title: An example of the usefulness of joinpoint trend analysis for assessing changes in traffic safety policies.
abstract: OBJECTIVE
  To show the usefulness of joinpoint trend analysis for assessing changes in traffic safety policies.
  
  
  METHODS
  Trends in driver death rates from traffic injury stratified by alcohol involvement in Spain during 2001-2011 were characterized with joinpoint regression to observe how changes in these rates match in time with the implementation of traffic regulations and interventions.
  
  
  RESULTS
  Both alcohol-related (blood alcohol concentration >0.3g/l) and non-alcohol-related rates decreased similarly (10-11% annually) during 2001-2011, although the former showed an earlier (2003 joinpoint) acceleration of the downward trend than the latter (2006 joinpoint); both joinpoints matched in time with relevant road safety interventions.
  
  
  CONCLUSIONS
  These results, which are consistent with results from previous analytical studies, show that joinpoint trend analysis, although not valid for causal inference, is useful for assessing changes in traffic safety policies. This methodology can be easily extended to other risk factors, such as excessive speeding or not wearing a seat belt.
authors.affiliation: Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Avenida Monforte de Lemos, 3-5, 28029 Madrid, Spain.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Barrio
authors.affiliation: Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Avenida Monforte de Lemos, 5, 28029 Madrid, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain. Electronic address: jpulido@isciii.es.
authors.forename: José
authors.initials: J
authors.lastname: Pulido
authors.affiliation: Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Avenida Monforte de Lemos, 5, 28029 Madrid, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: Bravo
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, Avenida de Madrid, 11, 18012 Granada, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Lardelli-Claret
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, Avenida de Madrid, 11, 18012 Granada, Spain.
authors.forename: Eladio
authors.initials: E
authors.lastname: Jiménez-Mejías
authors.affiliation: Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Avenida Monforte de Lemos, 5, 28029 Madrid, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: de la Fuente
mesh_terms: D000054:Acceleration; D000063:Accidents, Traffic / Q000401:mortality* / Q000517:prevention & control / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000066448:Driving Under the Influence / Q000331:legislation & jurisprudence* / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012449:Safety / Q000331:legislation & jurisprudence*; D011049:Social Control Policies / Q000331:legislation & jurisprudence*; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
keywords: Alcohol; Joinpoint regression; Safety management; Traffic accidents