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标题：Impact of the Penalty Points System on Road Traffic Injuries in Spain: A Time–Series Study
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作者：Ana M. Novoa ; Katherine Pérez ; Elena Santamariña-Rubio 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2010
卷号：100
期号：11
页码：2220-2227
DOI：10.2105/AJPH.2010.192104
语种：English
出版社：American Public Health Association
摘要：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. Traffic injuries cause considerable mortality and morbidity worldwide. Since 2004, traffic deaths in Spain have followed a downward trend. However, more than 135 000 road users were injured and more than 4000 were killed in 2005, numbers which placed Spain above the mean for the European Union (EU; ranked 13th of the 25 member states).¹ The penalty points system (PPS), introduced in Spain on July 1, 2006, attempts to deter drivers from committing traffic offenses. Because the PPS does not exclusively depend on monetary penalties, it affects all drivers irrespective of their income level.² In Spain, drivers start with a 12-point license (8-point for novice drivers), and the points are gradually removed if certain traffic violations are committed, such as exceeding the speed limit, driving while intoxicated, or using a hand-held mobile phone, culminating in license suspension if all points are lost. Only serious violations result in loss of points, with the number of points removed varying with the severity of the offense ( Table 1 ).³ Several months before its introduction, the PPS was announced via a publicity campaign in all news media, and was included in the media agenda, giving rise to public debate. TABLE 1 Number of Points Subtracted From the Driver's License, by Type of Offense, in Spain's Penalty Points System (PPS): Spain, 2000–2007 2 Points 3 Points 4 Points 6 Points Speeding > 20 km/h to 30 km/h over the limit (< 50% of the limit) Speeding > 30 km/h to 40 km/h over the limit (< 50% of the limit) Speeding > 40 km/h over the limit (< 50% of the limit) Driving with a blood alcohol content 0.25 mg/L to 0.50 mg/L (0.15 mg/L to 0.30 mg/L professionals and novices) Speeding > 50% of the limit, at least > 30 km/h Driving without headlights when headlights are required Changing direction illegally Not obeying stop signs, traffic lights, right-of-ways, and other traffic rules Overtaking dangerously or in locations with limited visibility Driving with a blood alcohol content > 0.50 mg/L (> 0.30 mg/L for professionals and novices) Circulating with a person aged < 12 y on a moped or motorcycle, with the statutory exceptions Failing to comply with the safety distance Hindering other vehicles from overtaking Overtaking putting cyclists at risk Driving under the influence of drugs or other substances Using systems to avoid traffic officers’ surveillance or to detect speed cameras Driving while using earphones or hand-held mobile phones Reversing in motorways Careless driving Refusing analysis of alcohol, drugs, and other similar behaviors Stopping or parking at dangerous places (e.g., road junction, tunnel) Driving without seat belt, helmet, and other compulsory safety devices Not obeying traffic officers’ signals Driving without the appropriate license Dangerous driving, wrong way, races, and other similar behaviors Stopping or parking disturbing circulation, pedestrians, or in lanes reserved for public transport Driving on a motorway with a forbidden vehicleThrowing objects on the road that may produce a fire or accidents Driving with > 50% more than the authorized number of occupants For professional drivers, exceeding the maximum permitted uninterrupted driving hours by > 50% or reducing subsequent rest hours by > 50% Open in a separate window 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 – 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.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. Our hypothesis was that the PPS is effective in reducing traffic injuries and that its effectiveness varies with gender, age, injury severity, type of road user, road type, and time of collision.