Nistal-Nuño Beatriz
Stanford University Medical Center, Emergency Medicine Department, Palo Alto, CA, 94304, USA.
Public Health. 2017 Sep;150:51-59. doi: 10.1016/j.puhe.2017.04.025. Epub 2017 Jun 15.
In Chile, a new law introduced in March 2012 decreased the legal blood alcohol concentration (BAC) limit for driving while impaired from 1 to 0.8 g/l and the legal BAC limit for driving under the influence of alcohol from 0.5 to 0.3 g/l. The goal is to assess the impact of this new law on mortality and morbidity outcomes in Chile.
A review of national databases in Chile was conducted from January 2003 to December 2014. Segmented regression analysis of interrupted time series was used for analyzing the data. In a series of multivariable linear regression models, the change in intercept and slope in the monthly incidence rate of traffic deaths and injuries and association with alcohol per 100,000 inhabitants was estimated from pre-intervention to postintervention, while controlling for secular changes. In nested regression models, potential confounding seasonal effects were accounted for. All analyses were performed at a two-sided significance level of 0.05.
Immediate level drops in all the monthly rates were observed after the law from the end of the prelaw period in the majority of models and in all the de-seasonalized models, although statistical significance was reached only in the model for injures related to alcohol. After the law, the estimated monthly rate dropped abruptly by -0.869 for injuries related to alcohol and by -0.859 adjusting for seasonality (P < 0.001). Regarding the postlaw long-term trends, it was evidenced a steeper decreasing trend after the law in the models for deaths related to alcohol, although these differences were not statistically significant.
A strong evidence of a reduction in traffic injuries related to alcohol was found following the law in Chile. Although insufficient evidence was found of a statistically significant effect for the beneficial effects seen on deaths and overall injuries, potential clinically important effects cannot be ruled out.
在智利，2012年3月出台的一项新法律将酒后驾驶时的法定血液酒精浓度（BAC）限制从1克/升降至0.8克/升，将醉酒驾驶时的法定BAC限制从0.5克/升降至0.3克/升。目的是评估这项新法律对智利死亡率和发病率结果的影响。
对智利2003年1月至2014年12月的国家数据库进行了回顾。采用中断时间序列的分段回归分析来分析数据。在一系列多变量线性回归模型中，估计了干预前到干预后每10万居民中交通死亡和受伤的月发病率以及与酒精相关的发病率的截距和斜率变化，同时控制长期变化。在嵌套回归模型中，考虑了潜在的混杂季节性效应。所有分析均在双侧显著性水平0.05下进行。
在大多数模型中以及在所有去季节性化模型中，从法律生效前时期结束后，所有月发病率立即下降，尽管仅在与酒精相关的伤害模型中达到统计学显著性。法律生效后，与酒精相关的伤害的估计月发病率突然下降了-0.869，经季节性调整后下降了-0.859（P<0.001）。关于法律生效后的长期趋势，在与酒精相关的死亡模型中，法律生效后呈现出更陡峭的下降趋势，尽管这些差异没有统计学显著性。
在智利，该法律实施后，有强有力的证据表明与酒精相关的交通伤害有所减少。尽管没有足够的证据表明对死亡和总体伤害的有益影响具有统计学显著性，但不能排除潜在的临床重要影响。
