141st APHA Annual Meeting

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277011
Role of impact location in concussion outcomes among US high school football players

Tuesday, November 5, 2013 : 12:30 PM - 12:45 PM

Zachary Kerr, MPH, MA , Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
Christy Collins , Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH
Jason Mihalik , University of North Carolina at Chapel Hill, Chapel Hill, NC
Stephen W. Marshall, PhD , Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
Kevin Guskiewicz , University of North Carolina at Chapel Hill, Chapel Hill, NC
R. Dawn Comstock, PhD , Colorado School of Public Health, Aurora, CO
Background: Research has examined concussion events by impact location (i.e., the area on the head in which impact occurs). However, little research exists regarding impact location's association with concussion-related outcomes, such as symptomatology, symptom resolution time, and length of time until return to play. Methods: National High School Sports-Related Injury Surveillance Study data (2008/09 to 2011/12) were analyzed to calculate rates and describe circumstances of football concussion by impact location (i.e., front-, back-, side-, and top-of-the-head). Results: The concussion rate was 5.1 per 100,000 athlete exposures (AEs) (95% Confidence Interval [CI]: 4.8, 5.4), with most concussions occurring from front-of-the-head impacts (57.1%) followed by side-of-the-head (27.9%), back-of-the-head (7.5%), and top-of-the-head impacts (7.4%). Most concussions were caused by head-to-head contact (70.0%), followed by contact with another body site (e.g., elbow, knee) (23.9%), and contact with playing surface (following player-player contact) (6.1%). The number of symptoms reported, symptom resolution time, and length of time to return to play were not associated with impact location. However, a higher proportion of football players sustaining concussions from top-of-the-head impacts experienced loss of consciousness (8.8%) than those sustaining concussions from impacts to other areas of the head (3.3%) (IPR [Injury Proportion Ratio]: 2.7; 95% CI: 1.4, 5.4; P=0.01). Conclusion: These findings support calls for better enforcement of rules prohibiting players from initiating contact with the top of the head and better education of players regarding proper tackling technique.

Learning Areas:
Epidemiology
Public health or related research

Learning Objectives:
Describe the incidence and rates of concussions by impact location among US high school football players. Identify the differences in concussion outcomes by impact location among US high school football players Explain the importance of how data such as RIO™ can help drive policy discussions

Keywords: Injury Prevention, Policy/Policy Development

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have led numerous studies related to the analysis of injury surveillance data. For this particular abstract, I led the development, analysis, and write-up. My scientific interests focus on physical activity-related injury across the lifespan, and the provision and evaluation of prevention recommendations at each point in the age continuum. Currently, these interests have led to research regarding the prevention of traumatic injuries such as concussions and exertional heat stroke.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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