[Evidence-based effectiveness of road safety interventions: a literature review].
BACKGROUND
Only road safety interventions with scientific evidence supporting their effectiveness should be implemented. The objective of this study was to identify and summarize the available evidence on the effectiveness of road safety interventions in reducing road traffic collisions, injuries and deaths.


METHODS
All literature reviews published in scientific journals that assessed the effectiveness of one or more road safety interventions and whose outcome measure was road traffic crashes, injuries or fatalities were included. An exhaustive search was performed in scientific literature databases. The interventions were classified according to the evidence of their effectiveness in reducing road traffic injuries (effective interventions, insufficient evidence of effectiveness, ineffective interventions) following the structure of the Haddon matrix.


RESULTS
Fifty-four reviews were included. Effective interventions were found before, during and after the collision, and across all factors: a) the individual: the graduated licensing system (31% road traffic injury reduction); b) the vehicle: electronic stability control system (2 to 41% reduction); c) the infrastructure: area-wide traffic calming (0 to 20%), and d) the social environment: speed cameras (7 to 30%). Certain road safety interventions are ineffective, mostly road safety education, and others require further investigation.


CONCLUSIONS
The most successful interventions are those that reduce or eliminate the hazard and do not depend on changes in road users' behavior or on their knowledge of road safety issues. Interventions based exclusively on education are ineffective in reducing road traffic injuries.
Novoa
Ana M
AM
Agència de Salut Pública de Barcelona, Barcelona, España.
Pérez
Katherine
K
Borrell
Carme
C
D000063:Accidents, Traffic / Q000517:prevention & control* / Q000706:statistics & numerical data; D004867:Equipment Design / Q000592:standards; D019317:Evidence-Based Medicine; D006266:Health Education; D006801:Humans; D018986:Motor Vehicles / Q000331:legislation & jurisprudence / Q000592:standards; D015397:Program Evaluation / Q000706:statistics & numerical data; D012449:Safety / Q000331:legislation & jurisprudence / Q000592:standards; D017751:Safety Management / Q000379:methods* / Q000706:statistics & numerical data; D012622:Seat Belts / Q000331:legislation & jurisprudence; D014193:Trauma Centers / Q000592:standards