Road traffic deaths in Brazil: rising trends in pedestrian and motorcycle occupant deaths

Objective: According to the World Health Organization, the global burden of road traffic mortality exceeds 1.27 million people annually; over 90 percent occur in low- and middle-income countries. Brazil's road traffic mortality rate of ～20 per 100,000 is significantly higher than nearby Chile or Argentina. To date, there has been very little information published on road traffic fatalities among vulnerable road users (VRUs) in Brazil. Methods: Road traffic fatality data from 2000 to 2008 were extracted from Brazil's Mortality Information System (SIM). Road traffic deaths were extracted using the International Classification of Diseases (ICD-10) V-codes (V01-V89) and then subcategorized by VRU categories. Information was then disaggregated by gender, age, and region. Results: In 2008, 39,211 deaths due to road traffic injuries were recorded in Brazil, resulting in a crude mortality rate of 20.7 per 100,000 inhabitants. Pedestrian mortality averaged 5.46 deaths per 100,000 between 2000 and 2008. The mortality rate for elderly pedestrians (80+ years) is 20.1 per 100,000, over 10 times that of 0- to 9-year-olds. In the past decade, motorcycle occupant mortality has dramatically increased by over 300 percent from 1.5 per 100,000 in 2000 to 4.7 per 100,000 in 2008. The 20- to 29-year age group remains most affected by motorcycle deaths, with a peak fatality rate of 10.76 per 100,000 in 2008. The north and northeast regions, with the lower per capita gross domestic product (GDP), have higher proportions of VRU deaths compared with other regions. Conclusions: Vulnerable road users are contributing an increasing proportion of the road traffic fatalities in Brazil. Nationally, elderly pedestrians are at particularly high risk and motorcycle fatalities are increasing at a rapid rate. Less prosperous regions have higher proportions of VRU deaths. Understanding the epidemiology of road traffic mortality in vulnerable road user categories will better allow for targeted interventions to reduce these preventable deaths.