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Aims Evaluate the effects of lowering the blood alcohol concentration (BAC) limit on road traffic fatalities and injuries in the State and capital of Sao Paulo, Brazil. Design Time series analysis using ARIMA modelling. Setting The augmented risk of road traffic accidents when under the influence of alcohol is well documented. However, many developing countries do not have a drink-driving law or have BAC limits that are above 0.05 g/dl. In Brazil, a new law introduced in 2008 has lowered the BAC limit for drivers from 0.06 to 0.02, but the effectiveness in reducing traffic accidents remains uncertain. Measurements and participants Data on injuries and deaths caused by road traffic accidents in both regions were collected from January 2001 to June 2010, comprising a total of 1,417,087 injuries and 51,561 fatalities. Findings The new traffic law was responsible for significant reductions in traffic injuries and fatalities rates in both localities (P<0.05). A stronger effect was observed for traffic fatalities (−7.2 and −16.0% in the average monthly rate in the State and capital, respectively) compared to traffic injuries rates (−1.8 and −2.3% in the State and capital, respectively). Conclusions Lowering BAC limits had a greater impact on traffic fatalities than injuries, with a higher effect in the capital where presumably the police enforcement was enhanced, and points to the relevance of these measures on the effectiveness of such law. Rigorous investigations on the effects of strategies derived from high-income countries to control alcohol-impaired driving should be promoted in developing countries.

This research provides evidence that not only alcohol but also illicit drug use is a real problem among professional drivers. The use of these substances should be controlled to better promote safe driving conditions on Brazilian roads.

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