• Inmaculada Melchor, Andreu Nolasco, Joaquín Moncho, José A Quesada, Pamela Pereyra-Zamora, Carmen García-Senchermés, Nayara Tamayo-Fonseca, Purificación Martínez-Andreu, Socorro Valero, and Manuel Salinas.
• Unidad de Investigación de Análisis de la Mortalidad y Estadísticas Sanitarias (Mortality and Health Statistics Research and Analysis Unit), Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Universidad de Alicante. Campus de San Vicente del Raspeig s/n, Apartado 99, 03080-Alicante, Spain; Registro de Mortalidad de la Comunidad Valenciana. Servicio de Estudios Epidemiológicos y Estadísticas Sanitarias, Subdirección General de Epidemiología y Vigilancia de la Salud, Conselleria de Sanitat, Plaza de España 6, 03010 Alicante, Spain. Electronic address: melchor_inm@gva.es.
• Accid Anal Prev. 2015 Apr 1; 77: 21-8.

ObjectiveTo analyse the time evolution of the rates of mortality due to motor vehicle traffic accidents (MVTA) injuries that occurred among the general population of Comunitat Valenciana between 1987 and 2011, as well as to identify trend changes by sex and age group.MethodsAn observational study of annual mortality trends between 1987 and 2011. We studied all deaths due to MVTA injuries that occurred during this period of time among the non-institutionalised population residing in Comunitat Valenciana (a Spanish Mediterranean region that had a population of 5,117,190 inhabitants in 2011). The rates of mortality due to MVTA injuries were calculated for each sex and year studied. These rates were standardised by age for the total population and for specific age groups using the direct method (age-standardised rate - ASR). Joinpoint regression models were used in order to detect significant trend changes. Additionally, the annual percentage change (APC) of the ASRs was calculated for each trend segment, which is reflected in statistically significant joinpoints.ResultsFor all ages, ASRs decrease greatly in both men and women (70% decrease between 1990 and 2011). In 1990 and 2011, men have rates of 36.5 and 5.2 per 100,000 men/year, respectively. In the same years, women have rates of 8.0 and 0.9 per 100,000 women/year, respectively. This decrease reaches up to 90% in the age group 15-34 years in both men and women. ASR ratios for men and women increased over time for all ages: this ratio was 3.9 in 1987; 4.6 in 1990; and 5.8 in 2011. For both men and women, there is a first significant segment (p<0.05) with an increasing trend between 1987 and 1989-1990. After 1990, there are 3 segments with a significant decreasing APC (1990-1993, 1993-2005 and 2005-2011, in the case of men; and 1989-1996, 1999-2007 and 2007-2011, in the case of women).ConclusionThe risk of death due to motor vehicle traffic accidents injuries has decreased significantly, especially in the case of women, for the last 25 years in Comunitat Valenciana, mainly as of 2006. This may be a consequence of the road-safety measures that have been implemented in Spain and in Comunitat Valenciana since 2004. The economic crisis that this country has undergone since 2008 may have also been a contributing factor to this decrease. Despite the decrease, ASR ratios for men and women increased over time and it is still a high-risk cause of death among young men. It is thus important that the measures that helped decrease the risk of death are maintained and improved over time.Copyright © 2015 Elsevier Ltd. All rights reserved.

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