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Motorcycle use as a functional and recreational means of transportation is increasing in Mexico; the associated mortality rate has also increased. Appropriate helmet use can reduce a motorcyclist's risk of death or serious injury. This study quantified the prevalence of motorcycle helmet use in three Mexican cities (Cuernavaca, Guadalajara-Zapopan, and León) within the context of several ongoing road safety initiatives. Four rounds of roadside observations were conducted between November 2010 and April 2012. The overall prevalence of helmet use was 73.8% among all users; helmet use was much lower among females (55.3%). Drivers tended to use helmets more frequently than passengers (76.3% vs. 51.6%). The prevalence was higher in León (85.9%, 95% CI = 84.8–87.0) than Cuernavaca (71.5%, 95% CI = 69.3–73.6) and Guadalajara-Zapopan (62.7%, 95% CI = 61.1–64.2). Helmet use decreased in León (p= 0.003) but increased in Guadalajara-Zapopan (p= 0.000) during this period. Motorcycle helmet use could be improved in all three cities. Since motorcycle use is increasing, interventions targeting motorcycle users and greater enforcement of helmet use are necessary to reduce crashes and non-fatal and fatal injuries. [ABSTRACT FROM PUBLISHER]

Background: In January 2008, a national multifaceted road safety intervention program (IMESEVI) funded by the Bloomberg Philanthropies was launched in Mexico. Two years later in 2010, IMESEVI was refocused as part of a 10-country international consortium demonstration project (IMESEVI/RS10). We evaluate the initial effects of each phase of the road safety intervention project on numbers of RT crashes, injuries and deaths in Mexico and in the two main target cities of Guadalajara-Zapopan and León. Methods: An interrupted time series analysis using autoregressive integrated moving average (ARIMA) modeling was performed using monthly data of rates of RT crashes and injuries (police data), as well as deaths (mortality system data) from 1999–2011 with dummy variables representing each intervention phase. Results: In the period following the first intervention phase at the country level and in the city of León, the rate of RT crashes decreased significantly (p<0.05). Notably, following the second intervention phase although there was no reduction at the country level, there has been a decrease in the RT crash rate in both Guadalajara-Zapopan (p = 0.029) and in León (p = 0.029). There were no significant differences in the RT injury or death rates following either intervention phase in either city. Conclusion: These initial results suggest that a multi-faceted road safety intervention program appears to be effective in reducing road crashes in a middle-income country setting. Further analysis is needed to differentiate the effects of various interventions, and to determine what other economic and political factors might have affected this change. [ABSTRACT FROM AUTHOR]

The article presents a study on the prevalence of distracted driving and road traffic injury (RTI) caused by mobile phone use while driving (MPUWD) in Mexico. It measures this prevalence among drivers in three Mexican cities and identifies associated demographic and environmental factors. The study, which was conducted from roadside observations of randomly selected automobile drivers between 2011-12, showed the importance of designing preventive interventions to address the MPUWD problem.

Background The use of non-standard motorcycle helmets has the potential to undermine multinational efforts aimed at reducing the burden of road traffic injuries associated with motorcycle crashes. However, little is known about the prevalence or factors associated with their use. Methods Collaborating institutions in nine low- and middle-income countries undertook cross-sectional surveys, markets surveys, and reviewed legislation and enforcement practices around non-standard helmets. Findings 5563 helmet-wearing motorcyclists were observed; 54% of the helmets did not appear to have a marker/sticker indicating that the helmet met required standards and interviewers judged that 49% of the helmets were likely to be non-standard helmets. 5088 (91%) of the motorcyclists agreed to be interviewed; those who had spent less than US$10 on their helmet were found to be at the greatest risk of wearing a non-standard helmet. Data were collected across 126 different retail outlets; across all countries, regardless of outlet type, standard helmets were generally 2-3 times more expensive than non-standard helmets. While seven of the nine countries had legislation prohibiting the use of non-standard helmets, only four had legislation prohibiting their manufacture or sale and only three had legislation prohibiting their import. Enforcement of any legislation appeared to be minimal. Interpretation Our findings suggest that the widespread use of non-standard helmets in low- and middle-income countries may limit the potential gains of helmet use programmes. Strategies aimed at reducing the costs of standard helmets, combined with both legislation and enforcement, will be required to maximise the effects of existing campaigns. [ABSTRACT FROM AUTHOR]

The article offers information on the progress made by the project that was funded by Bloomberg Philanthropies for carrying out road safety activities in ten countries including India, China, Egypt, Kenya, Mexico and Russia. The survey by Johns Hopkins International Injury Research Unit discusses the formation of new laws by countries like Brazil, India and China. Better enforcement and increased population reach are some of the main benefits caused by the project.

Background: The use of non-standard motorcycle helmets has the potential to undermine multinational efforts aimed at reducing the burden of road traffic injuries associated with motorcycle crashes. However, little is known about the prevalence or factors associated with their use., Methods: Collaborating institutions in nine low- and middle-income countries undertook cross-sectional surveys, markets surveys, and reviewed legislation and enforcement practices around non-standard helmets., Findings: 5563 helmet-wearing motorcyclists were observed; 54% of the helmets did not appear to have a marker/sticker indicating that the helmet met required standards and interviewers judged that 49% of the helmets were likely to be non-standard helmets. 5088 (91%) of the motorcyclists agreed to be interviewed; those who had spent less than US$10 on their helmet were found to be at the greatest risk of wearing a non-standard helmet. Data were collected across 126 different retail outlets; across all countries, regardless of outlet type, standard helmets were generally 2-3 times more expensive than non-standard helmets. While seven of the nine countries had legislation prohibiting the use of non-standard helmets, only four had legislation prohibiting their manufacture or sale and only three had legislation prohibiting their import. Enforcement of any legislation appeared to be minimal., Interpretation: Our findings suggest that the widespread use of non-standard helmets in low- and middle-income countries may limit the potential gains of helmet use programmes. Strategies aimed at reducing the costs of standard helmets, combined with both legislation and enforcement, will be required to maximise the effects of existing campaigns.

Objective: The Road Safety in 10 Countries (RS-10) project will implement 12 different road safety interventions at specific sites within 10 low- and middle-income countries (LMICs). This evaluation reports the number of lives that RS-10 is projected to save in those locations, the economic value of the risk reduction, and the maximum level of investment that a public health intervention of this magnitude would be able to incur before its costs outweigh its health benefits., Methods: We assumed a 5-year time implementation horizon corresponding to the duration of RS-10. Based on a preliminary literature review, we estimated the effectiveness for each of the RS-10 interventions. Applying these effectiveness estimates to the size of the population at risk at RS-10 sites, we calculated the number of lives and life years saved (LYS) by RS-10. We projected the value of a statistical life (VSL) in each RS-10 country based on gross national income (GNI) and estimated the value of the lives saved using each country's VSL. Sensitivity analysis addressed robustness to assumptions about elasticity, discount rates, and intervention effectiveness., Results: From the evidence base reviewed, only 13 studies met our selection criteria. Such a limited base presents uncertainties about the potential impact of the modeled interventions. We tried to account for these uncertainties by allowing effectiveness to vary ± 20 percent for each intervention. Despite this variability, RS-10 remains likely to be worth the investment. RS-10 is expected to save 10,310 lives over 5 years (discounted at 3%). VSL and $/LYS methods provide concordant results. Based on our estimates of each country's VSL, the respective countries would be willing to pay $2.45 billion to lower these fatality risks (varying intervention effectiveness by ± 20 percent, the corresponding range is $2.0-$2.9 billion). Analysis based on $/LYS shows that the RS-10 project will be cost-effective as long as its costs do not exceed $5.14 billion (under ± 20% intervention effectiveness, the range = $4.1-$6.2 billion). Even at low efficacy, these estimates are still several orders of magnitude above the $125 million projected investment., Conclusion: RS-10 is likely to yield high returns for invested resources. The study's chief limitation was the reliance on the world's limited evidence base on how effective the road safety interventions will be. Planned evaluation of RS-10 will enhance planners' ability to conduct economic assessments of road safety in developing countries.

Introduction: We present a novel multistep technique to estimate the actual burden of road traffic mortality in Mexico during the time period 1999 to 2009 by comparing 3 approaches for redistribution of nonspecific ("garbage") International Classification of Diseases (ICD)-coded deaths., Methods: Road traffic (RT) mortality data were extracted using a secondary analysis of the Mexican mortality databases for the period 1999 to 2009. In an attempt to correct for underestimation due to inappropriately coded deaths, those deaths assigned to nonspecific codes were redistributed utilizing 3 different adjustment methods. A comparison of the 3 adjustment approaches (proportional, multiple imputation, and regression) is presented. A Poisson regression analysis was utilized to model mortality trends in the raw data and the 3 estimates., Results: After adjustments, the total number of RT deaths increased by 18 to 45 percent, showing significant underestimation when only the raw data are used. All 3 approaches showed statistically significantly higher RT mortality rates than the crude figures. The proportional approach resulted in the highest RT mortality rate estimate of 23 per 100,000 in 2009 and showed a statistically significant positive increase of 1.5 percent per year across the decade. The 60+ age group and pedestrians had the highest mortality rates of 40 and 10.3 per 100,000, respectively. Over the decade, there was an alarming 332 percent increase in the mortality rate for male motorcyclists., Conclusion: Though efforts to improve coding should continue to be implemented, we present an additional and often overlooked contribution to the underestimation of road traffic mortality: the ICD nonspecific codes. Improved estimates of road traffic mortality are important in Mexico for policy change and decision making, highlighting the importance of targeting road traffic deaths as a public health problem. The approach presented here may also be useful for estimating the burden of other deaths with similar coding problems.