Facial trauma and the compulsory seat belt law de Barros et al. trauma. However, these causes change according to loca- tion and year, as evidence by the marked change in the epi- demiological profile of the population.18-20,22,23 Never- theless, facial traumas continue to be associated with motorvehicle accidents, given that the number of vehicles has increased with the population. In addition, the negli- gence of the population regarding the dangers of traffic does not seem to have diminished. Brazil faces millions of deaths every year from motorvehicle crashes. In the comparision with other countries, Brazil is one of the worldwide leaders in terms of the number of motorvehicle accidents.6,9,10,12 In order to curb this type of trauma, authorities have taken extreme measures in relation to traffic safety laws. This year, the seat belt law has been enforced for 15 years in Sa˜o Paulo. The benefits and effectiveness that this law has provided to Brazilian society are unquestionable. After the law mandating the use of seat belts in Sa˜o Paulo was approved in 1994, authorities encountered a significant decrease in facial traumas. Several studies were conducted, and all of the authors agreed that facial trauma rates decreased after the implementation of this law. In 1996, just two years after the implementation of the new law, TEC confirmed that there was a decrease from 44.2% to 30.6% in head injuries in Sa˜o Paulo. The same year, Soriano et al.25 reported a decrease of 4.9% in ocular perforations. Mello Jorge et al.26 reported that traffic accidents decreased from 29.8% in 1996 to 25.3% in 1999. According to results of a study published in 1996 by the TEC, there was a 30% reduction in the number of traffic deaths in Sa˜o Paulo with the use of the seat belt.24 Between 2007 and 2008, after the seat belt law first came into effect, in a public hospital in the northern part of Sa˜o Paulo, accidents accounted for only 3% of the causes of facial trauma, which suggested that the epidemiological profile of the population was changing.41 The most frequent cause of facial trauma in this study was physical assault.41 In 2007, the WHO6 reported that the use of seat belts reduced deaths to 40% from 65% in patients sitting in the front seat and to 25% from 75% in the back seat. Despite all of the reported benefits, Pine et al.42 revealed in 2009 that one-quarter individuals in a university population were not using their seat belt. This is an alarming figure, considering that the age group most affected by deaths and facial injuries related to the use of seat belts is 20- to 40-year- olds.21,28 This has a significant impact on families and face traumas put these patients away from social interaction. In addition, the treatments represent heavy expenditures for the public health system because hospitalizations for external causes, such as motorvehicle accidents, have the largest average expense and daily costs. They also require greater spending on health care, accounting for up to 41% of the causes of public spending. After the implementation of the law, we noted that the expenses decreased to 22%.7,32-34 The seat belt law provided numerous benefits to Sa˜o Paulo and other cities in Brazil. As a result, similar laws were created to reduce the accident rate, such as the Dry Law, which restricts the consumption of alcoholic beverages and has a greater impact on the population of individuals between the ages of 18 and 40 years, who are most at risk for this type of accident. After the implementation of the Dry Law, the number of deaths in Sa˜o Paulo was reduced by 40%. In addition, it accounted for only 25% of the Mobile Service’s work and saved 4 million reais on hospital costs.37,39 1046 CLINICS 2010;65(10):1043-1047 CONCLUSIONS There is no doubt that all of these measures have changed the epidemiological indices of Brazil’s largest city and had impacts in the population’s life. In addition, epidemiological data allows a better planning of the public health services, reducing its costs. The system now provides less assistance to accident victims due to the reduction in the number of accidents and of facial traumas. We are certain that we can improve and reduce these rates. There is still a need for greater awareness among the population, especially young people, in relation to the laws adopted by the authorities. However, it is clear that it has brought only benefits and moved Brazil toward a better future. REFERENCES 1. Pennella APA, Pereira JHS, Sevilha F, Amante´a D, Campolongo GD, Barros TEP. Cinto de seguranc¸a x trauma de face. 10 anos da lei em vigor na cidade de Sa˜o Paulo. Unidor; 2006;1-8. Dispon´ıvel em: http:// www.unidor.com.br/publi/cinto.pdf. Acessado em 2009 (10 ago). 2. Brasil. Presideˆncia da Repu´ blica. Casa Civil. Subchefia para Assuntos Jur´ıdicos. Lei no¯ 9.503, de 23 de setembro de 1997. Institui o Co´digo de Traˆnsito Brasileiro. Cap´ıtulo III. Das normas gerais de circulac¸ a˜o e conduta. [Art. 65. E´ obrigato´rio o uso do cinto de seguranc¸a para condutores e passageiros em todas as vias do territo´rio nacional, salvo em situac¸ o˜es regulamentadas pelo CONTRAN]. 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