The Most Dangerous Game: A Review of Head and Neck Injuries in American Football and Rugby

Study Design The investigators designed and implemented a 20-year cross-sectional study using the National Electronic Injury Surveillance System database. Objective The purpose of this study is to estimate and compare hospital admission (danger) rates between rugby and football of those who presented to the emergency department with head and neck injuries after playing these sports. Methods The primary predictor variable was sport played. The primary outcome variable was danger, measured by hospital admission rates. Results Over the past 20 years, there has been a trend of decreasing incidence of injuries presenting to the emergency department in both sports. There was no difference in the rate of hospital admission when comparing football and rugby (OR, 1.2; P = .1). Male gender was associated with an increased risk of admission. Other variables associated with hospital admission included white racial group, injury taking place in the fall, being either young (15–24 years old) or senior (65 years of age and over), and being injured at school or at a sport/recreational facility. Conclusions There is no difference in danger as measured by admission rates between American football and rugby. There exists, however, several variables that are associated with admission when sustaining injury to the head and neck, when playing these two sports.

In-Competition Severe Injury Events in Elite Alpine Ski Racing from 1997 to 2020: The Case of the Austrian Ski Team

Background To increase safety in elite alpine ski racing Injury Surveillance Systems were implemented and preventive measures introduced. However, studies analysing the change in athletes’ injury risk by controlling for their exposure are still scarce. Objectives This study aimed to describe and analyse the risk of in-competition severe injury events (SIEcomp) in elite alpine ski racing. Methods Data recorded in the Austrian Ski Federation’s Injury Surveillance System were used to analyse the SIEcomp incidence. Information on athletes’ competition exposure was obtained from the official website of the International Ski Federation. In 23 seasons, 2333 skier seasons were recorded for the Austrian Ski Team. Within a total of 114,531 runs 169 SIEcomp occurred. Generalised Estimating Equation for Poisson Regressions were applied. Results The SIEcomp incidence per 1000 runs was 1.48 [95% confidence interval (CI) 1.26–1.73] for elite alpine ski racers and 2.21 (95% CI 1.79–2.75) for the subgroup of World Cup racers. A significant sex difference was detected for the subgroup of junior racers with a higher risk for female athletes [risk ratio (RR): 2.97, 95% CI 1.46–6.05]. Between the seasons of 1997 and 2020, the seasonal SIEcomp incidence increased by a factor of 2.67 for elite alpine ski racers and 3.53 for World Cup racers. Downhill (2.75, 95% CI 2.18–3.47) had the highest SIEcomp incidence, followed by super-G (1.94, 95% CI 1.30–2.88), giant slalom (1.40, 95% CI 1.06–1.85), and slalom (0.64, 95% CI 0.43–0.96). Conclusion Although many preventive measures have been implemented in elite alpine ski racing, the risk of SIEcomp has increased over the last two decades.

Pandemic-related decline in injuries related to women wearing high-heeled shoes: Analysis of U.S. data for 2016-2020

Background Wearing high-heeled shoes is associated with injury risk. During the COVID-19 pandemic, changes in work and social behavior may have reduced women's use of such footwear. Methods This study assessed the trend in high-heel related injuries among U.S. women, using 2016-2020 data from the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS). Results In 2020 there were an estimated 6,290 high-heel related emergency department visits involving women ages 15-69, down from 16,000 per year in 2016-2019. The 2020 decline began after the start of the COVID-19 shutdowns on March 15. There was no significant change in the percentage of fractures or hospital admissions. Conclusions The COVID-19 pandemic was associated with a decline in reported injuries related to high-heeled shoes among US women. If this resulted from fewer women wearing such shoes, and such habits influence future behavior, the result may be fewer injuries in the future.

Predictive Analytic Techniques to Identify Hidden Relationships between Training Load, Fatigue and Muscle Strains in Young Soccer Players

This study aimed to analyze different predictive analytic techniques to forecast the risk of muscle strain injuries (MSI) in youth soccer based on training load data. Twenty-two young soccer players (age: 13.5 ± 0.3 years) were recruited, and an injury surveillance system was applied to record all MSI during the season. Anthropometric data, predicted age at peak height velocity, and skeletal age were collected. The session-RPE method was daily employed to quantify internal training/match load, and monotony, strain, and cumulative load over the weeks were calculated. A countermovement jump (CMJ) test was submitted before and after each training/match to quantify players’ neuromuscular fatigue. All these data were used to predict the risk of MSI through different data mining models: Logistic Regression (LR), Random Forest (RF), Support Vector Machine (SVM). Among them, SVM showed the best predictive ability (area under the curve = 0.84 ± 0.05). Then, Decision tree (DT) algorithm was employed to understand the interactions identified by the SVM model. The rules extracted by DT revealed how the risk of injury could change according to players’ maturity status, neuromuscular fatigue, anthropometric factors, higher workloads, and low recovery status. This approach allowed to identify MSI and the underlying risk factors.

Injuries related to respiratory masks in the US are very rare

Background. Protective facemasks are important for preventing the spread of COVID-19, and almost all Americans have worn them at least some of the time during the pandemic. There are reasonable concerns about some ill effects of mask-wearing, especially for people who wear masks for extended periods, and for the risk of falling as a result of visual obstruction. But there are also unsupported fears and objections stemming from misinformation and fueled by political disputes. Methods. The study analyzed the Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS) for 2020, using the product code for Respiratory Protection Devices, and calculated population incidence rates using Census data. Results. The NEISS included 128 cases, representing an estimated 5122 reported injuries in the population (95% CI 3322, 6922). The overall rate of injury reports was 1.54 per 100,000 U.S. residents (95% CI 1.00, 2.08). People over age 75 had higher rates than the population overall, with 5.27 injuries per 100,000 (95% CI 2.17, 8.37). The most common type of incidents involved facial injuries, rashes, falls, and those that might be considered anxiety-related. Conclusion. Wearing protective face masks is extremely safe, especially in comparison with other common household products, and in light of their protective benefits with regard to prevent the spread of COVID-19. This information may be useful for public health messaging, and for practitioners trying to increase compliance with mask-wearing guidance.

Epidemiology of Pediatric Baseball and Softball Player Injuries

Background: Baseball and softball are popular sports in the United States and are responsible for a large number of youth sports injuries each year. Purpose: To investigate recent differences in youth baseball and softball injuries evaluated in nationwide emergency departments. Study Design: Descriptive epidemiology study. Methods: The National Electronic Injury Surveillance System (NEISS) database was examined for softball and baseball injuries in pediatric patients (age, 7-21 years) from 2010 through 2019. Patients were classified as children (age, 7-13 years), adolescents (age, 14-18 years), or young adults (age, 19-21 years). Case narratives were used to categorize injuries as contact injuries (hit by bat or ball), field injuries (sliding into base, collision with another player, catching, or running), throwing injuries, or other. Results: An unweighted total of 24,717 baseball injuries and 13,162 softball injuries were recorded. A nationwide estimate of 861,456 baseball injuries and 511,117 softball injuries were sustained during the studied time period, with estimated respective injury rates of 86,146 and 51,112 per year. Injured softball players were most commonly adolescent (47%) and female (92%), while injured baseball players were most commonly children (54%) and male (90%). There was a greater proportion of baseball-related injuries involving the head/neck (41%) as compared with softball-related injuries (30%) ( P < .01). Conversely, a greater proportion of softball-related injuries involved the lower extremity (32%) as compared with baseball-related injuries (19%) ( P < .01). When comparing diagnosis, softball injuries were more often sprains/strains (28%) than baseball injuries (18%) ( P < .01). When comparing mechanisms of injury, baseball athletes were more likely to be evaluated with contact injuries than were softball athletes (49% vs 40%, P < .01). Conclusion: Youth baseball athletes were more likely to be injured through contact mechanisms and had a higher proportion of injuries related to the head/neck/face, whereas softball injuries more frequently involved the lower extremity and resulted in a sprain/strain. League guidelines should focus on reducing contact injuries within youth baseball, and injury-prevention programs should focus on reducing lower extremity injuries in youth softball.

Age-Related Injuries From Escalators

Introduction Escalators and moving stairways are omnipresent in modern life. No study to date has examined nationwide incidence and outcomes associated with injuries directly related to escalator use. The aim of this study was to describe the injury patterns, incidence, and disposition as it pertains to youth compared to adults. Methods Descriptive and comparative analyses were performed using National Electronic Injury Surveillance System data. The frequencies of categorical variables were calculated across the two age groups. Chi-squared test was performed on all categorical variables. Significance was defined as two-tailed P < 0.05. Logistic regression was used on variables that were determined to be significant from the frequency tables, with additional variable selection being used to arrive on a final model for each outcome. Results From 2009 to 2019, there were 810 youth and 3669 adults injured in escalator-associated emergency department visits. Incidence in the youth population decreased over time. Disposition was similar between groups. Injury types were similar among groups. White female adults were more likely to sustain injuries related to escalator use. Adult patients were also significantly more likely to sustain head/neck/facial trauma. Last, adult patients were found to be more likely to suffer a fatal event in comparison to the youth population. Discussion Differences in the injury patterns between youth and adult patients related to the use of escalators illustrate a need for improved injury prevention. Improved education and safety guidelines, particularly in individuals in ages 18 and up, would likely lessen the discrepancies between age groups identified in this study.

Firework-related injuries treated at emergency departments in the United States during the COVID-19 pandemic in 2020 compared to 2018–2019

Background Despite a national decrease in emergency department visits in the United States during the first 10 months of the pandemic, preliminary Consumer Product Safety Commission data indicate increased firework-related injuries. We hypothesized an increase in firework-related injuries during 2020 compared to years prior related to a corresponding increase in consumer firework sales. Methods The National Electronic Injury Surveillance System (NEISS) was queried from 2018 to 2020 for cases with product codes 1313 (firework injury) and narratives containing “fireworks”. Population-based national estimates were calculated using US Census data, then compared across the three years of study inclusion. Patient demographic and available injury information was also tracked and compared across the three years. Firework sales data obtained from the American Pyrotechnics Association were determined for the same time period to examine trends in consumption. Results There were 935 firework-related injuries reported to the NEISS from 2018 to 2020, 47% of which occurred during 2020. National estimates for monthly injuries per million were 1.6 times greater in 2020 compared to 2019 (p < 0.0001) with no difference between 2018 and 2019 (p = 0.38). The same results were found when the month of July was excluded. Firework consumption in 2020 was 1.5 times greater than 2019 or 2018, with a 55% increase in consumer fireworks and 22% decrease in professional fireworks sales. Conclusions Firework-related injures saw a substantial increase in 2020 compared to the two years prior, corroborated by a proportional increase in consumer firework sales. Increased incidence of firework-related injuries was detected even with the exclusion of the month of July, suggesting that the COVID-19 pandemic may have impacted firework epidemiology more broadly than US Independence Day celebrations.

EPIDEMIOLOGY EVALUATION OF ATHLETIC INJURY IN UNIVERSITY CENTER

Introduction: Athletics is a sport with varied modalities, which are based on patterns and activities that are natural to human beings. As a sport, it has several benefits, such as improved physical condition and interpersonal interactions, but it is not free from risks, especially injuries related to competitions or training. Objectives: Characterize injuries presented by the university athletics group of the medical course and identify possible risk factors. Methods: Participants, enrolled in the athletics group of the medicine course, of both sexes, had anthropometric measurements evaluated and answered an injury screening questionnaire modified from the "Injury Surveillance System". Results: 31 participants responded to the questionnaire where 65% of them had at least one injury. A total of 23 injuries were reported, 20 of which were serious, with no significant difference between both sexes. The total practice time was almost 2 times longer in injured practitioners than in non-injured ones. Conclusion: The practice of university athletics is associated with a high occurrence of serious injuries.

Injury incidence within male elite New Zealand cricket from the early T20 era: 2009–2015

ObjectivesThis study aimed to describe the injury epidemiology of domestic and international level male New Zealand cricketers from seasons 2009–2010 to 2014–2015 across all match formats given the increasing popularity of T20 cricket.MethodsMatch exposure and injury surveillance data collected prospectively by New Zealand Cricket was analysed using international consensus recommendations for injury surveillance and reporting in cricket. Relationships between playing level, role and injury were statistically analysed.ResultsA total of 268 elite male New Zealand cricketers from seasons 2009–2010 to 2014–2015 were analysed from the New Zealand Cricket injury surveillance system. Total new match injury incidence rates were 37.0 and 58.0 injuries per 10 000 player hours in domestic and international cricket, respectively. Total new and recurrent match injury incidence in international cricket was approximately 1.7 times higher than domestic cricket (277.6 vs 162.8 injuries per 1000 player days). Injury prevalence rates were 7.6% and 10.0% in domestic and international cricket. The hamstring (8.2%) in domestic cricket and the groin (13.5%) in international cricket were the most injured body sites. Most match days lost in domestic cricket were to the lumbar spine (417 days), and groin in international cricket (152 days). There were statistically significant differences in injury between domestic and international level cricketers (χ2=4.39, p=0.036), and playing role (χ2=42.29, p<0.0001).ConclusionsTotal injury incidence rates in elite New Zealand cricket increased in 2009–2015 compared with previous data. International-level players and pace bowlers were the most injured individuals.