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Drink driving and speeding in Sao Paulo, Brazil: empirical cross-sectional study (2015–2018)
  1. Gabriel Andreuccetti1,
  2. Vilma Leyton1,
  3. Heráclito Barbosa Carvalho2,
  4. Daniele M Sinagawa1,
  5. Henrique S Bombana1,
  6. Julio C Ponce2,
  7. Katharine A Allen3,
  8. Andres I Vecino-Ortiz3,
  9. Adnan A Hyder4
  1. 1 Department of Legal Medicine, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil
  2. 2 Department of Preventive Medicine, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil
  3. 3 Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  4. 4 Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
  1. Correspondence to Dr Gabriel Andreuccetti;{at}


Objectives To evaluate the prevalence of drink driving and speeding during 2015–2018 in Sao Paulo, Brazil.

Design Cross-sectional observational study.

Setting Roads representing the five main regions of the city of Sao Paulo in Brazil, one of the world’s largest urban areas.

Participants Drivers (N=10 294) stopped at routine roadside breath testing checkpoints and those driving in selected roads for speeding measurement (N=414 664).

Primary and secondary outcome measures Microwave radar guns were used to measure the speed of vehicles, while the prevalence of drivers under the influence of alcohol was observed in police checkpoints. Data were collected during three consecutive years (2016–2018) following a baseline study established in 2015 using a city-level representative sample of observational data representing all days of the week.

Results Alcohol-related fatalities kept at a constantly high percentage, with 39% of road traffic deaths involving alcohol in 2016. Drivers testing above the legal breath alcohol concentration limit showed a decreasing trend, from 4.1% (95% CI 2.9% to 5.5%) at baseline to 0.6% (95% CI 0.2% to 1.2%) in the end of 2018 (p<0.001); however, more than half of drivers refused breath tests at checkpoints despite steep legal penalties. The prevalence of speeding among all vehicles decreased from 8.1% (95% CI 7.9% to 8.2%) to 4.9% (95% CI 4.7% to 5.1%) by the end of 2016 (p<0.001), but then increased again to 13.5% (95% CI 13.2% to 13.9%) at the end of the study period (p<0.001).

Conclusions Drink driving rates have reduced, likely due to an increase in drivers refusing breath alcohol tests, while speeding rates have increased significantly by the end of the study period, particularly among motorcycles. Future strategies aiming at reducing road traffic injuries in the major Brazilian city should tailor drink driving and speeding enforcement based on the new evidence provided here.

  • alcohol
  • drink driving
  • injuries
  • road safety
  • speed

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  • Contributors GA coordinated data collection, conducted analysis and developed the manuscript. VL, HBC, KA, AIV-O and AAH supervised the entire study, contributed to the manuscript, helped with data analysis and obtained funding. DMS, HSB and JCP conducted data collection. All authors were involved in data interpretation and contributed to the final version of the manuscript.

  • Funding This work was supported by Bloomberg Philanthropies as part of the BIGRS. GA was supported by Sao Paulo Research Foundation (FAPESP) and CAPES Foundation from Brazil during the study period.

  • Map disclaimer The depiction of boundaries on the map(s) in this article do not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The IRB committees at the Johns Hopkins Bloomberg School of Public Health, USA, and the University of Sao Paulo Medical School, Brazil, have approved the study protocol and deemed it as a study with no risk.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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