Increasing mouthguards usage among junior rugby and basketball players

OBJECTIVE: To evaluate a Western Australian mouthguard promotion campaign, launched at the start of the 1997/98 junior rugby union and junior basketball seasons, aimed at increasing mouthguard usage at competition and training. METHOD: A quasi-experimental field design was used to assess the impact of the mouthguard campaign on behavioural change. Observational data were collected pre- and post-campaign on mouthguard usage by players present at a rugby and basketball competition event and at a training session. Junior Australian Rules Football players were used as a control group. RESULTS: Pre-post observational surveys showed a significantly greater increase in mouthguard usage in competition games among rugby union (77% to 84%) and basketball players (23% to 43%) compared with the control group (72% to 73%). All codes showed a post-campaign increase in mouthguard usage at training, but the intervention codes' increases were greater than the control's increase (rugby union: 29% to 40%; basketball: 11% to 36%; football: 34% to 40%). CONCLUSIONS: The campaign had a significant and substantial effect on behaviour and provides evidence of the benefits of leveraging a sponsorship to modify the behaviour of the target group. IMPLICATIONS: This campaign provides a model for promoting mouthguard usage in other sports among junior players.     

Evaluation of protective equipment for prevention of injuries in rugby union

BACKGROUND: Rugby union has a high rate of injury. The increased use of protective equipment may help mitigate these injuries. This study investigated the injury prevention effectiveness of the protective equipment used in rugby union. METHODS: A cohort of 304 rugby players in Dunedin, New Zealand was followed weekly during the 1993 club season to assess protective equipment use, participation in rugby, and injury outcomes. Generalized Poisson regression was used to model the rate of injury while adjusting for covariates such as level of competition, playing position, and injury history. RESULTS: The use of mouthguards appeared to lower the risk of orofacial injury [rate ratio (RR) = 0.56, 95% confidence interval (CI): 0.07-4.63], and padded headgear tended to prevent damage to the scalp and ears (RR = 0.59, 95% CI: 0.19-1.86). Support sleeves tended to reduce the risk of sprains and strains (RR = 0.58, 95% CI: 0.26-1.27). The risk of concussion was not lessened by the use of padded headgear (RR = 1.13, 95% CI: 0.40-3.16) or mouthguards (RR = 1.62, 95% CI: 0.51-5.11). There was no evidence of protective effects for any other equipment item (taping, shinguards, and grease). CONCLUSIONS: The protective equipment used in rugby union has limited effectiveness in preventing injuries. The results are supportive, however, of a role for mouthguards and padded headgear in preventing orofacial and scalp injuries, respectively, and for support sleeves in preventing sprains and strains.     

Cervical spinal cord injury in rugby union and rugby league: are incidence rates declining in NSW?

OBJECTIVES: To estimate trends in incidence rates of rugby code-related severe cervical spinal cord injuries in New South Wales (NSW) from 1986 to 2003. To evaluate the Australian Spinal Cord Injury Register (ASCIR) for injury surveillance by comparison with two published studies. METHODS: Data were cases of complete and incomplete tetraplegia in rugby union and rugby league admitted to the two spinal units in NSW. Trends in incidence rates were estimated using Poisson regression modelling. RESULTS: There was a small, non-significant decline from 1986 to 2003 in the incidence rate of tetraplegia in rugby union (9.8 vs. 6.1 per 100,000 player-years; p = 0.378) and rugby league (2.3 vs. 1.6 per 100,000 player-years; p = 0.564). The most common causes of injury were scrums for rugby union (35%) and tackles for rugby league (78%). This did not change over time (rugby union, p = 0.118; rugby league, p = 0.288). The ASCIR identified more cases of tetraplegia than insurance claims data and at least 75% of the cases ascertained by medical record review. CONCLUSIONS: There remains an urgent need to further improve safety in rugby union and rugby league. Scrummage in union and tackles in league remain the leading causes of tetraplegia. Rates of tetraplegia were significantly higher and more variable in rugby union than in rugby league. IMPLICATIONS: The ASCIR is a useful tool to monitor trends in spinal cord injury incidence in both rugby codes. Its potential value is constrained by the lack of accurate estimates of player numbers.     

Parental safety concerns – a barrier to sport and physical activity in children?

OBJECTIVE: To examine the extent to which parents and carers perceive injury and safety risks as serious enough to prevent or discourage their children, aged 5-12 years, from participating in sports/physical activity and to identify factors that influence these perceptions. METHODS: An analysis of the 2001 New South Wales Child Health Survey. RESULTS: More than one-quarter of parents/ carers of active children aged 5-12 years reported discouraging or preventing children from playing a particular sport (34.7% for boys and 16.6% for girls) because of injury and safety concerns. In boys, the most frequently discouraged sport was rugby league (23.2%), followed by rugby union (7.5%) and Australian rules football (2.8%). Among girls, the most frequently discouraged activities were rollerblading (2.7%), rugby league (2.3%) and soccer (2.1%). Multivariate analysis shows that factors independently associated with parents' decision to prevent/discourage their child from engaging in sport/physical activity include their child's age and gender, language spoken at home, presence of disability, and the respondent's relation to the child. CONCLUSIONS AND IMPLICATIONS: Efforts need to be made to modify some sports/ activities, such as football codes, in order to minimise injury and to ensure that children continue enjoying their favourite activity well into adulthood. Guidelines designed to promote physical activity among children and young adolescents need to take into account parental concerns regarding the associated risk of injury.     

An ecologic study of protective equipment and injury in two contact sports

BACKGROUND: Contact sports have high rates of injury. Protective equipment regulations are widely used as an intervention to reduce injury risk. The purpose of this study was to investigate the injury prevention effect of regulations governing protective equipment in two full-body contact sports. METHODS: Injury rates in US collegiate football were compared to New Zealand club Rugby Union. Both sports involve significant body contact and have a high incidence of injury. Extensive body padding and hard-shell helmets are mandated in collegiate football but prohibited in Rugby Union. RESULTS: The injury rate in football was approximately one-third the rugby rate (rate ratio [RR] = 0.35; 95% CI: 0.31-0.40). The head was the body site with the greatest differential in injury incidence (RR = 0.11; 95% CI: 0.08-0.16). Rugby players suffered numerous lacerations, abrasions, and contusions to the head region, but the incidence of these injuries in football was almost zero (RR = 0.01; 95% CI: 0.01-0.03). Injury rates were more similar for the knee (RR = 0.61; 95% CI: 0.43-0.87) and ankle (RR = 0.72; 95% CI: 0.46-1.13), two joints largely unprotected in both sports. CONCLUSIONS: The observed differences are consistent with the hypothesis that regulations mandating protective equipment reduce the incidence of injury, although important potential biases in exposure assessment cannot be excluded. Further research is needed into head protection for rugby players.     

Health and safety implications of injury in professional rugby league football

BACKGROUND: Professional sport is characterized by high injury rates but is also covered by health and safety legislation. AIM: To examine the incidence of injury in professional rugby league as defined by the Reporting of Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR 95). METHODS: All injuries received during playing and training to both first-team and 'academy' (<19 years old) players during two playing seasons at one professional club were recorded. The length of time a player was unable to take part in full training and playing was used as a measure of severity. Injuries were classified into minor injuries (0-3 days), over 3 day injuries or major injuries, in which the final two categories corresponded with RIDDOR 95. RESULTS: Thirty-two per cent (95% confidence interval=26-39%) of all injuries received satisfied the RIDDOR 95 criteria. The overall injury rate was 8.5 per 1000 h (7.2-9.9) for the first team and 4.1 per 1000 h (3.2-5.4) for the academy team. During match play the first-team injury rate was 157.7 per 1000 h (133.5-185.1) and 67.7 (51-81.1) for the academy team. Training injury rates were lower, at 0.5 per 1000 h (0.2-1.0) and 0.3 per 1000 h (0.1-0.8), respectively. CONCLUSION: The injury rate for professional rugby league is much higher than reported in other high-risk occupations such as mining and quarrying. The large differences in injury rates between first and academy teams have implications for young players likely to progress to first-team status.     

Sports injury experiences from the Western Australian Sports Injury Cohort Study

OBJECTIVE: The Western Australian Sports Injury Study is the first prospective cohort study of sports injuries sustained during community-level sports participation in Australia. METHODS: The players were nonprofessional/non-elite participants of hockey, Australian football, basketball and netball from metropolitan Perth. Players completed a baseline questionnaire relating to their sports injury history, training practices, protective equipment use, demographic profile, general health and lifestyle factors. Sports participation and injury experiences were monitored by monthly telephone surveys over two consecutive five-month winter sporting seasons during 1997 and 1998. RESULTS: Of the 1,512 players recruited into the initial cohort, 966 (i.e. 64%) responded to at least 700% of the callback surveys over the two-year follow-up. Across all sports, the injury incidence rate was 16.1 injuries/ 1,000 exposure hours (both games and training). Injury rates were highest in Australian football and lowest in netball. Lower limb injuries were twice as common as those to the upper limb (67% vs. 31%). Three-quarters of injured players sought treatment from a health care practitioner. CONCLUSIONS AND IMPLICATIONS: This is the first longitudinal study of injuries to community-based sports participants in Australia. Compared with elite sports participants, the risk of injury is relatively low. The results provide valuable direction for the design and conduct of further aetiological studies.     

Changes in sports injuries to children between 1983 and 1998: comparison of case series

BACKGROUND: Sports injuries sustained by children are worrying because they prevent and deter participation in physical activity. Before we can address such injuries we need to understand the size of the problem and whether there have been changes in occurrence. A study of sports injuries to children, carried out in a Cardiff Accident and Emergency department in 1983, provided the data against which to compare data gathered in 1998. METHODS: Data on all sports injuries to children aged 16 and under treated between September and December 1998 were compared with those reported for the same hospital, age group, injury and period in 1983. RESULTS: A total of 953 injuries were treated in 1998, representing an increase of 54 per cent [95 per cent confidence interval (CI) 44-64 per cent]. The male:female distribution remained constant and the majority of injuries were due to rugby and soccer. The number of females injured playing rugby and soccer increased and a wider range of sports led to injuries for both males and females. Amongst 10-15-year-olds injury risk increased from 1 in 78 for boys in 1983 to 1 in 22 in 1998 (p < 0.0001). For girls, the increase was from 1 in 117 to 1 in 55 (p < 0.0001). The number of soccer- and rugby-related fractures increased by 52 per cent (95 per cent CI 22-87 per cent). CONCLUSIONS: Sports injury rates have increased considerably over 15 years. With minimal population change, little variation in minor injuries and only small improvements in data capture, the main reason for change appears to be increased participation.     

Boys soccer league injuries: a community-based study of time-loss from sports participation and long-term sequelae

Background: Youth soccer is important for keeping European childrenphysically active. The aim of this study is to examine injuriessustained in a community soccer league for boys with regardto age-related incidence, time lost from participation and long-termsequelae. Methods: Primary injury data was collected from asoccer league including 1800 players, comprising approximately25% of all boys 13–16 years of age in three Swedish municipalities(population 150 000). Injuries were primarily identified basedon a time loss definition of sports injury. At the end of theseason, a physician interviewed every player who reported injuredto determine whether there were any remaining sequelae. If asequela was confirmed, the physician repeated the interview6, 18 and 48 months after the end of the season. Results: Forty-fourinjuries were recorded during 18 720 player game hours (2.4injuries per 1000 player game hours). The highest injury incidence(6.8 injuries per 1000 player game hours) was recorded in thefirst-year elite divisions. Thirty-two injuries (73%) were categorizedas moderate-severe, and 21 injuries (48%) required medical attention.Eight injuries caused sequelae that remained 6 months afterthe end of the season, and 3 injuries caused sequelae that lasted4 years after the injury event. Conclusion: An overall low injuryrate makes soccer a suitable sport for inclusion in programmesthat promote physical activity among children. When organizingsoccer leagues for boys, injury prevention programmes shouldbe provided to adolescent players when they begin playing incompetitive divisions.     

Sport injury prevalence and risk by level of play and sports played among a representative population of French adolescents. A school-based study

BackgroundSports practice has both benefits and physical risks. In France, data related to adolescent sports injury are rare. The main purpose of this article is to study the prevalence and risk of injuries by level of play and sports in the southeast of France.MethodsData collection was conducted in French schools among adolescents in 2015 and 2017 (n = 1849; aged 14–19). Only sports players were included (n = 1366). Two level of play were created. The low-level group included adolescents playing sport either outside or within a club, at the local level of competition or below. The high-level group included adolescents playing sport within a club at the state (regional) level of competition or higher. Odds-ratios and their 95% confidence intervals adjusted for variables selected using stepwise regression procedures were calculated to determine the injury risk of high-level athletes compared with those at low-level, in each sport. We also calculated the injury risk of each sport compared to all the other sports, by level of play.ResultsIn almost all sports activities, the prevalence of injured athletes was higher in the high-level of play than in the low-level of play. The increase in injury risk was the highest in tennis, basketball, dance, athletics and volleyball. When comparing sports, at the lowest level, handball, boxing, soccer and gymnastics practitioners were more at risk than the rest of the sample. At the highest level of play, only basketball players were more at-risk. Dancing is the less dangerous sport in terms of injury outcome, regardless the level.ConclusionFrom the state level of competition, injury risk increases significantly across most of the sports. Meanwhile, differences appeared regarding the prevalence, severity and nature of the sustained injuries. It would be useful to perform such analysis on a greater sample size, ideally representative of the national population of adolescents.     

Sun exposure and sun protection behaviours among young adult sport competitors

OBJECTIVES: To explore the relationship between sun protection and physical activity in young adults (18-30 years) involved in four organised sports. METHODS: Participants (n=237) in field hockey, soccer, tennis and surf sports completed a self-administered survey on demographic and sun-protective behaviours while playing sport. Differences in sun-protective behaviour were explored by sport and by gender. RESULTS: Sunburn during the previous sporting season was high (69%). There were differences between sports for sunburn, sunscreen use and reapplication of sunscreen. Lifesaving had the highest rates compared with the other three sports. Hats and sunglasses worn by participants varied significantly by sports. A greater proportion of soccer and hockey players indicated they were not allowed to wear a hat or sunglasses during competition. For all sports, competition was played mainly in the open with no shade provision for competitors while they were playing. There were some gender differences within each of the sports. Female soccer and tennis players were more likely to wear sunscreen compared with males. Female hockey players were more likely to wear a hat compared with males. CONCLUSIONS: Our findings highlight that there is still room for improvement in sun-protective behaviours among young adult sport competitors. There is a need for a systematic approach to sun protection in the sporting environments of young adults. IMPLICATIONS: Health promotion efforts to increase physical activity need to be paired with sun protection messages.     

医院急诊室的伤害监测情况分析

目的了解伤害病人急诊治疗的情况及其伤害发生的特点及规律,为伤害预防策略的制定提供科学依据.方法自1999年11月21日至2000年11月20日期间,凡因有意或无意导致身体受创伤的伤害者首次就诊于我们监测医院急诊室的病人均为本研究的调查对象,接诊医护人员亲自询问调查对象,统一填写调查表格.结果本研究共收集到2 611名受伤害者的情况,男、女性别比为2.51.意外伤害占伤害总人数的80.8%,其中,道路交通伤占到56.8%,在伤害类型中居首位.不同年龄组的伤害发生构成比不同(P,0.01),20～35岁的伤害病人的构成比最高(占47.2%),在该年龄组中,道路交通伤占76.9%.对不同职业伤害病人的构成比分析显示工人>学生>农民>经商>干部职员>学前儿童(P,0.01).发生于路上的伤害事件占首位(49.3%),其中93%的伤害为道路交通伤,伤害发生部位以头部的构成比最高(36.8%),其中52%是道路交通伤,以冬季发生的受伤害人数最多(占33.2%);自伤/自杀集中发生在9～11月.道路交通伤的受伤害的人数以周末最高(占36%).82%的伤害病人痊愈,14%的伤害病人留下残障,4%的伤害病人医治无效而死亡.结论伤害的急诊室监测资料是有价值的,也是伤害发生情况的重要信息来源,同时体会到伤害的急诊室监测尚存在一些问题及局限性,目前急需探索、发展适合我国体制与实际情况的、具有代表性的全国伤害监测系统.     

Soccer Injuries in Female Youth Players

A cross-sectional survey of injuries among female youth soccer players found 44.6% (95% confidence interval 34.9%–54.8%) had ever been injured. The injury incidence rate for the current season was 2.2/1000 soccer exposure hours (95% CI 1.5–3.1). Future studies should evaluate modifiable risk factors in youth to identify injury prevention strategies.     

A prospective study of injury incidence among North Carolina high school athletes

Sports-related injuries are an issue of concern in high school sports athletes. A prospective cohort study of injury risk factors was conducted from 1996 to 1999 among varsity high school athletes in 12 sports in 100 North Carolina high schools. Data were collected by trained school personnel. Unadjusted and adjusted incidence rates and rate ratios were estimated using Poisson regression models. The overall rate of injury was 2.08 per 1,000 athlete-exposures (95% confidence interval (CI): 1.79, 2.41). At 3.54 per 1,000 athlete-exposures (95% CI: 2.87, 4.37), football had the highest rate of injury of all sports. The adjusted rate ratio for athletes with a history of injury, compared with those without a prior injury, was 1.94 (95% CI: 1.69, 2.22). The injury rate rose with each year of playing experience (rate ratio=1.06, 95% CI: 1.01, 1.12). In a subanalysis restricted to gender-comparable sports, boys had a higher rate of injury than did girls (rate ratio=1.33, 95% CI: 0.99, 1.79). All other factors did not appear to be independent predictors of the injury rate. The influence of prior injury suggests that proper rehabilitation and primary prevention of the initial injury are important strategies for injury control.     

Buddies in Bad Times? The Role of Co-workers After a Work-Related Injury

Introduction Co-workers can play an important role after a work-related injury. They can provide details about the circumstances of an accident, offer emotional support to the injured worker and help with job tasks upon a co-worker’s return to work (RTW). Working with an injured co-worker, however, can also strain work relationships and increase workload. The purpose of this study was to determine the role that co-workers play after a work-related injury and during the RTW process in the unionized, electrical construction sector. Methods We conducted two focus groups with injured electricians and union representatives. We also interviewed co-workers who had worked with someone who had been injured in the course of employment. We examined the role that co-workers can play after a work-related injury and some of the factors facilitating and hindering co-worker support. Results The structure of work in the electrical sector—a focus on cost-cutting and competition, job insecurity, perceptions of “different camps” among co-workers, little modified work and poor formal communication—can impede co-worker support and contribute to making injured workers’ experiences difficult. Management can play an important role in setting an example for how injured workers are regarded and treated. Conclusions Future research should explore how workers can better be supported after a work-related injury and during the RTW process.     

Work-related injuries in residential and drywall carpentry

Findings are reported on the first two years of an active injury surveillance project designed to test the utility of active injury investigations in identifying causes of injury among a large cohort of carpenters who did residential building and drywall installation. Occupational Safety and Health Administration recordable injuries were reported by participating contractors. Injured union carpenters were interviewed by experienced journeymen trained in a standard questionnaire protocol. Enumeration of workers and hours worked were provided by the union. These data allowed the definition of a dynamic cohort of 4429 carpenters, their hours worked, detailed information on the circumstances surrounding recordable injuries, and possible preventive measures from the perspectives of the injured worker and an experienced journeyman investigator. The overall estimated injury rate (16.9 per 200,000 hours worked) was considerably higher than recent Bureau of Labor Statistics rates despite less than complete ascertainment of injuries. Injuries most commonly involved being struck by or against something, manual materials handling injuries, and falls. Manual materials handling injuries often involved very heavy objects or tasks and were injuries carpenters most often reported needs for adequate help and coordinated team work to prevent. Falls from heights occurred from a variety of surfaces and were not just injuries of inexperience. Carpenters reported the need for more attention to common fall protection practices, such as the use of more toe boards and guardrails. Poor housekeeping was involved in the majority of same level falls, as well as some manual materials handling injuries.     

The Relationship of Farm Residency Status to Demographic and Service Characteristics of Agricultural Injury Victims in Central Wisconsin

Abstract: This study performed a surveillance of a defined population in central Wisconsin during a two-year period that included six months of follow-up. The study included those who worked and lived on farms and those who only worked on farms. The injury rate for farm residents was 3.15 injuries per 100 persons per year. However, 195 of the 510 injuries (38.2%) involved persons who were not farm residents. For nonfarm residents, 88.7 percent of the victims were male, whereas for farm residents 79 percent of the victims were male. More than one half of the farm residents who were injured were the owners and an additional 21 percent were juvenile children. Of those aged 18 to 29 years, 51.3 percent were nonfarm resident victims and 15.2 percent were farm resident victims. Of nonfarm residents, 41.1 percent were married; of farm residents, 65.3 percent were married. More than one half of all injured nonfarm residents were seen within two hours of injury while one quarter of the injured farm residents were seen more than 24 hours after the injury. Only 4 percent of the injured farm residents were self-insured, but 15 percent of the nonfarm residents were self-insured. However, the time of injury, actual injuries, diagnoses rendered, and services received were similar for injured farm residents and injured nonfarm residents. Effective attempts to intervene on agricultural injuries will need to consider different risk factors for injuries for nonfarm residents as compared to farm residents.     

广东省四城市青少年伤害发生现况及其社会经济损失

目的：阐明青少年伤害的发生现况和常见伤害类型的原因,评价其社会经济损失及危害程度。方法：１９９８￣１９９９年在广州,茂名,江门,汕头等市采用分层整群抽样方法,调查１９所学校１４５３３名７￣１８岁的中小学生１年中发生伤害的情况,伤害的判断标准是：（１）到医院或校医室诊治,（２）因伤休息０．５ｄ以上,（３）由家长或老师做紧急处理。结果：１年内发生伤害６９４１人,发生率为４７．７６％（男生５０．０８％,