Abstract
Sports-related injuries in U.S. Peace Corps Volunteers, 2005-2014
Rennie Ferguson, MHS, Susan Henderson, MD, MPH and Paul Jung, MD, MPH, FACPM
U.S. Peace Corps, Washington, DC
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Background: Sports-related injuries are a major cause of morbidity in the U.S., resulting in almost 2 million visits to emergency departments each year. Common sports-related injuries include sprained ankles and knees, fractures, facial injuries, and dislocated fingers. While sports injuries have been described in the U.S., the risk of sports-related injuries among U.S. citizens abroad, particularly among long-term travelers, has not been well documented.
Methods: Data on sports-related injuries among U.S. Peace Corps Volunteers who served from 2005 to 2014 were analyzed from the Peace Corps Epidemiologic Surveillance System. Volunteer-months were used to calculate incidence rates for countries and regions.
Results: A total of 2,481 sports-related injuries were observed over the course of 893,360 Volunteer-months served in 80 countries, for a rate of 2.78 injuries per 1,000 Volunteer-months (95% CI: 2.67, 2.89). The highest rate of sports-related injuries was observed in the Central America region (4.30 injuries per 1,000 Volunteer-months, 95% CI: 3.94, 4.69). This was significantly greater than the rate observed among Volunteers in each of the other 6 regions (p<0.05). The rate of sports-related injuries generally declined during the time period. The highest rate was observed in 2006 (3.65 injuries per 1,000 Volunteer-months), and the lowest was observed in 2013 (2.07 injuries per 1,000 Volunteer-months); the difference was statistically significant (p<0.05).
Conclusions: This research indicates that while the rate of sports-related injuries has decreased among Volunteers during the time period, regional variation exists. Future research could explore factors related to the types of injuries seen in different regions.
Epidemiology Public health or related research
Abstract
Academic performance in high school students with athletic injuries
Ginger Stringer, MPH, PhD1, Yvonne L. Michael, ScD2 and Andrew E. Lincoln, ScD, MS3
(1)Saguache County Public Health Department, Saguache, CO, (2)Drexel University School of Public Health, Philadelphia, PA, (3)MedStar Health Research Institute, Baltimore, MD
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Background
Understanding the recovery of adolescent athletes following concussion, including effects on academic performance, is essential to minimize the consequences for the future health of the injured athlete. This study used longitudinal statistical methods to characterize the impact of sport-related concussion on academic performance in high school athletes.
Methods
A retrospective cohort of athletes participating in school sports in a single school district during the 2009-2010 academic year was analyzed. Athletes with concussion or lower leg injury during the study period were included in analyses. Academic grades and absence from school in the two academic periods prior to injury, the period of the injury, and the two periods following the injury were analyzed. Growth curve and random coefficient models were used to explore trends in academic performance.
Results
Athletes with both concussion and ankle/leg injury show a decline in academic performance in the academic period of injury and those that follow, but no overall main effect was noted. Analyses restricted to younger athletes (grade 9 or 10) with more severe injuries show a greater decline in academic performance for the group with concussion injury compared to those with ankle/leg injury. (coeff=-0.18, p=0.017, 95%CI = -0.32 to -0.03)
Conclusions
Academic performance is a primary predictor and determinant of adult health outcomes. While there was not an overall main effected noted in this population, there is an indication that younger athletes with more severe concussion injury are at risk for poor academic outcomes following injury.
Epidemiology Public health or related research
Abstract
Comparison of Ankle Injuries Presenting to US Emergency Departments, High School Athletic Trainers and NCAA Athletic Trainers, 2005/06 through 2013/14 Academic Years
Lina Brou, MPH1, Alexandria Wiersma, MD2, Sarah K. Fields, PhD3, R. Dawn Comstock, PhD4 and Zachary Kerr, PhD, MPH5
(1)University of Colorado Anschutz, Aurora, CO, (2)Children's Hospital Colorado, Aurora, CO, (3)University of Colorado Denver, Denver, CO, (4)Colorado School of Public Health, Aurora, CO, (5)Datalys Center for Sports Injury Research and Prevention, Inc, Indianapolis, IN
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Background/Aim: To compare ankle injuries presenting to EDs and high school and collegiate athletic training settings by sport and diagnosis.
Methods:
Ankle injury data was collected from 3 national surveillance datasets covering high school and collegiate athletic training and ED settings for patients 14-22 years old participating in 12 sports (male football, baseball, basketball, lacrosse, soccer, and wrestling and female softball, basketball, lacrosse, soccer, volleyball, and field hockey) during academic years 2009/10 through 2013/14 . We calculated sport-specific injury rates and proportions to compare subgroups of interest.
Results:
Rates and patterns of ankle injury varied by presentation setting and sport. Rates were higher in collegiate compared to high school athletes in each sport and overall (RR: 3.0; 95% CI: 2.8-3.1). While football accounted for the largest proportion of ankle injuries presenting to high school (31.2%) and college (41.0%) athletic training settings, male basketball accounted for the largest proportion at EDs among both high school (41.0%) and college (65.8%) aged patients. Sprains/strains accounted for over 80% of injuries in all three settings. Fractures accounted for a larger proportion of ankle injuries presenting to EDs (9.5%) compared to high school (3.8%) and college (0.8%) athletic training settings.
Conclusions:
Injury rates and patterns varied by sport and presentation setting. Understanding such patterns will help readers interpret differences in publications reporting data from varied clinical settings. Current findings as well as previous research can help drive the development of more effective interventions to prevent sport-related ankle injuries.
Epidemiology
Abstract
Parkour injuries resulting in U.S. emergency department visits: An exposure series study
Caroline Stephenson and Matthew Rossheim, PhD, MPH, CPH
George Mason University, Fairfax, VA
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Parkour is an activity in which practitioners travel through a complex, generally urban environment by means of jumping, flipping or climbing over obstacles. Some maneuvers attempted by participants appear to pose substantial risk of injury. Participation in parkour is increasing globally yet, to date, case studies are the primary source of information on related injuries. The U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) was utilized to assess parkour-related injuries presenting to U.S. emergency departments between the years 2009 and 2014. This study identifies 33 parkour injuries, which is greater than the combined previous research literature (n = 8). There were approximately the same number of parkour related injuries in 2014 (n = 17) as there were between 2009 and 2013 (n = 16). This appears to support that parkour is either increasing in popularity and/or there is greater awareness and thus better reporting than in the past. The most common parkour injuries resulted from landing or striking objects. Landing injuries most commonly caused fractures and sprains and accounted for all of the noted foot/ankle/toe injuries. Striking objects caused all of the recorded lacerations, and landing from flipping cause the majority of dislocations. Although not comparable to the number of injuries from mainstream sports, reported parkour injuries are increasing and should be better monitored. NEISS data should include a unique code for parkour to better monitor related injuries. Large cohort studies are needed to assess the risk of injury from practicing parkour.
Public health or related research
Abstract
Comparison of Indiana high school football injury rates by inclusion of a Player Safety Coach
Thomas Dompier, PhD, ATC1, Zachary Kerr, PhD, MPH1, Sara Dalton, MA, ATC2, Karen Roos, PhD, MSPT, ATC1, Aristarque Djoko, MS1 and Jennifer Phelps, J.D., M.P.H.3
(1)Datalys Center for Sports Injury Research and Prevention, Inc, Indianapolis, IN, (2)Datalys Center For Sports Injury Research and Prevention, Inc., Indianapolis, IN, (3)USA Football, Indianapolis, IN
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Background: In 2014, the Indiana General Assembly passed the Senate Enrolled Act Number 222 (SEA222), requiring high school football coaches to complete a coaching education course on concussion awareness, equipment fitting, and proper technique. Some high schools have also opted to implement a Player Safety Coach (PSC), which is a coach that ensures other coaches implement proper tackling and blocking technique. This study compares injury rates in Indiana high school football teams by their usage of a PSC.
Methods: Athletic trainers tracked injuries at practices and games during the 2015 high school football season. Three teams with 204 players used the PSC component. Three teams with 186 players utilized coaching education only (EDU). Injury rates and injury rate ratios (IRRs) were reported with 95% confidence intervals (CIs).
Results: A total of 149 injuries were reported, of which 54 (36.2%) and 95 (63.8%) originated from the PSC and EDU groups, respectively. Injury rates was lower in the PSC group than the EDU group for both practices (2.99 vs. 4.83/1000AE; IRR=0.62; 95%CI: 0.40-0.95) and games (11.37 vs. 26.37/1000AE; IRR=0.43; 95%CI: 0.25-0.74). When examining concussions only, the rate was lower in the PSC group (0.09 vs. 0.73/1000AE; IRR=0.12; 95%CI: 0.01, 0.94), although only one concussion was reported in the PSC group. Game concussion rates did not differ (0.60 vs. 4.39/1000AE; IRR=0.14; 95%CI: 0.02-1.11).
Conclusion: Findings support the PSC as an effective method of injury mitigation in high school football. Future research should seek to replicate this study using larger samples from additional states.
Administer health education strategies, interventions and programs Epidemiology Public health or related organizational policy, standards, or other guidelines Public health or related public policy
Abstract
Preseason Symptoms of Depression and Anxiety and Prospective Injury Risk in Collegiate Athletes
Hongmei Li, PhD1, Jennifer Moreland, PhD2 and Jingzhen Yang, PhD, MPH3
(1)Medical College of Soochow University, Suzhou, China, (2)Nationwide Children's Hospital, Columbus, OH, (3)Nationwide Children's Hospital/Ohio State University, Columbus, OH
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Objective: To determine the effect of symptoms of depression and anxiety measured at preseason on the prospective incidence rate of injury during the season in a cohort of collegiate athletes.
Methods: An open cohort of collegiate athletes participating in 4 men's sports and 5 women's sports from 2 National Collegiate Athletic Association (NCAA) Division I universities were enrolled and prospectively followed during the 2007–2011 seasons. Injury incidence rate was calculated as total number of injuries divided by total number of athlete-exposures (i.e., games and practices). The generalized estimation equations method with log linkage was utilized to model incidence rates and injury rate ratios.
Results: Of 958 enrolled athletes (90.2% response rate), 389 (40.1%) athletes sustained a total of 597 injuries. At preseason, 208 (21.7%) athletes reported experiencing depression symptoms, 276 (28.8%) reported experiencing anxiety, and 158 (16.5%) reported both. Athletes who reported preseason anxiety had a higher injury incidence rate than athletes without anxiety (adjusted rate ratio (RR) = 2.30, 95%CI= 2.01-2.64). These differences were observed for both male and female athletes. Furthermore, male athletes who experienced preseason symptoms of depression had significantly higher incidence rate of injury than did male athletes who did not experience preseason depression symptoms (RR=1.28, 95%CI =1.06-1.60). However, such a relationship was not observed in female athletes who experienced preseason depression symptoms.
Conclusion: Collegiate athletes with preseason symptoms of depression and anxiety are at increased risk of injury. Effective injury prevention programs should include strategies that address psychological symptoms.
Biostatistics, economics Epidemiology Other professions or practice related to public health Public health or related research Social and behavioral sciences
Abstract
Epidemiology of initial and subsequent injuries in collegiate football athletes
Jacob Williams, MD Candidate1, Bhavna Singichetti, MPH2, Hongmei Li, PhD3, Huiyun Xiang, MD, PhD2, Kevin Klingele, MD2 and Jingzhen Yang, PhD, MPH4
(1)The Ohio State University College of Medicine, Columbus, OH, (2)Nationwide Children's Hospital, Columbus, OH, (3)Medical College of Soochow University, Suzhou, China, (4)Nationwide Children's Hospital/Ohio State University, Columbus, OH
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Objective: To determine athlete exposures (AEs) and rates of initial and subsequent injury among collegiate football athletes.
Methods: Injury and exposure data were collected from collegiate football players in 2 Division I universities (2007-2011). Rate of initial (or subsequent) injury was calculated as the number of initial (or subsequent) injuries divided by the total number of AEs for initial (or subsequent) injuries. AEs of athletes who had an initial injury were used to estimate rate of subsequent injury. Poisson regression was used to determine injury rate ratio (subsequent vs. initial injury), adjusting for other covariates.
Results: The total AEs during the study period were 67,564, resulting in an overall injury rate of 35.2 per 10,000 AEs. Rates for initial and subsequent injuries were 31.73 and 45.28 per 10,000 AEs, respectively, with a rate ratio (RR) of 1.43 for rate of subsequent injury vs. rate of initial injury (95% CI: 1.09-1.87). The rate of subsequent injuries to the head/neck/face was 10.9 per 10,000 AEs, nearly double the rate of initial injuries to the same sites (RR = 1.95; 95% CI: 1.1-3.5). For wide receivers, the rate of subsequent injuries was 2.17 times the rate of initial injuries (95% CI: 1.25-3.76) and for defensive lineman, the rate of subsequent injuries was 2.10 times the rate of initial injuries (95% CI: 1.14-3.89).
Conclusions: The methodology used in this study allowed for a more accurate determination of injury risk for subsequent injuries. Further research on specific risk factors for subsequent injury is warranted.
Epidemiology Public health or related research
Abstract
Comparing Injury Rates and Patterns in High School Ice Hockey and Football
Dustin W. Currie, MPH1, Matthew J. Kraeutler, MD2, Lauren A. Pierpoint, MS3, Eric C. McCarty, MD4 and R. Dawn Comstock, PhD3
(1)Colorado School of Public Health, Denver, CO, (2)University of Colorado School of Medicine, Aurora, CO, (3)Colorado School of Public Health, Aurora, CO, (4)University of Colorado School of Medicine, Department of Orthopedics, Boulder, CO
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
BACKGROUND
Although studies report sports competition injury rates significantly exceed practice rates, little research compares differences in rates by exposure type across sports.
OBJECTIVE
Compare injury rates among two full contact sports (boys' football and ice hockey) and rank these sports relative to 22 other high school sports.
METHODS
Injury rates for 24 sports were calculated using data from High School RIO, a national high school sports-related injury surveillance system, from 2008/09-2014/15 as number of injuries per 1,000 athlete-exposures (AEs).
RESULTS
Football had the highest competition injury rate (12.53 per 1,000 AEs) of the 24 sports, while ice hockey had the third highest rate (5.45). Football also had the highest practice injury rate (2.24 per 1,000 AEs), but the ice hockey practice rate (0.68) dropped to 16th of the 24 sports. Similarly, boys' football had the highest concussion rates in competition (30.35 per 10,000 AEs) and practice (4.56 per 10,000 AEs), while ice hockey had the second highest concussion rate in competition (17.50 per 10,000 AEs) but 7th highest rate in practice (1.50 per 10,000 AEs). Only one quarter of practice hockey injuries occurred during activities associated with intentional player-player contact (e.g., checking) compared to over half of football practice injuries being associated with intentional player-player contact (e.g., tackling).
CONCLUSION
While football and ice hockey are both full contact sports with high competition injury rates, ice hockey has a relatively low practice injury rate. Researchers should determine if ice hockey coaching practice approaches could translate to make football practices safer.
Epidemiology Other professions or practice related to public health Public health or related research
Abstract
Evaluating Implementation of the Massachusetts Sports Concussion Law
Jonathan Howland, PhD, MPH1, Alyssa Taylor, MPH1, Linda Brown, MBA2, Mary Ann Gapinski, R.N., M.S.N.2, Holly Hackman, MD, MPH2 and Julie Kautz Mills, PhD2
(1)Boston Medical Center, Boston, MA, (2)Massachusetts Department of Public Health, Boston, MA
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
purpose: In 2010, Massachusetts enacted legislation with regulations for the identification, treatment, and return to activity for public middle and high school students with suspected or actual head injuries incurred during school athletics. School Nurses (SNs) and Licensed Athletic Trainers (ATs) play pivotal roles responding to students with head injury and monitoring their recovery. In 2015, the Massachusetts Department of Public Health conducted focus groups with SNs and ATs to assess implementation of the law from their perspective.
methods: Four tape-recorded focus groups were conducted by experienced facilitators. To identify themes, investigators independently took notes at the focus groups and subsequently while listening to transcripts. Lists of themes were then reconciled for each focus group.
results: Participants from both professions supported the sports concussion legislation; felt that implementation had gone well; indicated that the law empowered them in managing return-to-school and return-to-play for students with suspected or confirmed concussion; and, expressed satisfaction with support from their school administrators. An unanticipated and positive consequence of the law was the extent to which SNs had generalized the legislation to all students with head injuries, regardless of how or where the injury occurred. Thus, a new and functioning public health system has spontaneously developed that provides for the management of concussions for many school-aged children throughout the state.
conclusions: Initial implementation of the Massachusetts sports concussion legislation has gone well from the perspective of SNs and ATs. Further research is required to assess the perspectives of parents, physicians, and students.
Conduct evaluation related to programs, research, and other areas of practice Planning of health education strategies, interventions, and programs Program planning Public health or related laws, regulations, standards, or guidelines Public health or related public policy
Abstract
Epidemiology of Youth Related Sports and Recreational Injuries in Florida 2006-2012
Charlotte Baker, DrPH, MPH, CPH
Florida A&M University, Tallahassee, FL
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
background: Unintentional injuries are one of the leading causes of morbidity and mortality for youth in the United States. Recreation and sport are encouraged to keep youth healthy and reduce morbidity from chronic diseases. The purpose of this study is to quantify the burden of unintentional sports and recreation injuries (SRI) among Florida youth.
methods: We used emergency department (ED) data from the State of Florida Agency for Health Care Administration to describe the epidemiology of SRI for Florida residents aged 5 to 18 years of age from 2006 to 2012. Visits for SRI were identified by the presence of the ICD-9-CM external cause of injury code E849.4. Descriptive statistics and linear regression were used to characterize ED visits and patterns of SRI.
results: SRI accounted for 6.7% (376,129) of all ED visits (5.6 million) for Florida residents aged 5 to 18 years from 2006 to 2012. Eighty-nine percent of ED visits were completed in less than 24 hours. The total number of visits to EDs significantly increased for both males and females from 2006 to 2012. In addition, the proportion of ED visits for female patients increased over the same seven-year period. Most ED visits were for fractures (27.2%) and sprains/strains (26.4%). Charges for SRI seen in the ED topped $1 billion dollars.
conclusions: Descriptive assessments of SRI are useful to identify state needs for programmatic intervention. Results suggest a significant burden of SRI for Florida youth aged 5 to 18, both male and female.
Epidemiology Public health or related research