{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T05:43:24Z","timestamp":1777959804050,"version":"3.51.4"},"reference-count":55,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T00:00:00Z","timestamp":1600905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Debates regarding lowering the blood alcohol concentration (BAC) limit for drivers are intensifying in the United States and other countries, and the World Health Organization recommends that the limit for adults should be 0.05%. In January 2016, Uruguay implemented a law setting a zero BAC limit for all drivers. This study aimed to assess the effect of this policy on the frequency of moderate\/severe injury and fatal traffic crashes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A quasi\u2010experimental study in which a synthetic control model was used with controls consisting of local areas in Chile as the counterfactual for outcomes in Uruguay, matched across population counts and pre\u2010intervention period outcomes. Sensitivity analyses were also conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Uruguay and Chile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Cases<\/jats:title><jats:p>Panel data with crash counts by outcome per locality\u2010month (2013\u20132017).<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention and comparator<\/jats:title><jats:p>A zero blood alcohol concentration law implemented on 9 January 2016 in Uruguay, alongside a continued 0.03\u00a0g\/dl BAC threshold in Chile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Per\u2010capita moderate\/severe injury (i.e. moderate or severe), severe injury and fatal crashes (2013\u20132017).<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Our base synthetic control model results suggested a reduction in fatal crashes at 12\u00a0months [20.9%;<jats:italic>P<\/jats:italic>\u2010value\u00a0=\u00a00.018, 95% confidence interval (CI)\u00a0=\u00a0\u22120.340, \u22120.061]. Moderate\/severe injury crashes did not decrease significantly (10.2%,<jats:italic>P<\/jats:italic>\u00a0=\u00a00.312, 95% CI\u00a0=\u00a0\u22120.282, 0.075). The estimated effect at 24\u00a0months was smaller and with larger confidence intervals for fatal crashes (14%;<jats:italic>P<\/jats:italic>\u00a0=\u00a00.048, 95% CI\u00a0=\u00a0\u22120.246, \u22120.026) and largely unchanged for moderate\/severe injury crashes (\u22129.4%,<jats:italic>P<\/jats:italic>\u00a0=\u00a00.302, 95% CI\u00a0=\u00a0\u22120.248, 0.058). Difference\u2010in\u2010differences analyses yielded similar results. As a sensitivity test, a synthetic control model relying on an inferior treatment\u2013control match pre\u2010intervention (measured by mean squared error) yielded similar\u2010sized differences that were not statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Implementation of a law setting a zero blood alcohol concentration threshold for all drivers in Uruguay appears to have resulted in a reduction in fatal crashes during the following 12\u00a0and 24\u00a0months.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.15231","type":"journal-article","created":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T10:43:33Z","timestamp":1598265813000},"page":"1054-1062","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Assessment of the impact of implementation of a zero blood alcohol concentration law in Uruguay on moderate\/severe injury and fatal crashes: a quasi\u2010experimental study"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9999-2449","authenticated-orcid":false,"given":"Steven","family":"Davenport","sequence":"first","affiliation":[{"name":"RAND Corporation, Santa Monica, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4972-1733","authenticated-orcid":false,"given":"Michael","family":"Robbins","sequence":"additional","affiliation":[{"name":"RAND Corporation, Santa Monica, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8441-7046","authenticated-orcid":false,"given":"Magdalena","family":"Cerd\u00e1","sequence":"additional","affiliation":[{"name":"Center for Opioid Epidemiology and Policy, Department of Population Health NYU School of Medicine, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4860-2791","authenticated-orcid":false,"given":"Ariadne","family":"Rivera\u2010Aguirre","sequence":"additional","affiliation":[{"name":"Center for Opioid Epidemiology and Policy, Department of Population Health NYU School of Medicine, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9333-8080","authenticated-orcid":false,"given":"Beau","family":"Kilmer","sequence":"additional","affiliation":[{"name":"RAND Corporation, Santa Monica, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,9,24]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"World Health Organization.Global Status Report on Road Safety 2018.Geneva:World Health Organization;2018. 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