motor-vehicle use. Inconsistent enforcement, therefore, may
contribute to thousands of deaths each year worldwide.
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