Department of Public Health and Maternal and Child Health, Complutense University of Madrid, Madrid, Spain; National School of Public Health, Institute of Health Carlos III, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Granollers General Hospital, Research and Innovation Area, Granollers, Barcelona, Spain.
Accid Anal Prev. 2021 Jun;156:106154. doi: 10.1016/j.aap.2021.106154. Epub 2021 Apr 29.
The purpose of this study was to assess the effect of the Penalty Point System (PPS) on road traffic accident mortality by gender and socioeconomic status. We conducted a nationwide prospective study covering adult people living in Spain on November 2001. They were followed up until 30 Nov 2007 to determine vital status and cause of death. An interrupted time-series analysis was used to assess whether PPS (explanatory variable) had both immediate and long-term effect on the rates of road traffic accident mortality (RTAMs) separately by gender. Subjects were classified by socioeconomic status (low and high) using two indicators: educational attainment (up to lower secondary education; upper secondary education or more) and occupation (manual and non-manual workers). We performed several segmented Poisson regression models, controlling for trend, seasonality, 2004 road safety measures and fuel consumption as proxy for traffic exposure. Among men, we found a decrease on the RTAMs immediately after PPS in those with low educational level (16.2 %, IC95 %: 6.1 %-25.2 %) and manual workers (16.3 %, IC95 %: 2.8 %-27.8 %), and a non-significant increase among those with high education level and non-manual workers (6.2 % and 1.8 %). Among women, there were no significant differences in the immediate effect of PPS by socioeconomic status. We did not identify significant trend changes between pre-PPS and post-PPS periods in any socioeconomic group. In a context of downward trend of traffic mortality, the PPS implementation led to an immediate reduction on death rates only among men with a low socioeconomic status.
本研究旨在评估记分罚款制度（PPS）对男女和社会经济地位的道路交通事故死亡率的影响。我们开展了一项全国性的前瞻性研究，涵盖了 2001 年 11 月居住在西班牙的成年人。他们随访至 2007 年 11 月 30 日，以确定生死状况和死因。采用中断时间序列分析来评估 PPS（解释变量）是否对男女的道路交通事故死亡率（RTAMs）分别具有即时和长期影响。使用两个指标来对社会经济地位（低和高）对受试者进行分类：教育程度（至中学以下；中学以上）和职业（体力劳动和非体力劳动）。我们进行了几项分段泊松回归模型，控制了趋势、季节性、2004 年道路安全措施和燃料消耗（交通暴露的替代指标）。在男性中，我们发现 PPS 后，低教育水平者（16.2%，95%CI：6.1%-25.2%）和体力劳动者（16.3%，95%CI：2.8%-27.8%）的 RTAMs 立即下降，而高教育水平者和非体力劳动者的 RTAMs 则无显著增加（6.2%和 1.8%）。在女性中，PPS 对社会经济地位的即时影响没有显著差异。在任何社会经济群体中，我们都没有发现 PPS 前后期间趋势变化的显著差异。在交通死亡率下降的背景下，PPS 的实施仅导致低社会经济地位男性的死亡率立即下降。
