This article was downloaded by: [186.115.34.218] On: 22 February 2014, At: 11:21 Publisher: Taylor & Francis Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK International Journal of Injury Control and Safety Promotion Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/nics20 Trends in fatal motorcycle injuries in the Americas, 1998–2010 Eugênia M. S. Rodrigues a , Andrés Villaveces b , Antonio Sanhueza a & José A. Escamilla- Cejudo a a Pan American Health Organization / World Health Organization, Washington, DC b Cisalva Institute, Universidad del Valle, Cali, Colombia Published online: 28 May 2013. To cite this article: Eugênia M. S. Rodrigues, Andrés Villaveces, Antonio Sanhueza & José A. Escamilla-Cejudo , International Journal of Injury Control and Safety Promotion (2013): Trends in fatal motorcycle injuries in the Americas, 1998–2010, International Journal of Injury Control and Safety Promotion, DOI: 10.1080/17457300.2013.792289 To link to this article: http://dx.doi.org/10.1080/17457300.2013.792289 PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Versions of published Taylor & Francis and Routledge Open articles and Taylor & Francis and Routledge Open Select articles posted to institutional or subject repositories or any other third-party website are without warranty from Taylor & Francis of any kind, either expressed or implied, including, but not limited to, warranties of merchantability, fitness for a particular purpose, or non-infringement. Any opinions and views expressed in this article are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor & Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions Taylor & Francis and Routledge Open articles are normally published under a Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0/. However, authors may opt to publish under a Creative Commons Attribution-Non-Commercial License http://creativecommons.org/licenses/by-nc/3.0/ Taylor & Francis and Routledge Open Select articles are currently published under a license to publish, which is based upon the Creative Commons Attribution-Non-Commercial No-Derivatives License, but allows for text and data mining of work. Authors also have the option of publishing an Open Select article under the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0/.
13
Embed
Tendencia de lesiones fatales en motociclitas las americas 1998 2010
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
This article was downloaded by: [186.115.34.218]On: 22 February 2014, At: 11:21Publisher: Taylor & FrancisInforma Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House,37-41 Mortimer Street, London W1T 3JH, UK
International Journal of Injury Control and SafetyPromotionPublication details, including instructions for authors and subscription information:http://www.tandfonline.com/loi/nics20
Trends in fatal motorcycle injuries in the Americas,1998–2010Eugênia M. S. Rodriguesa, Andrés Villavecesb, Antonio Sanhuezaa & José A. Escamilla-Cejudoa
a Pan American Health Organization / World Health Organization, Washington, DCb Cisalva Institute, Universidad del Valle, Cali, ColombiaPublished online: 28 May 2013.
To cite this article: Eugênia M. S. Rodrigues, Andrés Villaveces, Antonio Sanhueza & José A. Escamilla-Cejudo , InternationalJournal of Injury Control and Safety Promotion (2013): Trends in fatal motorcycle injuries in the Americas, 1998–2010,International Journal of Injury Control and Safety Promotion, DOI: 10.1080/17457300.2013.792289
To link to this article: http://dx.doi.org/10.1080/17457300.2013.792289
PLEASE SCROLL DOWN FOR ARTICLE
Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained inthe publications on our platform. Taylor & Francis, our agents, and our licensors make no representations orwarranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Versionsof published Taylor & Francis and Routledge Open articles and Taylor & Francis and Routledge Open Selectarticles posted to institutional or subject repositories or any other third-party website are without warrantyfrom Taylor & Francis of any kind, either expressed or implied, including, but not limited to, warranties ofmerchantability, fitness for a particular purpose, or non-infringement. Any opinions and views expressed in thisarticle are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. Theaccuracy of the Content should not be relied upon and should be independently verified with primary sourcesof information. Taylor & Francis shall not be liable for any losses, actions, claims, proceedings, demands,costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly inconnection with, in relation to or arising out of the use of the Content.
This article may be used for research, teaching, and private study purposes. Any substantial or systematicreproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in anyform to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions
Taylor & Francis and Routledge Open articles are normally published under a Creative Commons AttributionLicense http://creativecommons.org/licenses/by/3.0/. However, authors may opt to publish under a CreativeCommons Attribution-Non-Commercial License http://creativecommons.org/licenses/by-nc/3.0/ Taylor & Francisand Routledge Open Select articles are currently published under a license to publish, which is based upon theCreative Commons Attribution-Non-Commercial No-Derivatives License, but allows for text and data mining ofwork. Authors also have the option of publishing an Open Select article under the Creative Commons AttributionLicense http://creativecommons.org/licenses/by/3.0/.
It is essential that you check the license status of any given Open and Open Select article to confirmconditions of access and use.
Dow
nloa
ded
by [
186.
115.
34.2
18]
at 1
1:21
22
Febr
uary
201
4
Trends in fatal motorcycle injuries in the Americas, 1998–2010
Eugenia M. S. Rodriguesa*, Andr�es Villavecesb, Antonio Sanhuezaa and Jos�e A. Escamilla-Cejudoa
aPan American Health Organization / World Health Organization, Washington, DC; bCisalva Institute,Universidad del Valle, Cali, Colombia
(Received 11 December 2012; final version received 18 February 2013)
Injuries, disabilities and deaths among motorcyclists have been rising worldwide but what is happening in the AmericanContinent is not completely known. Deaths from motorcycle crashes of the Pan American Health Organization database(PAHO/WHO, 1998–2010) were included in an ecologic multi-national study to quantify the temporal trends and to esti-mate the association between motorcycle riders’ deaths and selected socio-economic indicators. Mortality rates increasedin all sub-regions. The highest increase was reported in the countries of the Andean sub-region (Ecuador, 78.3%) and Mes-oamerica (Costa Rica, 60.0%). Poorer countries fared worse in terms of motorcycle mortality relative to richer countries,as did more unequal ones. Recent economic changes, rapid increment of motorisation rates, affordability of motorcyclesover public transportation, lack of adequate public transportation policies and other insufficient measures aimed at improv-ing safety can explain these trends.
� 2013 The Author(s). Published by Taylor & Francis.
This is an Open Access article. Non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly attributed, cited, and is not
altered, transformed, or built upon in any way, is permitted. The moral rights of the named author(s) have been asserted.
International Journal of Injury Control and Safety Promotion, 2013
Figure 1. Motorcycle-related mortality by sex, Americas rate per 100,000.Source: Pan American Health Organization, Health Information and Analysis, Mortality database May, 2012.
International Journal of Injury Control and Safety Promotion 3
Dow
nloa
ded
by [
186.
115.
34.2
18]
at 1
1:21
22
Febr
uary
201
4
Table 2 shows the estimated rate ratio, confidence inter-
vals and p-values by sub-region, sex and age
(Mesoamerica, Female and less than 15 years old serve as
the reference, as they have the lowest mortality rates).
Motorcycle-related mortality rate ratios by region were
greater in the Southern Cone followed by the Andean
region, were more common among males, and occurred
most commonly among riders aged 25–34 years. Figure 3
Figure 2. Motorcycle-related mortality by age group, Americas rate per 100,000.Source: Pan American Health Organization, Health Information and Analysis, Mortality database May, 2012.
Table 2. Mortality rate ratios (and 95% confidence intervals) among motorcyclists in the Americas
Figure 3. Age-adjusted motorcycle mortality trends by sub-region per 100,000. (a) Andean Region, (b) Latin Caribbean,(c) Mesoamerica, (d) Non-Latin Caribbean, (e) North America, (f) Southern Cone.
International Journal of Injury Control and Safety Promotion 5
Dow
nloa
ded
by [
186.
115.
34.2
18]
at 1
1:21
22
Febr
uary
201
4
Figure 3. (Continued)
6 E.M.S. Rodrigues et al.
Dow
nloa
ded
by [
186.
115.
34.2
18]
at 1
1:21
22
Febr
uary
201
4
shows the trends of motorcycles age-adjusted mortality rates
for the countries within each sub-region. Over this period,
Colombia had higher rates than Venezuela and Ecuador in
the Andean Region, Cuba had decreasing rates in the Latin
Caribbean and Costa Rica showed higher rates than Mexico,
Nicaragua and Panama in the Mesoamerican sub-region.
Suriname had greater rates than Trinidad and Tobago in the
Non-Latin Caribbean, the USA reports greater rates than
Figure 3. (Continued)
International Journal of Injury Control and Safety Promotion 7
Dow
nloa
ded
by [
186.
115.
34.2
18]
at 1
1:21
22
Febr
uary
201
4
Canada, and Brazil had in general greater rates, compared to
Argentina, Chile and Paraguay in the Southern Cone.
Motorcycle crash mortality rates are unevenly dis-
tributed throughout the Americas. Part of the explanation
might be related to differentials in socio-economic char-
acteristics. We also explored this by assessing the rela-
tion between poverty (gross national income – GNI
converted to international dollars using purchasing
power parity rates) as well as how income is distributed
across the population: how income is shared between the
20% richest versus the 20% poorest families of a coun-
try. Table 3 shows that income distribution seems to be
more associated to mortality rates than income levels:
countries with better income distribution tend to have
lower age-adjusted mortality rates, with a mean mortal-
ity rate 2.3 times higher among the poorest. Table 4
shows the association between motorcycle-related mor-
tality and selected socio-economic indicators. Results
suggest that countries that are poorer tend to have greater
rates of motorcycle fatalities as well as countries that
have more inequalities as measured by the percentage of
share of income by the highest and lowest 20% of the
population.
Discussion
To the best of our knowledge, this is the first paper to
show the overall status of motorcycle fatalities over a
period of time for the entire region of the Americas. In
this region overall, motorcycle-related fatalities have been
steadily increasing in the last few years. Despite this, there
are important differences in magnitude between countries
with some having alarmingly high rates such as Paraguay,
Brazil and Colombia, while others despite lower rates,
show marked increases in fatalities. For the majority of
countries in this region, patterns of mortality are similar
to those reported in other studies or from other parts of the
globe. Young males are the most affected and most deaths
occur in urban settings (Agnihotri & Joshi, 2006; Chi &
Wang, 2007).
Our analysis has some limitations. First, it relies on
country-reported information and many countries have
different systems. Mortality rates may be underestimated
due to data quality problems such as the proportion of
deaths that have not been registered, and the proportion of
injuries-related deaths of unknown intention.
Our data are country-based and consequently miss any
detailed information within country that might provide
additional clues about where motorcycle fatalities are
higher or lower. We used a series of economic indicators
Table 3. Age-adjusted motorcycle mortality rates per 100,000pop by income and shared income among countries with avail-able information for these variables (2000–2010)
(a) Countries sorted from lowest to highest indicator value (lower valuesindicate better income sharing)(b) Percentage of income sharing (poorest and richest 20% of population)(c) GNI ($ ppp) is gross national income converted to international dol-lars using purchasing power parity rates. An international dollar has thesame purchasing power over GNI as a US dollar has in the United States.(x) Mortality rate per 100,000 in period 1998–2010.(�) Median value of percentage share of income (poorest and richest 20%of population)
Table 4. Association of mortality rate ratios and 95% confidence intervals among motorcyclists in relation to selected socio-economicindicators
95% CI
Covariate Rate Ratio Inferior Limit Superior Limit p-value
H20%/L20%Lower Income Sharing 2.4 1.1 5.2 0.0308Higher Income Sharing (reference) - - -
GNI (�)Lower income 1.5 0.4 5.4 0.5077Upper middle income 1.5 0.6 3.5 0.3484High income (reference) - - -
(�) Based on the income group classification developed by the World Bank:Lower income¼ GNI $3,975 or lessUpper middle income¼ GNI $3,976–12,275High income ¼ GNI $12,276 or more
8 E.M.S. Rodrigues et al.
Dow
nloa
ded
by [
186.
115.
34.2
18]
at 1
1:21
22
Febr
uary
201
4
as proxies for social conditions in the country that might be
modulating changes in motorcycle fatalities. At an ecologi-
cal level for example, we found that measures of low
income distribution or higher inequalities were related to
mortality rates, more than income levels per capita: coun-
tries with better income sharing had the lowest mortality
rates. Finally, we could not include information from all
countries, as some of the data coming from some nations is
non-existent or not reliable enough to extrapolate to the
entire country. Despite these shortcomings, we believe this
study shows differences within the region of the Americas
as well as important economic differences related to motor-
cycle mortality and overall trends of motorcycle-related
deaths in several countries of this region.
While the economic situation in several richer coun-
tries has been stagnant in the last five years, Latin Amer-
ica has experienced during the same period economic
growth that has contributed to an overall reduction in pov-
erty indexes and an increase in wealth (World Bank
Group, 2011). These improvements however, have not
been equal among different nations and some have fared
better than others.
Parallel to these economic changes, increases in
motorcycle fatalities have also been greater in Latin
America relative to North America. One consequence of
economic growth is increased motorisation. With
increased wealth and reduced poverty, there is evidence
that populations experience shifts in modes of transporta-
tion as they acquire more means to purchase certain prod-
ucts (Chi & Wang, 2007). As countries become motorised
and populations acquire more economic means, a percent-
age of the population shifts from pedestrians and bicy-
clists to motorcyclists, or from motorcyclists to
automobile drivers.
In addition, economic growth is associated with
increased demands from transport infrastructure, and
mobility becomes a basic factor for satisfying economic
needs (Chi & Wang, 2007). More demand or use of
motorcycles and automobiles has increased the pressure
on urban infrastructures (E. Vasconcellos, 2008). This fur-
ther complicates mobility issues as more motorcycles are
competing for space used by automobiles and potentially
further exacerbating risks of injury, and mortality among
riders. In Latin America, the rapid growth of cities and
urban populations has considerably outpaced the develop-
ment of urban transport infrastructures and as a conse-
quence mobility in many large cities has been seriously
compromised. To address this, many cities have passed
legislation aimed at curbing large motor pools mostly by
restricting access to urban areas. These strategies include
limiting the use of automobiles on selected days based on
the license plate registration numbers (E. A. Vasconcellos,
2012). Such a strategy initially used in Mexico City
though for controlling air pollution, is now widely spread
through the region to address mobility. However, in
countries like Colombia, some of these measures do not
apply to motorcycle riders. In this country, to circumvent
these measures, people have either opted to buy another
vehicle, which they use when the other one has restric-
tions, or buy motorcycles, for which mobility restriction
legislation does not apply. A result of this is that popula-
tions with lesser resources are buying motorcycles for the
first time (da Fonseca Holz & Lindau, 2009; E. A. Vas-
concellos, 2012), and individuals with more resources are
also buying these and other vehicles to circumvent mobil-
ity restrictions. Added to this, are the increasing costs of
public transportation that hinder access to work for popu-
lations with the least socio-economic resources (de �AvilaGomide, 2004).
In cities with large levels of congestion, motorcycles
are used in delivery services, as mototaxis, and for moto-
freight (Silva et al., 2011). Groups working in delivery
services in Brazil are known as motoboys who tradition-
ally work under time pressure, and in poor and unsafe
conditions leading to a large increase in motorcycle
crashes (E. Vasconcellos, 2008). Mototaxi service offer
has also increased and in Brazil legislation was passed to
regulate this service almost a decade ago (Barros Loren-
zetti, 2003). Data from this country shows that mototaxis
are now offered in 90% of the country’s towns and 50%
of the major cities (Instituto Brasileiro de Geografia e
Estatistica, 2009). Motorcycle types and types of users
might also have different risks. This is an area of study
that will require further research in Latin America espe-
cially because it can have direct implications among cer-
tain occupations or in some regions.
Research has shown that excessive automobile depen-
dence can reduce economic productivity, and policy
reforms that improve mobility management by reducing
per capita vehicle travel can increase transport system
efficiency (Litman, 2010). Motorcycles seem to have
some advantages for urban mobility because of their size
however they are perhaps the most dangerous type of
motor vehicle because of their inherent lack of protection
for users.
While this study provides no evidence that these eco-
nomic issues are in fact driving such increases, it shows
the important increase of mortality risk in the region of
the Americas among motorcycle riders in a short period
of time and calls for much-needed research on the human,
public health, transportation and social-economic costs
associated with motorcycle injuries. The PAHO Plan of
Action on Road Safety (Pan American Health Organiza-
tion, 2011) and the Road Safety Decade of Action (World
Health Organization, 2009) reports highlight relevant
interventions that can be considered in order to slow or
reverse the increasing trend of motorcycle injury mortal-
ity. Examples of such measures could include the devel-
opment and implementation of motorcycle safety
standards regulations.
International Journal of Injury Control and Safety Promotion 9
Dow
nloa
ded
by [
186.
115.
34.2
18]
at 1
1:21
22
Febr
uary
201
4
Implications for safety promotion and public policy
The highlighted socio-economic scenario is further
affected by insufficient legislation and enforcement of
helmet use. Less than half (40.6%) of the countries in this
region have an adequate helmet law implying that helmets
should be worn by all passengers of all ages, for all engine
types of motorised two wheelers, on all roads, and with
helmets required to meet specific safety standards. On a
PAHO/WHO generated scale of 0–10 where zero repre-
sents no enforcement and 10 is full enforcement, the aver-
age regional helmet law enforcement is 5.1/10 while
enforcement of speeding laws was reported to be low,
with a value of 3.7/10 (Hijar et al., 2012).
It is imperative for the region of the Americas to docu-
ment more clearly what social and economic costs are
associated with increased motorcycle-related mortality
and morbidity and what are the benefits of managing these
modal changes within countries as well as throughout the
region. Consequently legislative frameworks will likely
need to address issues going beyond helmet use, speed lim-
its and motorcycle driver’s licensing procedures to include
motorcycle industry responsibilities and occupational
safety provisions for workers. Both legislative frameworks
as well as infrastructure characteristics need to respond to
these challenges so as to reduce morbidity and mortality
amongst one of the most productive sectors of population.
References
Agnihotri, A.K., & Joshi, H.S. (2006). Pattern of road trafficinjuries: one year hospital-based study in Western Nepal.International Journal of Injury Control and Safety Promo-tion, 13(2), 128–130.
Ahmad, O., Boschi-Pinto C.A., Murray, C., Lozano, R., & Inoue,M. (2001). Age Standardization of Rates: A New WHO Stan-dard. Geneva: World Health Organization.
Barros Lorenzetti, R.S. (2003). A regulac~ao do servico demotot�axi. In C. o. Representatives (Ed.), Urban Develop-ment, Transit and Transportation. Brasilia: Chamber ofRepresentatives.
Beck, L.F., Dellinger, A.M., & O’Neil, M.E. (2007). Motor vehi-cle crash injury rates by mode of travel, United States: usingexposure-based methods to quantify differences. AmericanJournal of Epidemiology, 166(2), 212–218.
Chandran, A., Sousa, T.R., Guo, Y., Bishai, D., & Pechansky,F. (2012). Road traffic deaths in Brazil: rising trends inpedestrian and motorcycle occupant deaths. Traffic InjuryPrevention, 13(Suppl 1), 11–16.
Chi, G. B., & Wang, S.Y. (2007). Study on the secular trend ofroad traffic injuries and its influencing factors in China.Zhonghua liu xing bing xue za zhi ¼ Zhonghua liuxingbing-xue zazhi, 28(2), 148–153.
Crandon, I.W., Harding, H.E., Cawich, S.O., McDonald, A.H.,& Fearron-Boothe, D. (2009). Motorcycle accident injuryprofiles in Jamaica: an audit from the University Hospital ofthe West Indies. International Journal of Injury Control andSafety Promotion, 16(3), 175–178.
da Fonseca Holz, R., & Lindau, L.A. (2009). Panorama interna-cional do uso e operac~ao de motocicletas. Porto Alegre:
Pol�ıtica de Transporte e Inclus~ao Social 1, (3). Laborat�oriode Sistemas de Transportes, LASTRAN, Programa de P�os-Graduac~ao em Engenharia de Produc~ao, PPGEP, Universi-dade Federal do Rio Grande do Sul, UFRGS.
de �Avila Gomide, A. (2004). Regulac~ao economica e organ-izac~ao dos servicos de transporte p�ublico urbano emcidades brasileiras : Estudos de caso : Relat�orio final. Brasi-lia, Ipea: Minist�erio das Cidades.
Espitia-Hardeman, V., Velez, L., Munoz, E., Gutierrez-Martinez, M.I., Espinosa-Vallin, R., & Concha-Eastman, A.(2008). [Impact of interventions directed toward motorcy-clist death prevention in Cali, Colombia: 1993–2001]. Saludpublica de Mexico, 50, Suppl 1, S69–77.
Franco Arias, C. (2010a). Auditor�ıa en seguridad vial. Ambienteseguro: Intervenciones para prevenci�on de atropellamientos(ASIPA): Estudios viales. Cuernavaca: Instituto Nacional deSalud Publica.
Franco Arias, C. (2010b). Auditor�ıa en seguridad vial. Ambienteseguro: Intervenciones para prevenci�on de atropellamientos(ASIPA): Problem�atica y propuestas. Cuernavaca: InstitutoNacional de Salud Publica.
Gawryszewski, V.P., Coelho, H.M., Scarpelini, S., Zan, R., Jorge,M.H., & Rodrigues, E.M. (2009). [Land transport injuriesamong emergency department visits in the state of Sao Paulo,in 2005]. Revista de Saude Publica, 43(2), 275–282.
Hazen, A., & Ehiri, J.E. (2006). Road traffic injuries: Hiddenepidemic in less developed countries. Journal of theNational Medical Association, 98(1), 73–82.
Hertz, E.S. (1989). The effect of helmet law repeal on motorcy-cle fatalities. A four year update. National Highway TrafficSafety Administration. Research Notes, September, 1–4.
Hijar, M., Perez-Nunez, R., Inclan-Valadez, C., & Silveira-Rodrigues, E.M. (2012). Road safety legislation in theAmericas. Revista Panamericana de Salud Publica ¼ PanAmerican Journal of Public Health, 32(1), 70–76.
Instituto Brasileiro de Geografia e Estatistica. (2009). Pesquisasobre oferta de transporte p�ublico nos munic�ıpios brasileiros.Brasilia: Instituto Brasileiro de Geografia e Estatistica.
Instituto de Pesquisa Economica Aplicada. (2006). Impactossociais e economicos dos acidentes de transito nas rodoviasbrasileiras. Brasilia: Departamento Nacional de Transito.
Litman, T. (2010). Evaluating transportation economic develop-ment impacts. Understanding how transport policy and plan-ning decisions affect employment, incomes, productivity,competitiveness, property values and tax revenues (p. 99).Victoria Transport Policy Institute, August 10. Retrievedfrom http://www.vtpi.org/econ_dev.pdf
Muelleman, R.L., Mlinek, E.J., & Collicott, P.E. (1992). Motor-cycle crash injuries and costs: Effect of a reenacted compre-hensive helmet use law. Annals of Emergency Medicine, 21,266–272.
National Highway Traffic Safety Administration. (2011). Deter-mining estimates of lives and costs saved by motorcycle hel-mets. Washington, DC: U. S. Dept. of Transportation.
Naumann, R.B., Dellinger, A.M., Zaloshnja, E., Lawrence, B.A.,& Miller, T.R. (2010). Incidence and total lifetime costs ofmotor vehicle-related fatal and nonfatal injury by road usertype, United States, 2005. Traffic Injury Prevention, 11(4),353–360.
Pan American Health Organization. (2008). Health informationand analysis – health situation in the Americas: Basic indica-tors. Washington, DC: Pan American Health Organization.
Pan American Health Organization. (2009). Regional statusreport on road safety in the Americas. Washington, DC: PanAmerican Health Organization.
10 E.M.S. Rodrigues et al.
Dow
nloa
ded
by [
186.
115.
34.2
18]
at 1
1:21
22
Febr
uary
201
4
Pan American Health Organization. (2011). Plan of action onroad safety. Washington, DC: Pan American HealthOrganization.
Peden, M., Scurfield, R., Sleet, D., Mohan, D., Hyder, A.A., Jara-wan, E., & Mathers, C. (Eds.). (2004). World Report on RoadTraffic Injury Prevention. Geneva: World Health Organization.
Silva, E.R., Cardoso, B.C., & Santos, M.P.S. (2011). O aumento dataxa de motorizac~ao de motocicletas no Brasil. Revista Brasi-leira de Administrac~ao Cient�ıfica, Aquidab~a, 2(2), 50–62.
Vasconcellos, E. (2008). O custo social da motocicleta no Brasil.Revista dos Transportes Publicos, 119(20), 127–142.
Vasconcellos, E.A. (2012). Road safety impacts of the motorcy-cle in Brazil. International Journal of Injury Control andSafety Promotion. doi: 10.1080/17457300.2012.696663.
Villaveces, A., Cummings, P., Koepsell, T.D., Rivara, F.P.,Lumley, T., & Moffat, J. (2003). Association of alcohol-related laws with deaths due to motor vehicle and
motorcycle crashes in the United States, 1980–1997. Ameri-can Journal of Epidemiology, 157(2), 131–140.
Watson, G.S., Zador, P.L., & Wilks, A. (1980). The repeal ofhelmet use laws and increased motorcyclist mortality in theUnited states, 1975–1978. American Journal of PublicHealth, 70, 579–585.
World Bank Group. (2011). A Break with history: Fifteen yearsof inequality reduction in Latin America (pp. 1–29).Washington, DC: World Bank Group.
World Health Organization. (2009). Global status report on roadsafety: A time for action. Retrieved from http://whqlibdoc.who.int/publications/2009/9789241563840_eng.pdf
Zentner, J., Dellinger, C., Adkins, W.E., & Greene, J. (1995).Nurse practitioner provided primary care: managing healthcare costs in the workplace. AAOHN Journal; Official Jour-nal of the American Association of Occupational HealthNurses, 43(1), 52–53.
International Journal of Injury Control and Safety Promotion 11