Death in Community Australian Football: A Ten Year National Insurance Claims Report

Epidemiology of craniofacial and spinal injuries in French Rugby union: A report including medical, social, and professional consequences

OBJECTIVES

First, to investigate the medico-socio-professional repercussions of non-fatal cranioencephalic and spinal injuries occurring across all levels of play in male and female Rugby Union in France. Second, to determine whether an association existed between the severity of injuries and the circumstances of their occurrence and/or the profiles of the injured players. Third, to gather new epidemiological data regarding the severity and long-term consequences of these injuries in the sport.

DESIGN

National retrospective observational open cohort study conducted using medical expertise files on all injuries registered by the insurer affiliated to the French Rugby Federation.

METHODS

We analysed the medical reports of spinal, craniofacial or radicular trauma occurred from 26/08/2011 to 31/01/2018. Data relating to the severity and the circumstances of the injury, and its medical and socio-professional consequences (e.g., ability of players to continue playing rugby and/or professional/scholastic activity, receiving or not financial compensation) were extracted.

RESULTS

199 cases were identified. The overall incidence rate of injuries was 10.57/100,000 person-years. The median PMI value after consolidation was 6 %. Five cases had a PMI value equivalent or higher than 50 %. 85 % of players were able to return to work/studies whilst 47 % returned to rugby overall. Injury severity did not differ between age groups, genders, performance levels, training/match-play or according to the game situation.

CONCLUSIONS

Although rare, craniofacial and spinal injuries in rugby can leave sequelae with substantial repercussions on personal, professional/scholastic and sporting life. Further research into their potential causes and targeted prevention strategies is warranted.

Mortality of Spanish soccer referees and coaches: a retrospective cohort study

There is evidence that elite soccer players live longer than general population, but there is no information on soccer coaches and referees. We aimed to analyze the longevity of both professionals, comparing them with soccer players and with general population. In this retrospective cohort study, a total of 328 male Spanish soccer coaches, 287 referees, and 1230 soccer players, all born before 1950, were divided in two cohorts, matched 2:1 with coaches and referees. We compared the survival of the cohorts with the Kaplan-Meier estimator and significance with the log-rank test. We calculated hazard ratios of death for coaches and referees compared with male Spanish general population of the same period. Differences in survival among cohorts were found, but they did not reach statistical significance. The estimated median survival time was 80.1 years (95% CI 77.7-82.4) for referees, 78 years (95% CI 76.6-79.3) for coaches, 78.8 years (95% CI 77.6-80) for referees matched with players, and 76.6 years (95% CI 75.3-77.9) for coaches matched with players. Both coaches and referees had lower mortality than general population, but this advantage disappeared after 80 years of age. We found no differences in longevity among Spanish elite soccer referees, coaches and players born before 1950. Both coaches and referees had lower mortality than general population, but this advantage disappeared after 80 years of age.

Injury deaths in Australian sport and recreation: Identifying and assessing priorities for prevention

Introduction

Sport and recreation is beneficial for health and wellbeing but comes with a probability of loss, including occasional fatal injuries. Following high-profile injury deaths in Australia, concerns are raised regarding the safety of sport participation. To understand the scale and scope of injury deaths, and identify potential prevention opportunities, the aim of this investigation was to describe the number and nature of fatal injuries in Australian sport and recreation.

Methods

This is a retrospective cohort study of injury deaths reported between 1 July 2000 to 31 December 2019 using data from the National Coronial Information System, Australia. Unintentional deaths with an external cause, where the activity was recorded as sport and exercise during leisure time were included. Drowning deaths were excluded. Presented are the number and % of cases by age, sex, sport, broad cause and annual crude death rate (population).

Results

There were 1192 deaths, averaging 63 per year. Deaths were mostly in males (84.4%), with the largest proportion in people aged 15–24 years (23.1%). Wheeled motor (26.9%) and non-motor (16.2%) sports accounted for the highest proportion of cases. The primary mechanism of death was most commonly blunt force (85.4%), followed by piercing/penetrating force (5.0%). The years 2001 and 2005 recorded the highest crude injury death rate (2001, n = 92, 0.47 per 100,000 population; 2005, n = 95, 0.47 per 100,000 population).

Conclusions

On average, there is more than one injury death per week in a sport or recreation setting in Australia. Cases occurred in many sports and recreation activities, including those generally considered to be safe (e.g. individual athletic activities, team ball sports.) Detailed investigation of the coronial recommendations that are present within each case is now needed to understand and identify potential prevention opportunities.

Mortality of Spanish Former Elite Soccer Players and Coaches

We analyzed whether male Spanish elite soccer players live longer than the general population. Secondly, we compared their mortality with a cohort of soccer players who continued working as soccer elite coaches after retirement. Using age and calendar-date adjusted life tables, we analyzed the mortality hazard ratio of 1333 Spanish male players born before 1950, and who played in elite leagues from 1939, compared with the Spanish population. Using Cox proportional hazards model we compared their mortality with a cohort of 413 players who continued as coaches. Players showed significantly lower mortality than the general population, but this advantage decreased with advanced age, disappearing after 80 years. Coaches showed a similar pattern. Comparing players versus coaches, date of birth and years as professional were associated with survival, but debut age and player position were not. Unadjusted median survival time was 79.81 years (IQR 72.37-85.19) for players and 81.8 years (IQR 74.55-86.73) for coaches. Kaplan-Meier estimator adjusted for covariables showed no difference between cohorts (p=0.254). In conclusion, former Spanish male players showed lower mortality than the general population, but this effect disappeared after 80 years of age. Continuing their career as coaches after retirement from playing did not confer major benefits.

"It Doesn't Make Sense for Us Not to Have One"-Understanding Reasons Why Community Sports Organizations Chose to Participate in a Funded Automated External Defibrillator Program

OBJECTIVE

Implementation of automated external defibrillators (AEDs) in community sports settings is an important component of emergency medical planning. This study aimed to understand motivations for why sports organizations participated in a government-funded program that provided AEDs and associated first-aid training.

DESIGN

Face-to-face interviews.

SETTING

Community sports organizations in Victoria, Australia.

PARTICIPANTS

Representatives from 14 organizations who participated in a government-funded AED program.

MAIN OUTCOME MEASURES

Motivations to participate in the AED program were explored using a qualitative descriptive approach.

RESULTS

Two overarching themes emerged: awareness of the program and decision to apply. Awareness was gained indirectly through grant advertising in newsletters/emails/web sites and directly through their sporting associations. For most organizations, there was no decision process per se, rather, the opportunity to apply was the key determinant for participating in the program. A duty of care also emerged as a key driving factor, with recognition of AEDs as a valuable asset to communities broadly, not just the participants' immediate sports setting. Reflecting on participation in the program, these participants identified that it was important to increase awareness about AED ownership and use. The program benefits were clearly summed up as being best prepared for a worst-case scenario.

DISCUSSION

This study provides new understanding of why community sports organizations apply for an AED and training. The strongest reason was simply the opportunity to acquire this at no cost. Therefore, for wider implementation of AEDs, additional funding opportunities, targeted awareness of these opportunities, and continued promotion of AED importance are recommended.

Injuries in Australian Rules Football: An Overview of Injury Rates, Patterns, and Mechanisms Across All Levels of Play

CONTEXT

The nature of Australian rules football (Australian football) predisposes both unique and common injuries compared with those sustained in other football codes. The game involves a combination of tackling, kicking, high-speed running (more than other football codes), and jumping. Two decades of injury surveillance has identified common injuries at the professional level (Australian Football League [AFL]).

OBJECTIVE

To provide an overview of injuries in Australian rules football, including injury rates, patterns, and mechanisms across all levels of play.

STUDY DESIGN

A narrative review of AFL injuries, football injury epidemiology, and biomechanical and physiological attributes of relevant injuries.

RESULTS

The overall injury incidence in the 2015 season was 41.7 injuries per club per season, with a prevalence of 156.2 missed games per club per season. Lower limb injuries are most prevalent, with hamstring strains accounting for 19.1 missed games per club per season. Hamstring strains relate to the volume of high-speed running required in addition to at times having to collect the ball while running in a position of hip flexion and knee extension. Anterior cruciate ligament injuries are also prevalent and can result from contact and noncontact incidents. In the upper limb, shoulder sprains and dislocations account for 11.5 missed games per club per season and largely resulted from tackling and contact. Concussion is less common in AFL than other tackling sports but remains an important injury, which has notably become more prevalent in recent years, theorized to be due to a more conservative approach to management. Although there are less injury surveillance data for non-AFL players (women, community-level, children), many of these injuries appear to also be common across all levels of play.

CLINICAL RELEVANCE

An understanding of injury profiles and mechanisms in Australian football is crucial in identifying methods to reduce injury risk and prepare players for the demands of the game.

Online news media reporting of football-related fatalities in Australia: A matter of life and death

OBJECTIVES

While deaths in sports settings are rare, they do occur. To develop an understanding of the sports and people most at risk, and to identify opportunities for prevention, routine and systematic data detailing the occurrence of these fatalities is required. There is currently no routine reporting of data of this nature in Australia. As there is often strong community interest in these incidents, the media offers an opportunity for surveillance. However before this can occur, understanding of the terminology used by the media is required. The aim of this study was to identify the terminology most frequently used in online Australian news media coverage of football-related deaths.

DESIGN

Retrospective review of online news media.

METHODS

Three databases were searched for online news media reports of people who died while participating in football (all football codes) in Australia. A descriptive analysis of terminology was undertaken to identify the common language applied.

RESULTS

Thirty-four football-related fatalities in Australia were identified between 2010-2016, via 149 separate articles. The most frequent terms identified in the media items were: Family; Club; Rugby; Football; Player; League; Died; Game; Death; Life; Loved; Hospital; Match; Young; Community; Playing; Friends; Sport; Heart; AFL [Australian Football League].

CONCLUSIONS

This study identified terminology used in reporting football-related fatalities in Australia, identifying common reference to terms relating to 'death' as metaphors and the frequent celebration of 'life.' The findings suggest that a reliance on researcher-generated terminology will be insufficient to reflect media discourse in prospective monitoring of sports deaths for surveillance.