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. 2017 Sep 18;5(9):2325967117727262.
doi: 10.1177/2325967117727262. eCollection 2017 Sep.

State-Level Implementation of Health and Safety Policies to Prevent Sudden Death and Catastrophic Injuries Within Secondary School Athletics

William M Adams  1 , Samantha E Scarneo  1 , Douglas J Casa  1
Affiliations

State-Level Implementation of Health and Safety Policies to Prevent Sudden Death and Catastrophic Injuries Within Secondary School Athletics

William M Adams et al. Orthop J Sports Med. .

Erratum in

  • Corrigendum.
    [No authors listed] [No authors listed] Orthop J Sports Med. 2017 Oct 31;5(10):2325967117741461. doi: 10.1177/2325967117741461. eCollection 2017 Oct. Orthop J Sports Med. 2017. PMID: 29119125 Free PMC article.

Abstract

Background: Sudden death and catastrophic injuries during sport can be attenuated with the implementation of evidence-based health and safety policies. However, the extent of the implementation of these policies within secondary school athletics is unknown.

Purpose: To provide an assessment of the implementation of health and safety policies pertaining to the leading causes of sudden death and catastrophic injuries in sport within secondary school athletics in the United States.

Study design: Descriptive epidemiology study.

Methods: A rubric for evidence-based practices for preventing the leading causes of death and catastrophic injuries in sport was created. The rubric comprised 5 equally weighted sections for sudden cardiac arrest, head injuries, exertional heat stroke, appropriate medical coverage, and emergency preparedness. State high school athletic association (SHSAA) policies, enacted legislation, and Department of Education policies were extensively reviewed for all 50 states and the District of Columbia. States meeting the specific criteria in the rubric, which required policies to be mandated for all SHSAA member schools, were awarded credit; the weighted scores were tabulated to calculate an aggregate score. States were then ranked from 1 (best) to 51 (worst) based on the aggregate score achieved.

Results: The median score on the rubric was 47.1% (range, 23.00%-78.75%). States ranked 1 through 10 (from 78.75% to 56.98%) were North Carolina, Kentucky, Massachusetts, New Jersey, South Dakota, Missouri, Washington, Hawaii, Wisconsin, and Georgia, respectively. States ranked 11 through 20 (from 56.03% to 50.55%) were Arkansas, New York, Mississippi, West Virginia, Oregon, Illinois, Tennessee, Arizona, Texas, and District of Columbia, respectively. States ranked 21 through 30 (from 49.40% to 44.00%) were Virginia, Pennsylvania, Florida, New Mexico, Alabama, Maine, Rhode Island, Indiana, Nevada, and Utah, respectively. States ranked 31 through 40 (from 43.93% to 39.80%) were Ohio, Delaware, Alaska, Vermont, Louisiana, Maryland, Oklahoma, Connecticut, Idaho, and South Carolina, respectively. States ranked 41 through 51 (from 38.73% to 23.00%) were Michigan, North Dakota, Nebraska, New Hampshire, Kansas, Wyoming, Minnesota, Montana, Iowa, California, and Colorado, respectively.

Conclusion: State scores ranged from 23.00% to 78.75% for the implementation of evidence-based best practices for preventing the leading causes of sudden death and catastrophic injuries (sudden cardiac arrest, traumatic head injuries, exertional heat stroke, and exertional sickling) in sport. Continued advocacy for the development and implementation of policies at the secondary school level surrounding sudden death and catastrophic injuries is warranted to optimize the health and safety of these student athletes.

Keywords: emergency action plans; exertional heat stroke; preparticipation examination; sudden cardiac death; traumatic head injuries.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: W.M.A. is a consultant for Clif Bar & Company, the Gatorade Sports Science Institute, BSX Athletics, and Nobo Inc; has received an honorarium from the National Athletic Trainers’ Association, Connecticut Athletic Trainers’ Association, and Wolters Kluwer Health; and serves on the technical advisory board of Body Biolytics. D.J.C. previously served on the board of advisors for Quest Diagnostics–Blueprint for Athletes; has provided expert testimony on many legal cases related to sudden death in sport; was compensated to serve on the medical and science advisory boards of Clif Bar & Company, the National Football League, and Sports Innovation Lab; receives honoriariums for talks given for Gatorade; and receives royalties from Jones & Bartlett Learning, UpToDate, Springer, and Lippincott Williams & Wilkins. The Korey Stringer Institute is a not-for-profit organization housed at the University of Connecticut; corporate partners include Gatorade, the National Football League, Kestrel, HeartSmart.com, Mission, CamelBak, Eagle Pharmaceuticals, and the University of Connecticut.

References

    1. Adams WM, Casa DJ, Drezner JA. Sport safety policy changes: saving lives and protecting athletes. J Athl Train. 2016;51(4):358–360. - PMC - PubMed
    1. Adams WM, Huggins RA, Stearns RL, Anderson SA, Kucera KL, Casa DJ. Policy changes reduce exertional sickling related deaths in Division I collegiate football players. J Athl Train. 2016;51(suppl 6):S–167.
    1. Adams WM, Scarneo SE, Stearns RL, Casa DJ. Implementation of heat acclimatization policies in secondary school athletics. J Athl Train. 2017;52(suppl 6):S103.
    1. Almeraya A, Adams WM, Scarneo SE, Stearns RL, Casa DJ. Implementation of automated external defibrillator policies in secondary school athletics. J Athl Train. 2017;52(suppl 6):S50.
    1. Andersen J, Courson RW, Kleiner DM, McLoda TA. National Athletic Trainers’ Association position statement: emergency planning in athletics. J Athl Train. 2002;37(1):99–104. - PMC - PubMed

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