The relation between the Number of Hours that authorize the  sale of liquors Beverages and traffic Injuries, the Peruvian ...
The Peruvian problem•   During 2007, there were registered 76.928 wounded in traffic accidents in a population of    27.14...
The relation with alcohol consumption•   In middle-income countries between 33 to 69% of fatally injured drivers and betwe...
External injuries by group on weekends(FSS) or not (MTWT) - HNCH, 2004                                                    ...
Violent deaths tree problem                                                                HIGH INCIDENCE OF              ...
Objectives tree: Reduction of violence                                                        Violence Reduction          ...
Reduction in hours for alcoholic beverages authorized sellingThe Latin American Experience•   This police was originally d...
Ley Zanahoria in La Victoria    •    In the District of La Victoria, due to the serious violence problem, in January 2007,...
Results of the study on injuries of external cause admitted to aNational Hospital•   In La Victoria there was a reduction ...
Rate of men aggressions x 10.000 according to ages groupsCercado – La Victoria 2006 – 2008, HN2DM                         ...
Age and sex specific homicide rates /100.000      Cali. 1994 - 1997 - 2001500                               +             ...
Relationship between the sales of liquors measured on fractionof day and aggressions in La Victoria 30 25 20            Y ...
Source: Sanchez A. et al 2011•   Numbers and crude incidence rates per 100.000 person-years of interpersonal violence and ...
How to explain that deaths by traffic accidents did not decline•   The dead by traffic accidents increased 5.5% in Cercado...
Local Ban 1568 Secure Hour    C: First we have to finish the beers handsome prince... After    midnight I will give you my...
First week and injuries due to traffic accidents in three hospitalsby day and hour of occurrence in Metropolitan Lima     ...
Deaths in traffic accidents by day of the weekDec-2010 vs Dec-2011                                                 Source:...
Behavior of violent deaths, one year after •    Reduction on Deaths by traffic accidents and homicides by 11%, •    Reduct...
District of occurrence injuries by traffic accidents                       The injuries by                                ...
Relationship between the sales of liquors measured on fractionof day and traffic accidents deaths in Metropolitan LimaDec-...
Deaths by traffic accidentsDec-2010 to Nov-2011 against Dec-2011 to Nov-2012 •   Reduction on Deaths by traffic accidents ...
Deaths by traffic accidents by sex and ageDec-2010 to Nov-2012Sex        Deaths in traffic accidents   2011             20...
Alcoholized bodies that came from traffic accidentsDec-2010 to Nov-2012               Deaths in traffic accidents         ...
Deaths by traffic accidents by day of the weekDec-10 to Nov-12       80       70       60       50       40       30      ...
Occurrence of violent deaths  Dec-2010, Dec-2011 and Dec-2012                                  Dec-10                     ...
Saving in health in one year                                                                Cost per Medical    Kind of In...
Local Ban 1568 Secure HourConclusions•   Is possible that the ban has had an effect in the diminished of the deaths by tra...
Amigos de la ley zanahoriahttp://www.facebook.com/home.php?sk=group_176654789042977&ap=1https://www.facebook.com/ley.zanah...
The relation between the number of hours corta
Upcoming SlideShare
Loading in …5
×

The relation between the number of hours corta

49 views

Published on

Presentación sobre Experiencias Peruanas de restricción de horarios de venta de bebidas alcohólicas y la reducción de muertes violentas en Lima Metropolitana. Curitiba,Brasil,27 de Febrero ,2013

0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
49
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
0
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

The relation between the number of hours corta

  1. 1. The relation between the Number of Hours that authorize the sale of liquors Beverages and traffic Injuries, the Peruvian Experiences Dr. Hernán Málaga “Evaluación de intervenciones en seguridad vial: componente clave de la Década de Acción”.
  2. 2. The Peruvian problem• During 2007, there were registered 76.928 wounded in traffic accidents in a population of 27.148.1014.• 3510 fatal victims (12, 9 per 100 000).• 78% of them male5.• An index of 25 deaths every 10.000 vehicles6.• Mortality rate of 21,5 per 100.000 inhabitants7. 2
  3. 3. The relation with alcohol consumption• In middle-income countries between 33 to 69% of fatally injured drivers and between 8 to 29% of non fatally injured drivers, would have consumed alcohol before their crash12.Evidenced based measures against alcohol consumptionTo reduce the burden of disease caused by alcohol, there are at least 10 evidenced-based public health measures:• Reduction in hours for alcoholic beverages authorized selling.• Reduction in the days for alcoholic beverages authorized selling.• Limit the number of alcoholic beverages selling stores.• Legal responsibility for the alcoholic beverages seller.• Supervise the firm control of the already established law.• Brief interventions in alcohol-positive traffic casualties.• To restrict advertising and patrician of alcohol .• Minimum age to buy alcoholic beverages• Measures to control traffic accidents.13 3
  4. 4. External injuries by group on weekends(FSS) or not (MTWT) - HNCH, 2004 Group 1 Group 2 Total Day n % n % n % FSS 4 210 57.54 3 107 42.46 7 317 100 MTWT 4 943 66.80 2 456 33.19 7 399 100 Total 9 153 62.20 5 563 37.80 14 716 100 OR = 1.49 (1.39 – 1.59) 95%External Injuries by group and hour of attention.(00:01 - 5:59 vs 06:00 - 24:00), HNCH, 2004 Group 1 Group 2 Total Hour of attention n % n % n % 00:01- 05:59 814 37.91 1 333 62.09 2 147 100 06:00-24:00 8 339 66.35 4 230 33.65 12 569 100 Total 9 153 62.20 5 563 37.80 14 716 100 OR = 3.23 (2.94 – 3.55) 95%Group 1: Occupational and recreational.Group 2: Aggressions, and traffic accidents. 4
  5. 5. Violent deaths tree problem HIGH INCIDENCE OF VIOLENT DEATHS Traffic accidents and agrettions Expuestos en las madrugadas Disponibilidad Alcohol and de arma Drugs de fuego Consumption Conductores Acceso inadecuado negligentes al alcohol y drogas Inappropriate Use of Free Time y violentos Varones Controles 15-40 años inadecuados Vacations, Holidays, Weekends, Pay Half Cinturones Verano Urbano Desempleo marginales Política nacional Instituciones posterga el desarticuladas y Nocturnality medio rural desprestigiadas Inadecuada Baja distribución escolaridad de riquezas Bad habits Respuestas del and life style Estado Ambiental Biológico y de la sociedad 5
  6. 6. Objectives tree: Reduction of violence Violence Reduction Reduction of traffic injuries and aggressions Monitory External Injuries Limit Consume of Cases Restricción Alcohol and Drugs porte de armas Control Alcoholemia Programa Desarrollo Urbano-Marginal Cambio de Armas Controles de velocidad por Dinero? Limit Nocturnality y buen estado de los Equidad Distribución vehículos Riqueza Disminuye Fomentar migración Priorizar Empleo Restriction on the campo- Desarrollo Fortalecer hours of sell ciudad Población Instituciones Incrementar Rural Excluida de control Escolaridad RecreaciónChange of habits and life Alternativa para jóvenes Respuestas Estado y de la style Sociedad Ambiental Biológico 6
  7. 7. Reduction in hours for alcoholic beverages authorized sellingThe Latin American Experience• This police was originally designed to reduce Violence in Colombia and Brazil.• Bogota, Cali and Medellin in Colombia, Asunción in Paraguay, and Diadema in Brazil 14-17, have applied successfully, restrictions of schedules for alcoholic beverages authorized selling, in order to reduce violence and traffic accidents. 7
  8. 8. Ley Zanahoria in La Victoria • In the District of La Victoria, due to the serious violence problem, in January 2007, a local restriction was established, in this regard. Alcohol beverage is sold until midnight on Sunday, Monday, Tuesday and Wednesday, and until 3:00 am on Thursdays, Fridays and Saturdays 18, 19.La Victoria Studies• The study should be considered as ecological 20 with a chronological and geographical comparison between two districts: La Victoria, with the restriction and Cercado de Lima without the ban.Materials and Method • The participants in the study were all the patients from a local National Hospital, with aggressions, from fighting, or were wounded in traffic accidents. There are other hospitals that could receive patients from those districts, but there’s an early study that shows that an important quantity of those lesions are being attended there21. For the violent deaths: homicides, suicides and deaths in traffic accidents that occur in both districts we use data from the Institute of Forensic Medicine, as numerator. 8
  9. 9. Results of the study on injuries of external cause admitted to aNational Hospital• In La Victoria there was a reduction of the aggressions of 40.7% in 2007 and 36.4% in 2008, with regard to 2006 ,with a significant negative tendency (P≤ 0,014). In Cercado, although aggressions declined in 2007 in 16%, in 2008, they increased in 7%, with regard to the 2006. They were more frequent in men in 2006 than in the 2007 and 2008 (Pearson chi 2(1) = 4.4260 Pr ≤ 0,035), OR=1.2 (95% CI 1, 0-1.4%) (P ≤0,035) in 2006.(Table N°1).• The male aggressions diminish in all ages, especially in younger’s. In Cercado, the behavior is similar in the 3 years (Figure Nº 1). Woman has almost one fifth of aggressions less, than men and diminished it at all ages after the restriction. No changes where observed in Cercado. 9
  10. 10. Rate of men aggressions x 10.000 according to ages groupsCercado – La Victoria 2006 – 2008, HN2DM 10
  11. 11. Age and sex specific homicide rates /100.000 Cali. 1994 - 1997 - 2001500 + + ++ +400 1994300 + 500200 + 400 1997 ++ ++100 + 300 + + + , , , , + + + , , , , , + + , , , , , + 0 200 15-19 5-9 <5 10-14 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 >65 100 + + +500 + ++ 0 ,, + , + , , , , , , + , , , , , 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 >65 <5400 + 2001300 ++ +200 + ++ + Males100 + , Females + 0 +++,, ,,,,,,,, ,,, , Rate/100.000 Inhabitants 5-9 >65 <5 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 1188: Sistema de Vigilancia de Violencia y Accidentalidad . CISALVA Con datos de: Med. Legal, Policia,Fiscalia, Sijin, Cdav
  12. 12. Relationship between the sales of liquors measured on fractionof day and aggressions in La Victoria 30 25 20 Y 11.25 27.32 X 15 105 .75 .8 .85 .9 .95 1 Weights Frequency of Aggressions Fitted values 12
  13. 13. Source: Sanchez A. et al 2011• Numbers and crude incidence rates per 100.000 person-years of interpersonal violence and unintentional injury deaths during the periods of days when the alcohol control policies were in effect. Cali, Colombia, 2004-08. (The most restrictive policies prohibited alcohol consumption and sales between 2 a.m. and 10a.m. The moderately restrictive policies prohibited alcohol consumption and sales between 3 a.m. and 10 a.m. The lax policies prohibited alcohol consumption and sales between 4 a.m. and 10 a.m. 13
  14. 14. How to explain that deaths by traffic accidents did not decline• The dead by traffic accidents increased 5.5% in Cercado and 11.2% in La Victoria.The difference of La Victoria, with Bogota and Asunción13, 36, 37 could be related to:• The victims came mainly from people that does not leave in La Victoria.• The time of occurrence.Frequency distribution of deaths, on traffic accidents for the periods 2005-06 and 2007-08, by hourof occurrence, in La Victoria District. 2005-06 2007-08 Hour of Ocurrence n % n % 0-2 8 7.1% 8 6.5% 3-5 11 9.7% 11 8.9% 6-8 16 14.2% 28 22.6% 9-11 10 8.8% 21 16.9% 12-14 15 13.3% 14 11.3% 15-17 18 15.9% 16 12.9% 18-20 23 20.4% 14 11.3% 21-23 12 10.6% 12 9.7% Total 113 100% 124 100% 14 Source: Institute of Forensic Medicine, 2009
  15. 15. Local Ban 1568 Secure Hour C: First we have to finish the beers handsome prince... After midnight I will give you my crystal shoe and every thing else... P: Cheers Cinderella! R: By midnight her car will be transformed in a carrot.Objectives• Analyze date of homicides, suicides and deaths on traffic accidents, after the local ban 1568• To coordinate efforts between: National Forensic Institute, Peruvian National Police, Direction of Epidemiology, Health of Person MINSA,DEVIDA, and Gerencial Structures of the Metropolitan City Hall of Lima.• To design interventions for different institutions that will contribute to our common goal. 15
  16. 16. First week and injuries due to traffic accidents in three hospitalsby day and hour of occurrence in Metropolitan Lima 24 14 15 15 14 11 10 7 8 5 6 11 4 Domingo Lunes Martes Miércoles Jueves Viernes Sábado Antes Después 40 31 4 5 5 2 2 3 3 2 0 0 1 1 0 1 00:00 - 02:59 03:00 - 05:59 06:00 - 08:59 09:00 - 11:59 12:00 - 14:59 15:00 - 17:59 18:00 - 20:59 21:00 - 23:59 Antes DespuésSource: DGE 16
  17. 17. Deaths in traffic accidents by day of the weekDec-2010 vs Dec-2011 Source: IML 17
  18. 18. Behavior of violent deaths, one year after • Reduction on Deaths by traffic accidents and homicides by 11%, • Reduction on death bodies with alcohol of traffic accidents of 28.5% and in homicides of 19%. • The reduction occurs all days of the week except on Fridays. • The reduction occurs at all hours of the day, but specially by 00:00 and 02:59 amDeaths by External Cause lesion with or without alcohol in their bodiesDec-10 to Nov-12 Dec-10 to Nov-11 Dec-11 to Nov-12 Death cause Alcohol Alcohol N° of cases % N° of cases % Positives Positives Homicide 344 105 31 307 86 28 Traffic Accidents 480 130 27 427 93 22 Suicides 271 42 15 265 53 20 Total 1 095 277 25 999 232 23 Source: IML - Lima Metropolitana. 2011 - 2012 18
  19. 19. District of occurrence injuries by traffic accidents The injuries by traffic have2011 vs 2012 decreased by 43%. Districts 2011 2012 Districts 2011 2012 Ancon 66 55 Pueblo Libre 119 0 Ate 1782 720 Puente Piedra 901 667 Barranco 162 13 Punta Hermosa 1 0 Breda 101 0 Punta Negra 2 1 Breña 0 80 Rimac 307 165 Carabayllo 321 331 San Bartolo 7 0 Chaclacayo 13 22 San Borja 83 19 Chorrillos 344 53 44 14 San Isidro Cieneguilla 0 1 1 0 San Juan de Comas 796 865 San Juan de Luri 76 41 El Agustino 75 46 San Juan de Mira 216 26 Independencia 160 93 San Luis 84 51 Jesus Maria 79 55 San Martin de P 0 298 La Molina 33 29 San Martin de Po 1149 110 La Victoria 568 400 Lima 918 786 San Miguel 73 98 Lince 67 48 Santa Anita 43 21 Los Olivos 278 211 Santa Rosa 5 1 Lurigancho 101 48 Santiago de 1 1 Lurin 15 1 Santiago de Surc 469 177 Magdalena del M 1 0 Surquillo 182 22 Magdalena del Ma 35 65 Villa el Sa 47 35 Magdalena Vieja 0 93 Villa el Salvado 79 22 Miraflores 333 22 Villa Maria 15 2 Pachacamac 6 4 Villa Maria del 127 32 Pucusana 9 0 (en blanco) 26 1 Source: DGE 2013 Total general 10320 5845 i 19
  20. 20. Relationship between the sales of liquors measured on fractionof day and traffic accidents deaths in Metropolitan LimaDec-2010 Aug-2011 Dec-2011 Aug-2012 20
  21. 21. Deaths by traffic accidentsDec-2010 to Nov-2011 against Dec-2011 to Nov-2012 • Reduction on Deaths by traffic accidents of 11.04%. • Reduction in both sexes, and in all ages with the exception of the older than 50 years. • Reduction of alcoholized bodies in males of 27%. • Reduction occurs mainly in Bachelors. • The largest increase comes from Puente Piedra and Comas. • Reduction occurs all the days of the week, excepted on Fridays. 21
  22. 22. Deaths by traffic accidents by sex and ageDec-2010 to Nov-2012Sex Deaths in traffic accidents 2011 2012 Variation (%) Male 357 313 -12.32 Female 123 114 -7.32 Total 480 427 -11.04Age Deaths in traffic accidents 2011 2012 Variation (%) 0-9 32 21 -34.38 10-24 54 45 -16.67 25 - 49 183 131 -28.42 + 50 211 230 9.00 Total 480 427 -11.04 Source: IML - Lima Metropolitana, Period 2011 - 2012 22
  23. 23. Alcoholized bodies that came from traffic accidentsDec-2010 to Nov-2012 Deaths in traffic accidents 2011 2012 Variation (%) With alcohol 130 93 -28.46 Whitout alcohol 350 334 -4.57 Total 480 427 -11.04Male Male Deaths in traffic accidents 2011 2012 Variation (%) With alcohol 121 88 -27.27 Without alcohol 236 225 -4.66 Total 357 313 -12.32 Source: IML - Lima Metropolitana, Period 2011 - 2012 23
  24. 24. Deaths by traffic accidents by day of the weekDec-10 to Nov-12 80 70 60 50 40 30 20 10 0 Sunday Monday Tuesday Wednesday Thursday Friday Saturday 2011 70 56 30 43 56 38 63 2012 56 45 29 39 43 43 38 Source: IML - Lima Metropolitana, Period 2011 - 2012 24
  25. 25. Occurrence of violent deaths Dec-2010, Dec-2011 and Dec-2012 Dec-10 Dec-11 Dec-12Death cause Alcohol Alcohol Alcohol N° of cases % N° of cases % N° of cases % Positives Positives PositivesHomicide 33 9 27% 30 7 23% 21 6 29%Traffic Accidents 60 17 28% 32 10 31% 30 9 30%Suicide 31 10 32% 19 5 26% 28 7 25%Total 124 36 29% 81 22 27% 79 22 28% Source: IML - Lima Metropolitana, Dec-2011 to Dec-2012 26
  26. 26. Saving in health in one year Cost per Medical Kind of Intervention n % Attention Hospitalized 94 2.1% $2,277.00 $214,038.00 Emergency 4328 97.9% $62.00 $268,336.00 Total 4422 100% - $482,374.00 Deaths 53 1.2% $514.00 $27,242.00 Total 4475 100% - $509,616.00NoteAccording to Bambaren on 2003, in Lima, the unit cost of:• An emergency, is US$ 62.00.• An hospitalized ,is US$ 2 277.00.• A death, is US$ 514.00.Being a total of 2.1% injuries, that require hospitalization. 27
  27. 27. Local Ban 1568 Secure HourConclusions• Is possible that the ban has had an effect in the diminished of the deaths by traffic accidents, specially on those that were occasioned by alcohol. The main diminish came from the alcoholized death.• The ban has possible diminished the deaths by traffic accidents in all days of the week, except Friday, This was possible due to the fact ,that the ban permit the sale of liquors on the night of the Thursday until 03:00am of Friday , and by this reason there has not been a cultural change.• The initial effect of December 2011 and January 2012,was not sustained for the hole year, possible due to the initial display of announcements. 28
  28. 28. Amigos de la ley zanahoriahttp://www.facebook.com/home.php?sk=group_176654789042977&ap=1https://www.facebook.com/ley.zanahoria?fref=tsReferences• Málaga, H. - Horarios de venta de bebidas alcohólicas y su efecto en Violencia. Editorial Académica Española. LAP LAMBERT Academic Publishing GmbH&Co.KG. Saarbrücken, Alemania 2012.• Malaga,H.; Gonzalez, M.; Huaco, C.; Sotelo, M. (2012) - The Relation between the Number of Hours That Authorize the Sale of Alcoholic Beverages and Violence. Health Promotion Perspectives, Vol. 2, No.1; P: 60-71• Cisneros G; Bambaren, C. Málaga H, González M. Lesiones de Causa Externa en el Municipio de San Martín de Porres. Lima-Perú. 9a Conferencia Mundial sobre prevención de lesiones y promoción de la seguridad; 2008 Marzo 15-18; Mérida, México; 2008. 29

×