 RESEARCH AND PRACTICE 
Reducing Road Traffic Injuries: Effectiveness of
Speed Cameras in an Urban Setting
| Katherine Pérez, PhD, Marc Marí-Dell’Olmo, MPH, Aurelio Tobias, PhD, and Carme Borrell, PhD
Road traffic injuries are a major cause of mor-
tality and morbidity worldwide.1 There is evi-
dence that driving speed is a risk factor for
road collisions and for increased severity of
road injuries.2 The laws of physics support
the view that, all else being equal, higher
speeds will increase both the probability that
an accident will occur and the severity of its
consequences.3 Therefore, interventions aim-
ing to reduce speeds through engineering
measures and law enforcement have been
recommended and widely implemented.
Speed cameras are one of the tools used in
enforcing lower speeds. Although they have
been widely used and many studies have
been carried out to evaluate their effective-
ness, evidence on their effects is still scarce. In
their systematic review, Pilkington and Kinra
reported that existing research consistently
shows that introducing speed cameras is ef-
fective in reducing road traffic collisions and
related casualties, but most studies have not
included satisfactory comparison groups or
suitably controlled for potential confounders.4
Variables commonly regarded as having po-
tential confounding effects on results of obser-
vational before-and-after studies of road safety
measures5 include regression to the mean,
long-term trends in numbers of collisions or in-
juries (a systematic tendency for the number of
accidents to rise or fall over a period of several
years),6 general changes in the number of colli-
sions around the time when the road safety
measure is introduced (i.e., differences between
the periods before and after the measure is im-
plemented),6 changes in traffic volume,3 and
other specific interventions introduced around
the same time as the road safety measure.
A suitably designed study is necessary to
address these factors, and that was our goal
with the present investigation. We assessed
the effectiveness of speed cameras installed on
the beltway of Barcelona, Spain, in reducing
numbers of road collisions, injuries, and vehi-
cles involved in collisions. We also examined
1632 | Research and Practice | Peer Reviewed | Pérez et al.
Objectives. We assessed the effectiveness of speed cameras on Barcelona’s
beltway in reducing the numbers of road collisions and injuries and the number
of vehicles involved in collisions.
Methods. We designed a time-series study with a comparison group to assess the
effects of the speed cameras. The “intervention group” was the beltway, and the
comparison group consisted of arterial roads on which no fixed speed cameras had
been installed. The outcome measures were number of road collisions, number of
people injured, and number of vehicles involved in collisions. We fit the data to
Poisson regression models that were adjusted according to trends and seasonality.
Results. The relative risk (RR) of a road collision occurring on the beltway after (vs
before) installation of speed cameras was 0.73 (95% confidence interval [CI]=0.63,
0.85). This protective effect was greater during weekend periods. No differences
were observed for arterial roads (RR=0.99; 95% CI=0.90, 1.10). Attributable frac-
tion estimates for the 2 years of the study intervention showed 364 collisions pre-
vented, 507 fewer people injured, and 789 fewer vehicles involved in collisions.
Conclusions. Speed cameras installed in an urban setting are effective in re-
ducing the numbers of road collisions and, consequently, the numbers of injured
people and vehicles involved in collisions. (Am J Public Health. 2007;97:1632–1637.
doi:10.2105/AJPH.2006.093195)
differences in effects between daytime and the total number of vehicle-kilometers trav-
nighttime hours and between weekdays and eled in the city area. The speed limit over
weekends. Finally, we estimated numbers of most of the beltway is 80 km per hour (49.7
collisions avoided and reductions in numbers miles per hour), with some stretches limited
of people injured and vehicles involved. to 60 km per hour; there are no traffic lights
or intersections. Arterial roads are defined as
METHODS streets of 2 to 4 lanes that cross the city and
interconnect with the metropolitan area. They
Setting and Design have intersections and traffic lights and ab-
Each year in Barcelona (population: 1.5 sorb 21.4% of the total vehicle-kilometers
million), there are more than 10 000 motor traveled in the area. The typical speed limit
vehicle collisions, more than 13 000 people on these roads is 50 km per hour.
injured, and approximately 50 road traffic Eight speed cameras went into operation on
deaths. In 2004, there were 1158 injurious the beltway in March 2003 with the aim of
collisions per 100 000 vehicles, 617 per reducing the number of road collisions and
100 000 inhabitants, and 718 per 1 million their consequences. The 8 cameras operate
km traveled; 56% of collisions involving in- from 22 different sites (i.e., they are moved
juries occurred at intersections. randomly from site to site). Therefore, al-
The Barcelona city road network includes though the cameras are visible, motorists
a total of 1275 km; the beltway that sur- never know whether a particular site has a
rounds the city accounts for 24.1 km, and working speed camera. Signs informing mo-
streets considered to be arterial roads account torists of the presence of speed cameras are
for 43.4 km. The beltway has 3 lanes in each posted along the beltway. In the period pre-
direction separated by a median barrier, and ceding their installation and during their first
it serves to connect the outlying metropolitan few months of operation, they were an-
area with the city center. It absorbs 20.7% of nounced to the public through a publicity
American Journal of Public Health | September 2007, Vol 97, No. 9

campaign. The cameras take a photo of a ve-
hicle when its speed exceeds by at least 5%
the limit allowed, and a ticket is mailed to the
driver within 2 to 3 weeks. The amount of the
fine is €300 (approximately US $400) when
the speed exceeds by 50% the limit allowed.
We conducted a natural “quasi-experiment”
(a time-series study with a comparison group)
designed to assess the effects of the beltway
speed cameras. The “intervention group” was
the beltway, and the comparison group con-
sisted of arterial roads on which no fixed
speed cameras had been installed. The pre-
intervention period of the study took place
from January 1, 2001, through March 31,
2003. The postintervention period spanned
April 1, 2003, through March 31, 2005.
Data Source
We derived our data from the local police
accident database. In Barcelona, a special
division of the police department is responsi-
ble for the reporting of road collisions in the
city. Trained police personnel report road
collisions according to a standard protocol.
All collisions that involve damage to property
or injuries are reported. We considered only
collisions that occurred on the beltway or on
arterial roads.
Variables and Indicators
Our outcome measures were numbers of
road collisions, numbers of people injured,
and numbers of vehicles involved in colli-
sions. All types of collisions were included,
rather than only collisions involving injuries
(the percentage of noninjurious collisions is
fairly constant, at approximately 9%). We did
not analyze numbers of deaths separately
from numbers of injuries because the number
of deaths resulting from beltway collisions is
very low (approximately 1 or 2 per year).
There is often heavy daytime traffic on the
beltway, particularly on weekdays; during
these periods, it is impossible for motorists to
exceed speed limits. Thus, speed cameras
should be more effective in reducing injuries
during nighttime hours and on weekends,
when traffic flows are lighter. We conducted
separate analyses comparing (1) daytime (7 AM
to 8:59 PM; this could perhaps have been
more appropriately labeled “working hours”
because our aim was not to assess the effects
September 2007, Vol 97, No. 9 | American Journal of Public Health
 RESEARCH AND PRACTICE 
of daylight or darkness but to assess com-
muter traffic flows during these periods) and
(2) weekdays (early Monday through late
Friday) with weekends (9 PM Friday to 4 AM
Monday). Month was the unit of analysis.
Statistical Analysis
Initially, we calculated ratios of road colli-
sions per 1000 vehicle-kilometers traveled per
year for the beltway and the arterial roads.
Subsequently, we analyzed our outcome mea-
sures using Poisson regression models.7 After
adjusting for potential confounding by linear
trends and seasonal patterns, we conducted an
intervention analysis in which we fit a dummy
variable to compare the preintervention and
postintervention periods. The model for each
outcome can be summarized as follows:
(1) ln(E[Yt]) = B + B1 × t + B2 × sin(2π t/T) +
B3 × cos(2π t/T) + B4 × Xt ,
where T is the number of periods described by
each sinusoidal function (e.g., T = 12 months),
t is the time period (e.g., t=1 for January, t=2
for February), and Xt =1 represents the postin-
tervention period (Xt =0 otherwise).
We used Stata statistical software to con-
duct the statistical analyses.8 We analyzed
data for 24 months after the intervention. We
derived relative risks (RRs) from the adjusted
models and calculated attributable fractions
from these relative risks ([RR − 1] ÷ RR) to esti-
mate the numbers of prevented collisions and
the reductions in numbers of people injured
and vehicles involved in collisions.
RESULTS
After 2 years of speed camera operation
on the Barcelona beltway, a significant de-
crease in the number of road traffic colli-
sions was observed, not only on the beltway
but also on the arterial roads. Before the in-
stallation of the speed cameras, probably as
a result of other road safety media cam-
paigns and actions, a decreasing general
trend in the number of accidents had been
evident in the city since the year 2000.
This trend was taken into account in the
time-series analysis.
Mean annual numbers of collisions occur-
ring on the beltway during the preintervention
and postintervention periods were 638 and
Pérez et al. | Peer Reviewed | Research and Practice | 1633
486, respectively; the corresponding means
for the arterial roads were 2567 and 2394.
Mean numbers of people injured yearly on the
beltway in the preintervention and postinter-
vention periods were 946 and 696, respec-
tively; means for the arterial roads were 3254
and 3074. Finally, mean numbers of vehicles
involved in beltway collisions yearly during
the preintervention and postintervention peri-
ods were 1466 and 1108, respectively, and
the corresponding means for the arterial roads
were 5068 and 4658.
Ratios of collisions per 100 000 vehicle-kilo-
meters traveled on the beltway increased from
21.1 in 2001 to 21.6 in 2002 and then de-
creased to 17.2 in 2003 and 13.2 in 2004.
On arterial roads, ratios of collisions per
100 000 vehicle-kilometers traveled decreased
from 100.2 to 93.2, 87.4, and 86.1 during
2001, 2002, 2003, and 2004 respectively.
Figure 1 shows numbers of road collisions
according to monthly subseries. Preinterven-
tion and postintervention years are depicted
for all monthly series. Numbers of beltway
road collisions were consistently lower in the
postintervention period than in the preinter-
vention period. Trends were inconsistent on
arterial roads.
Once we controlled for trends and seasonal-
ity by fitting Poisson distribution models, we
observed a decrease of 27% in number of col-
lisions and number of people injured and a de-
crease of 26% in number of vehicles involved
in collisions. The RR of a road collision occur-
ring on the beltway in the postintervention (vs
preintervention) period was 0.73 (95% confi-
dence interval [CI]=0.63, 0.85). That is, the
speed cameras appeared to have a protective
effect. The RR for the first year of intervention
was 0.71 (95% CI=0.62, 0.82), and the effect
increased in the second year (RR=0.61; 95%
CI=0.5, 0.75). As can be seen in Table 1, RRs
of injury were similar, as were values for vehi-
cles involved in collisions. By contrast, on arte-
rial roads, RRs of all 3 outcomes assessed
were close to 1, indicating that there were no
differences between the 2 periods.
The protective effect of speed cameras in
reducing collisions was evident during both
daytime and nighttime hours and on both
weekdays and weekends; effects were greater
in magnitude on weekends. RRs were similar
for daytime (RR = 0.73; 95% CI = 0.61, 0.88)

FIGURE 1—Monthly subseries time trends in numbers of road traffic collisions occurring on the beltway (a) and arterial (b) roads: Barcelona,
Spain, January 2001–March 2005.
and nighttime (RR = 0.72; 95% CI = 0.52,
0.99) hours but were lower on weekends
(RR = 0.66; 95% CI = 0.46, 0.94) than on
weekdays (RR = 0.75; 95% CI = 0.62, 0.91).
Figure 2 shows monthly observed distribu-
tions of number of road collisions and ex-
pected distributions had speed cameras not
been installed. There was a clear decrease in
the number of beltway road collisions during
the postintervention period, although the
slope of the trend did not change (i.e., was
not statistically significant). There was also a
steady decrease in the number of arterial
road collisions between 2001 and 2005, but
again there was no change in the slope. Ex-
pected numbers of beltway collisions during
the postintervention period were higher than
the actual numbers observed, but no differ-
ences were apparent for arterial roads.
From the attributable fractions, it can be
estimated that 364 collisions were prevented,
1634 | Research and Practice | Peer Reviewed | Pérez et al.
 RESEARCH AND PRACTICE 
507 fewer people were injured, and 789
fewer vehicles were involved in collisions as
a result of implementation of speed cameras
(Table 2). No significant reductions were ob-
served for arterial roads.
DISCUSSION
Our results show that speed cameras were
effective in reducing the numbers of road
collisions—and consequently the numbers of
people injured and vehicles involved in
collisions—in the context of a general overall
decline in the number of collisions occurring
in Barcelona. Effects were similar during day-
time and nighttime hours and were greater
on weekends than on weekdays. To our
knowledge, ours is the first study in which
time-series analyses with Poisson distribution
models have been used to evaluate the effec-
tiveness of speed enforcement cameras and
American Journal of Public Health | September 2007, Vol 97, No. 9
the first in which the number of vehicles in-
volved in collisions has been included as an
outcome measure.
The study design we used and the statisti-
cal analyses we conducted allowed us to con-
trol for major factors that might have affected
the results and that usually have an impact
in evaluation studies of road safety interven-
tions. Using time-series analyses, we con-
trolled for regression to the mean and long-
term effects, in that adjustment was made for
seasonality and trends. However, the study
period was not particularly long (52 months),
and further research is necessary to deter-
mine trends over longer periods.
Because of the characteristics and function
of the beltway as the quickest route connect-
ing the city with the outlying metropolitan
area, we do not believe that there would have
been a significant number of vehicles using
other routes in an attempt to avoid the speed
  RESEARCH AND PRACTICE 

TABLE 1—Relative Risks (RRs) for Outcome Variables Relative Risks During the Postintervention
Period Relative to the Preintervention Period: Barcelona, Spain, January 2001–March 2005

Collisions Injuries Vehicles Involved in Crashes

Time and Beltway, Arterial Roads, Beltway, Arterial Roads, Beltway, Arterial Roads,
Postintervention Subperiod RR (95% CI) RR (95% CI) RR (95% CI) RR (95% CI) RR (95% CI) RR (95% CI)

Overall
April 2003–March 2004 0.71* (0.62, 0.82) 1.00 (0.90, 1.11) 0.72* (0.60, 0.87) 1.00 (0.89, 1.13) 0.73* (0.63, 0.84) 0.99 (0.89, 1.10)
April 2004–March 2005 0.61* (0.50, 0.75) 1.02 (0.88, 1.19) 0.62* (0.48, 0.81) 0.99 (0.83, 1.17) 0.66* (0.54, 0.81) 1.04 (0.89, 1.20)
Daytimea
April 2003–March 2004 0.72* (0.60, 0.87) 1.00 (0.89, 1.12) 0.70* (0.56, 0.88) 1.01 (0.89, 1.15) 0.73* (0.62, 0.87) 1.00 (0.90, 1.12)
April 2004–March 2005 0.66* (0.51, 0.86) 1.06 (0.90, 1.24) 0.62* (0.45, 0.87) 1.01 (0.84, 1.21) 0.69* (0.54, 0.89) 1.08 (0.93, 1.27)
Nighttimeb
April 2003–March 2004 0.71* (0.52, 0.96) 0.99 (0.85, 1.16) 0.79 (0.54, 1.15) 1.02 (0.85, 1.23) 0.70* (0.50, 0.99) 0.96 (0.82, 1.14)
April 2004–March 2005 0.50* (0.33, 0.78) 0.93 (0.74, 1.17) 0.57* (0.33, 0.98) 0.96 (0.74, 1.24) 0.53* (0.33, 0.87) 0.88 (0.70, 1.12)
Weekdays
April 2003–March 2004 0.73* (0.61, 0.89) 0.99 (0.88, 1.11) 0.79* (0.66, 0.96) 0.98 (0.86, 1.13) 0.76* (0.64, 0.91) 0.99 (0.87, 1.11)
April 2004–March 2005 0.65* (0.49, 0.85) 1.05 (0.89, 1.23) 0.70* (0.53, 0.92) 1.01 (0.83, 1.23) 0.69* (0.54, 0.89) 1.06 (0.90, 1.26)
Weekends
April 2003–March 2004 0.65* (0.46, 0.93) 1.00 (0.83, 1.21) 0.57* (0.35, 0.93) 1.05 (0.86, 1.29) 0.63* (0.43, 0.93) 1.00 (0.82, 1.21)
April 2004–March 2005 0.50* (0.31, 0.83) 0.92 (0.70, 1.20) 0.46* (0.23, 0.90) 0.91 (0.68, 1.23) 0.56* (0.33, 0.97) 0.93 (0.70, 1.24)

Note. CI = confidence interval. Values were derived from time-series analyses using Poisson regression models in which we controlled for trends and seasonality.
a
Daytime was defined as 7 AM to 8:59 PM.
b
Nighttime was defined as 9 PM to 6:59 AM.
*P < .05.

cameras. In fact, vehicle-kilometers traveled

on the beltway increased over the period
under study (from 2 705 260 in 2002 to
2 786 417 in 2003 and 2 788 089 in 2004).

Limitations
Comparison groups can allow for control-
ling of changes in traffic volume and general
changes; however, in our study, the interven-
tion group and the comparison group were
not equivalent, as a result of engineering char-
acteristics and because mobile speed cameras
operated randomly on the arterial roads. The
engineering features of the beltway and arte-
rial roads are clearly different (the latter hav-
ing intersections and involving lower mean
speeds), but the function of the roads is the
same: to connect the center city with the out-
lying metropolitan area. Furthermore, the belt-
way and arterial roads account for similar pro-
Note. n = number of road collisions each year. Confidence intervals (CIs) refer to expected road collisions. We controlled for portions of vehicle-kilometers traveled.
trends and seasonality using time-series analysis with Poisson regression models. Because of our time-series study design, we
a
2005 includes January 1 through March 31.
did not need a strict comparison group, but
FIGURE 2—Monthly numbers of observed and expected road collisions on the beltway (a) and the use of this group bolstered our findings.
arterial (b) roads: Barcelona, Spain, January 2001–March 2005. Other road safety interventions that we did
not control for, such as screening for drinking

September 2007, Vol 97, No. 9 | American Journal of Public Health Pérez et al. | Peer Reviewed | Research and Practice | 1635

TABLE 2—Relative Risks, (RR) Attributable Fractions, and Observed, Expected, and Prevented
Numbers of Collisions, Injuries, and Vehicles Involved in Collisions After 24 Months of
Speed Camera Operation: Barcelona, Spain, January 2001–March 2005
RR
(95% CI)
Beltway
Collisions 0.73* (0.63, 0.85)
Injuries 0.73* (0.61, 0.89)
Vehicles involved 0.74* (0.64, 0.85)
in collisions
Arterial roads
Collisions 0.99 (0.90, 1.10)
Injuries 1.10 (0.90, 1.14)
Vehicles involved 0.99 (0.89, 1.09)
in collisions
Note. CI = confidence interval. Values were derived from time-series analyses using Poisson regression models in which we
controlled for trends and seasonality.
a
Observed minus expected.
*P < .05.
and driving or general safety campaigns,
could also have influenced the trends ob-
served here, although they would have af-
fected both the beltway and the arterial
roads. There also could have been effects as-
sociated with motorists driving at reduced
speeds on other city streets. Such factors
would have tended to produce reductions in
collisions, leading to underestimates of the ef-
fects produced by the introduction of speed
cameras.
Speed Camera Effectiveness
It is difficult to compare our results with
those of other published studies, because of
the different methodologies used. It must be
borne in mind that our study focused on the
beltway of a large city of which the speed
limit is 80 km per hour. Few published stud-
ies have reported maximum speeds, and
many have focused on highways. After we
controlled for time-dependent confounders,
we estimated a reduction of 27% in the num-
ber of collisions and the number of people in-
jured and a reduction of 26% in the number
of vehicles involved in collisions. Reported re-
ductions in outcomes across other studies
have ranged from 5% to 69% for collisions,
12% to 65% for injuries, and 17% to 71%
for deaths in the immediate vicinity of cam-
era sites.4
1636 | Research and Practice | Peer Reviewed | Pérez et al.
 RESEARCH AND PRACTICE 
Attributable
Fraction No. No.
(95% CI) Observed Expected Preventeda
–0.37 (–0.59, –0.18) 971 1335
–0.37 (–0.64, –0.12) 1391 1898
–0.35 (–0.56, –0.18) 2215 3004
–0.01 (–0.11, 0.09) 4788 4821
0.09 (–0.11, 0.12) 6147 6094
–0.01 (–0.12, 0.08) 9315 9451
A more recent systematic review re-
ported preintervention–postintervention
reductions in the vicinity of camera sites
from 14% to 72% for all collisions, 8% to
46% for collisions involving injuries, and
40% to 45% for collisions resulting in fa-
talities or serious injuries.9 Hess, in a study
conducted in the United Kingdom, esti-
mated a 46% global reduction in the num-
ber of accidents occurring in the vicinity
of cameras and a 29% reduction in the
number of accidents occurring on urban
roads.10 Christie et al. reported a 51% re-
duction of injurious collisions in a study
focusing on 101 mobile speed cameras im-
plemented in South Wales.11
Chen et al. reported a reduction of 16% in
the number of accidents on a British Columbia
highway on which the maximum speed was 80
to 90 km per hour.12 Mountain et al.,3 in a
study focusing on speed cameras installed in
48 km per hour areas of the United Kingdom,
reported a 24% reduction in personal injury
accidents, of which 19% was attributable to the
effects of the cameras. Overall, these compar-
isons show that our results fall into the range of
those from previously reported studies.
We explored differences in the effective-
ness of speed cameras during daytime versus
nighttime hours and on weekdays versus
weekends because on some stretches of the
beltway during certain hours, especially on
weekdays, traffic jams make it impossible to
drive at speeds higher than those permitted.
To take into account times during which there
are typically higher traffic flows, we defined
No.
“daytime” as 7 AM to 8:59 PM. Our aim was
not to assess effects of daylight or darkness
but, rather, to examine commuter traffic
–364 flows on workdays. In Spain, most people
–507
start work at 8 AM, and shops primarily close
–789
around 8:30 PM.
As expected, speed cameras had a signifi-
cant effect in terms of reducing road injuries
–33
on weekends, although confidence intervals
53
overlapped with weekday results. Contrary
–136
to expectations, however, the protective ef-
fects observed were similar for daytime and
nighttime hours. To our knowledge, only 1
study has provided RRs of injurious accidents
according to time of day,10 and that study
showed daytime and nighttime RRs of 0.46
and 0.55, respectively. Although in that inves-
tigation daytime and nighttime referred to
daylight and lack of daylight, the results were
similar to those revealed in our study. We
were unable to find any studies reporting
weekday–weekend comparisons of injury
outcome measures.
Although our study was set in a very local-
ized area, the characteristics of the roads
studied (i.e., an urban beltway and arterial
roads) are probably similar to those of many
other cities, not only in Spain but elsewhere.
Thus, we believe that the results described
here would be generalizable to other cities.
Our findings show that speed cameras are
effective in reducing the numbers of road
collisions and consequently the numbers of
people injured and numbers of vehicles in-
volved in collisions in an urban setting. In-
stallation of speed cameras in urban areas
should be considered in efforts to increase
road safety.
About the Authors
Katherine Pérez and Marc Marí-Dell’Olmo are with the
Agència de Salut Pública de Barcelona, CIBER Epidemi-
ología y Salud Pública, Barcelona, Spain. Aurelio Tobias
is with the Escuela Nacional de Sanidad, Instituto de Salud
Carlos III, Madrid, Spain. Carme Borrell is with the Agèn-
cia de Salut Pública de Barcelona, CIBER Epidemiología
y Salud Pública, Barcelona, and the Departament de Cièn-
cies Experimentals i de la Salut, Universitat Pompeu
Fabra, Barcelona.
American Journal of Public Health | September 2007, Vol 97, No. 9
  RESEARCH AND PRACTICE 

Requests for reprints should be sent to Katherine Pérez,
PhD, Agència de Salut Pública de Barcelona, Pl Lesseps, 1, E
08023 Barcelona, Spain (e-mail: cperez@aspb.es).
This article was accepted July 27, 2006.
Contributors
K. Pérez originated and designed the study and wrote
the original draft of the article. M. Marí-Dell’Olmo per-
formed the statistical analyses. A. Tobias assisted with
the statistical analyses. C. Borrell assisted in conceptual-
izing ideas.
and catchment area. Available at: http://www.cts.cv.ic.
ac.uk/StaffPages/StephaneHess/papers/Hess_slec_
2004.pdf. Accessed May 18, 2007.
11. Christie SM, Lyons RA, Dunstan FD, Jones SJ. Are
mobile speed cameras effective? A controlled before
and after study. Inj Prev. 2003;9:302–306.
12. Chen G, Meckle W, Wilson J. Speed and safety
effect of photo radar enforcement on a highway corri-
dor in British Columbia. Accid Anal Prev. 2002;34:
129–138.

Acknowledgments
The work described in this article was partially sup-
ported by the Red Española de Centros de Epidemiolo-
gia y Salud Pública (grant C03/09).
We thank Mercé Navarro, Diego Navarro, Angel
López, Joan Mañosa, and Alex Culubret, as well as
Manuel Haro, and Josep Royuela (Guàrdia Urbana de

The End of Polio?

Barcelona) for providing the data.

Human Participant Protection

No protocol approval was needed for this study. Behind the scenes of the campaign to vaccinate
every child on the planet.
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