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CDC Finds 60 Percent Increase in Youth-Athlete Head Injuries

Over the past eight years, reported traumatic brain injuries (TBIs) in youth athletes rose by nearly 100,000—an increase of 60 percent—according to a report issued Thursday by the Centers for Disease Control and Prevention.

Emergency department visits for TBIs (including concussions) in young athletes jumped from 153,375 in 2001 to 248,418 in 2009, according to the report.

"We believe that one reason for the increase in emergency department visits among children and adolescents may be a result of the growing awareness among parents and coaches, and the public as a whole, about the need for individuals with a suspected TBI to be seen by a health care professional," said Dr. Linda C. Degutis, the director of the CDC′s National Center for Injury Prevention and Control, in a statement.

An average of approximately 173,285 children, from birth to 19 years old, were treated for non-fatal sports- and recreation-related TBIs each year in emergency departments from 2001 to 2009, according to the report. The activities associated with the greatest percentage of TBIs were bicycling, basketball, football, playground activities, and soccer.

Roughly 71% of all TBI emergency department visits between 2001 and 2009 were by males, and 70.5% were among youths ages 10 to 19. Playground activities and bicycling accounted for a majority of TBIs among children 9 and younger in that eight-year span, while football and bicycling caused the largest portion of TBIs in children ages 10 to 19.

Why should this be cause for concern? A study from earlier this year suggested that a single brain injury could cause long-term, permanent damage.

And...

"While some research shows a child′s developing brain can be resilient, it is also known to be more vulnerable to the chemical changes that occur following a TBI," said Dr. Richard C. Hunt, the director of CDC′s Division for Injury Response.

Two U.S. congressmen recently announced that the CDC would be developing a national protocol for the diagnosis and treatment of youth concussions by fall 2013.

CDC and NFL Respond

Not-so-coincidentally, on the day this report was released, the CDC launched a new free online course for health care professionals about how to treat youth-athlete concussions, made possible with funding from the NFL.

The course, called "Heads Up to Physicians: Addressing Concussion in Sports among Kids and Teens," includes a quiz at the end that allows participants to obtain a certificate and continuing education credits through the American College of Sports Medicine.

"We are pleased that this public-private partnership between CDC and the NFL will expand knowledge of concussion prevention and treatment for kids and teens," said Charles Stokes, president and CEO of the CDC Foundation. "We are grateful to the NFL for generously supporting this initiative."

NFL Commissioner Roger Goodell hinted at the launch of the "Heads Up" course earlier this week during a speech at the Congress of Neurological Surgeons. In the same speech, Goodell reminded the audience of his wish that every U.S. state pass a youth-concussion law.

Mr. Goodell certainly has reason to be pleased this week.

In California, Gov. Jerry Brown signed his state's youth-concussion law on Tuesday, making California the 34th state (along with the District of Columbia) to have one.

California's law contains the three major provisions of Washington state's Lystedt Law, the model youth-concussion legislation in the eyes of the NFL.

The law requires parents to sign a concussion form before student-athletes can participate in sports; any student-athlete suspected of a concussion must immediately be removed from play; and student-athletes diagnosed with a concussion must obtain medical clearance before returning.

On the other hand, the law does not require formal concussion training for coaches.

In Wisconsin, a youth-concussion bill was introduced in the state Assembly last month, and a hearing on it was held in the Assembly education committee earlier this week.

The bill, in principle, is very similar to California's recently passed law. The Wisconsin bill contains the three Lystedt provisions (parental form, removal from play, medical clearance), but does not require any form of formal concussion training for coaches.

While it's a clear plus when any state takes a step toward better protecting student-athletes from concussions, let's not underrate the impact of not formally requiring coaches to undergo concussion training.

Dr. Kevin Guskiewicz, who was recently awarded a MacArthur Foundation "Genius Grant" for his work on concussions, told me earlier this year that states' youth concussion laws needed to be clearer in regards to concussion training.

"This has been too vaguely written in some of the states' laws," he said, "and while difficult to police or regulate, it would eliminate the confusion and would improve care."

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