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Objective To evaluate road safety in member countries of the Association of Southeast Asian Nations and estimate the benefits that vehicle safety interventions would have in this group of countries. Methods We used a counterfactual analysis to assess the reduction in traffic deaths and disability-adjusted life years (DALYs) lost if eight proven vehicle safety technologies and motorcycle helmets were entirely in use in countries of the Association of Southeast Asian Nations. We modelled each technology using country-level incidence estimations of traffic injuries, and the prevalence and effectiveness of the technology to calculate the reduction in deaths and DALYs if the technology was fitted in the entire vehicle fleet. Findings The availability of electronic stability control, including the antilock braking systems, would provide the most benefits for all road users with estimates of 23.2% (sensitivity analysis range: 9.7-27.8) fewer deaths and 21.1% (9.5-28.1) fewer DALYs. Increased use of seatbelts was estimated to prevent 11.3% (8.11-4.9) of deaths and 10.3% (8.2-14.4) of DALYs. Appropriate and correct use of motorcycle helmets could result in 8.0% (3.3-12.9) fewer deaths and 8.9% (4.2-12.5) fewer DALYs. Conclusion Our findings show the potential of improved vehicle safety design and personal protective devices (seatbelts and helmets) to reduce traffic deaths and disabilities in the Association of Southeast Asian Nations. These improvements can be achieved by vehicle design regulations and creating consumer demand for safer vehicles and motorcycle helmets through mechanisms such as new car assessment programmes and other initiatives. Objectif Evaluer le niveau de securite routiere des pays membres de l'Association des nations de l'Asie du Sud-Est et determiner les avantages que procureraient des interventions de securite sur les vehicules pour ce groupe de pays. Methodes Nous avons procede a une analyse contrefactuelle afin de mesurer la diminution du nombre de deces et d'annees de vie ajustees sur l'incapacite (DALY) dus aux accidents de la route si huit technologies eprouvees en matiere de securite des vehicules et casques pour motocyclistes etaient systematiquement d'application dans les pays appartenant a l'Association des nations de l'Asie du Sud-Est. Nous avons modelise chaque technologie en nous fondant sur la frequence estimee des blessures consecutives a des accidents de la route a l'echelle nationale, mais aussi sur la prevalence et l'efficacite de la technologie, dans le but de calculer la baisse des deces et DALY si l'ensemble de la flotte de vehicules etait equipe de cette technologie. Resultats C'est la disponibilite du controle electronique de la stabilite, systemes de freinage antiblocage inclus, qui offrirait le plus d'avantages pour tous les usagers de la route avec, selon nos estimations, 23,2% (plage de l'analyse de sensibilite: 9,7-27,8) de deces en moins et 21,1% (9,5-28,1) de DALY en moins. Une utilisation accrue des ceintures de securite permettrait d'eviter 11,3% (8,11-4,9) de deces et 10,3% (8,2-14,4) de DALY. Enfin, l'emploi correct et approprie des casques pour motocyclistes pourrait entrainer une baisse de 8,0% (3,3-12,9) au niveau des deces et de 8,9% (4,2-12,5) au niveau des DALY. Conclusion Nos resultats illustrent le potentiel que represente l'amelioration des systemes de securite des vehicules et des dispositifs de protection individuelle (casques et ceintures de securite) dans la prevention des deces et handicaps lies aux accidents de la route au sein de l'Association des nations de l'Asie du Sud-Est. Ces ameliorations peuvent etre apportees en imposant une reglementation relative a la conception des vehicules ainsi qu'en encourageant les consommateurs a reclamer des vehicules et des casques plus surs pour motocyclistes, notamment par des mecanismes tels que des programmes d'evaluation des voitures neuves et d'autres initiatives. Objetivo Evaluar la seguridad vial en los paises miembros de la Asociacion de Naciones de Asia Sudoriental y estimar los beneficios que tendrian las intervenciones en la seguridad de los vehiculos en este grupo de paises. Metodos Se aplico un analisis contrafactico para evaluar la reduccion de muertes por accidentes de trafico y de anos de vida ajustados por discapacidad (AVAD) perdidos si en los paises de la Asociacion de Naciones de Asia Sudoriental se emplearan en su totalidad ocho tecnologias de seguridad para vehiculos y cascos de motocicleta que han demostrado su eficacia. Se modelizo cada tecnologia utilizando estimaciones de incidencia de lesiones de trafico a nivel nacional y la prevalencia y eficacia de la tecnologia para calcular la reduccion de muertes y AVAD si la tecnologia se instalaba en todo el parque automovilistico. Resultados La disponibilidad del control de estabilidad electronico, incluidos los sistemas antibloqueo de frenos, proporcionaria los mayores beneficios para todos los usuarios de las vias publicas, con estimaciones de un 23,2 % (intervalo del analisis de sensibilidad: 9,7-27,8) menos de muertes y un 21,1 % (9,5-28,1) menos de AVAD. Se estimo que un mayor uso del cinturon de seguridad evitaria el 11,3 % (8,11-4,9) de las muertes y el 10,3 % (8,2-14,4) de los AVAD. El uso adecuado y correcto del casco de motociclista podria dar lugar a un 8,0 % (3,3-12,9) menos de muertes y un 8,9 % (4,2-12,5) menos de AVAD. Conclusion Los resultados muestran el potencial de la mejora del diseno de la seguridad de los vehiculos y de los dispositivos de proteccion personal (cinturones de seguridad y cascos) para reducir las muertes y discapacidades por accidentes de trafico en la Asociacion de Naciones de Asia Sudoriental. Estas mejoras pueden lograrse mediante normativas sobre el diseno de vehiculos y la creacion de una demanda de vehiculos mas seguros y cascos de motocicleta entre los consumidores a traves de mecanismos como los programas de evaluacion de vehiculos nuevos y otras iniciativas., Introduction The Association of Southeast Asian Nations (ASEAN) is one of the world's largest and fastest-growing economic regions. The association includes 10 countries with about 650 million people: Brunei Darussalam, [...]

Air bags in cars appear to be cost-effective when compared to other health interventions. Researchers used a spreadsheet to calculate the cost-effectiveness of air bags in a fleet of 10 million new vehicles over a 20-year period. The analysis included cars with seat belts only, cars with a driver-side air bag and cars with driver and passenger air bags. Adding a driver-side air bag to a car with seat belts led to a cost of $24,000 per quality-adjusted years of life saved (QALY). Adding a passenger-side air bag increased the cost to $61,000 per QALY. These costs could be reduced if infants and children are placed in the back seat., Context.--Motor vehicle crashes continue to cause significant mortality and morbidity in the United States. Installation of air bags in new passenger vehicles is a major initiative in the field of injury prevention. Objective.--To assess the net health consequences and cost-effectiveness of driver's side and front passenger air bags from a societal perspective, taking into account the increased risk to children who occupy the front passenger seat and the diminished effectiveness for older adults. Design.--A deterministic state transition model tracked a hypothetical cohort of new vehicles over a 20-year period for 3 strategies: (1) installation of safety belts, (2) installation of driver's side air bags in addition to safety belts, and (3) installation of front passenger air bags in addition to safety belts and driver's side air bags. Changes in health outcomes, valued in terms of quality-adjusted life-years (QALYs) and costs (in 1993 dollars), were projected following the recommendations of the Panel on Cost-effectiveness in Health and Medicine. Participants.--US population-based and convenience sample data were used. Main Outcome Measure.--Incremental cost-effectiveness ratios. Results.--Safety belts are cost saving, even at 50% use. The addition of driver's side air bags to safety belts results in net health benefits at an incremental cost of $24 000 per QALY saved. The further addition of front passenger air bags results in an incremental net benefit at a higher incremental cost of $61000 per QALY saved. Results were sensitive to the unit cost of air bag systems, their effectiveness, baseline fatality rates, the ratio of injuries to fatalities, and the real discount rate. Conclusions.--Both air bag systems save life-years at costs that are comparable to many medical and public health practices. Immediate steps can be taken to enhance the cost-effectiveness of front passenger air bags, such as moving children to the rear seat. JAMA. 1997:278:1418-1425

Abstract Background The role of alcohol as a risk factor for motor vehicle crashes is long known. Yet, reports on the prevalence of drinking and driving suggest values between 20%–30% when the adult driving population is interviewed. We wondered whether these values hold true among European educated citizens and whether there are any significant differences in prevalence by age, gender, type of profession and other lifestyle indicators. Methods Cross-sectional analyses of baseline data from a cohort of university graduates in Spain (SUN study). Answered questionnaires contained items on current drinking and driving practices, together with data on socio-demographic characteristics and lifestyle habits. Chi square, Fisher test, and multivariate logistic regression were used to investigate the impact of several variables on drinking and driving practices. Analyses were stratified by gender. Results Almost 30% of the participants reported "sometimes" drinking and driving. This percent increased to 47% when "almost never" was also included as a positive answer to the drinking and driving practice question. These percentages varied significantly by gender, with up to 64% of men reporting "sometimes" or "almost never" vs. 36% of women doing so. Drinking and driving practices also differed by overall alcohol consumption habits, smoking, use of safety belts, and notably, type of profession. Conclusion Our findings are amongst the first on the high prevalence of drinking and driving among Spanish. Particularly worrisome is the fact that health professionals reported this habit even at higher rates. Multidisciplinary interventions (e.g., legal, educational, economic) are needed to reduce this serious health risk.