Effectiveness of the Women's Lacrosse Protective Eyewear Mandate in the Reduction of Eye Injuries

Background: US Lacrosse initiated mandatory use of protective eyewear in women's lacrosse in the 2004-2005 season in response to findings of higher head, face, and eye injuries in the women's game than in the men's game. Hypothesis/purpose: We compared eye injury rates in girls' scholastic lacrosse before and after implementation of protective eyewear. We also compared head and facial injury rates, concussion rates, and overall injury rates before and after the rule change to assess unintended consequences of the change. Study design: Descriptive epidemiology study. Methods: The study group included girls playing scholastic lacrosse in the 25 public high schools in Fairfax County, VA, during the 2004-2008 spring seasons. Injury rates were compared with those from the same data source during the 1999-2003 seasons. Results: The rate of eye injuries was reduced from 0.06 injuries per 1000 athletic-exposures (AEs) in 1998 through 2003 before use of protective eyewear to 0.02 injuries per 1000 AEs in 2004 through 2007 (incident rate ratio [IRR]: 0.32, 95% CI: 0.11, 0.96). Rates of other head/face injuries decreased, though not significantly (IRR: 0.73, 95% CI: 0.42, 1.20). IRRs of concussion (2.2, 95% CI: 1.5, 3.2) and all injuries combined (1.5, 95% CI: 1.3, 1.7) increased after introduction of protective eyewear. Conclusions: Eye and other head/face injuries were reduced among female scholastic lacrosse players after implementation of protective eyewear. Increases were observed for rates of concussions and all injuries after the rule change.