ArticleBMC public health2025
Impact of drink-driving penalty enhancement policies on road traffic injury deaths among vulnerable road users in Shandong Province: an interrupted time series study.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRoad traffic injuries (RTIs) rank as the seventh leading cause of death in China, with over 70% of these fatalities involving vulnerable road users (VRUs). In 2011, the Chinese government revised and implemented a new road traffic safety law, imposing harsher penalties for drink-driving.
objectivesThis study examined the trends in mortality rates from RTIs among VRUs in Shandong Province from 2006 to 2023. It also evaluated the impact of the stricter drunk driving penalties introduced in May 2011, providing a foundation for the formulating effective RTIs prevention and control strategies in the province.
methodsThe death data of RTIs for VRUs was obtained from the death registration and reporting system in Shandong Province between 2006 and 2023 and the change trends of the crude mortality rates were depicted and assessed using Joinpoint regression analysis. To analyze changes in monthly age-standardized mortality rates and Years of Life Lost (YLL) rates among VRUs and various subgroups in the province, we employed an interrupted time series model, adjusting for seasonal effects using Fourier terms.
resultsThe overall mortality rate from road traffic injuries (RTIs) among VRUs in Shandong Province demonstrated a downward trend from 2006 to 2023, with an average annual percentage change (AAPC) of -3.88%. In the subgroups, the largest declines were observed across key subgroups: specifically, motorcyclists (AAPC: -8.44%) among types of VRUs, the 0–14 years (AAPC: -7.11%) and 15–64 years (AAPC: -6.06%) age groups, both showing considerable declines; urban areas (AAPC: -6.18%) by urbanization level; and males (AAPC: -4.91%) by gender. After the strengthening of drunk driving penalties, the overall monthly standardized mortality of VRUs decreased by 0.1762 (95% CI: -0.2734, -0.0790) with a significant reduction in the slope of 0.0072 (95% CI: -0.0095, -0.0049). YLL rates due to traffic deaths per 100,000 people also significantly decreased by 157.16 (95% CI: -235.74, -78.59), with a significant decline in the slope of 18.65 (95% CI: -35.67, -1.62). Stratified analysis showed that, except for cyclists, the implementation of the policy had different degrees of intervention effects. Notably, the intervention effect of male and urban VRUs was higher than that of female and rural VRUs and the elderly VRUs still had a higher risk of traffic fatalities despite the intervention effect.
conclusionThe policy of strengthening the punishment for drunk driving has a significant intervention effect on decreasing the mortality and disease burden of VRUs in Shandong Province. Continuing to implement effective measures for drunk driving prevention and control is essential. This includes enhancing the road traffic environment and law enforcement intensity in rural areas, managing electric bicycles and motorcycles more effectively, and prioritizing the protection of elderly VRUs. These actions are crucial for further reducing the risk of road traffic fatalities among VRUs.
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