Heat, Cold, and Environmental Emergencies in Athletes

With the increase in outdoor events, there is an inevitable rise in climate-related environmental emergencies. Heat exposure can place athletes at risk for life-threatening heatstroke which requires emergent diagnosis and rapid in-field management. Cold exposure can lead to hypothermia, frostbite, and other nonfreezing injuries that require prompt evaluation and management to minimize morbidity and mortality. Altitude exposure can lead to acute mountain sickness or other serious neurologic or pulmonary emergencies. Finally, harsh climate exposure can be life-threatening and require appropriate prevention and event planning.

Socioeconomic status and injury history in adolescent athletes: Lower family affluence is associated with a history of concussion

Background

While healthcare and health outcome disparities have been studied across a variety of different injuries, their relation to concussion incidence and management are relatively understudied.

Aim

The aim of this study was to evaluate the association between history of concussion or musculoskeletal injury, and family affluence and/or school-level measures of socioeconomic status.

Methods

We conducted a cross-sectional study of adolescent athletes in a local school district. Adolescent athletes (n = 192; mean age = 15.3, SD = 1.6 years; 49% female), who presented for a pre-participation physical evaluation reported concussion and injury history, and family affluence scale (FAS) scores. We also examined the percent of students on free/reduced lunch at each school compared to state averages. Independent variables, individual FAS score and school-based marker of socioeconomic status, were compared between those with and without a history of concussion and time-loss musculoskeletal injury.

Results

Of the participants, 40 (21%) reported a history of concussion. Athletes with a concussion history had significantly lower FAS scores than athletes without a history of concussion (mean difference = 0.7, 95%CI = 0.1, 1.4; P = 0.027). There was no significant difference in FAS scores between those with and without a history of time-loss musculoskeletal injury (mean difference = 0.0, 95% CI = -0.5, 0.5; P = 0.97). Athletes with a history of concussion had a higher proportion of a prior time-loss musculoskeletal injury (68% vs. 32%; P < 0.001). After adjusting for age, school free-reduced lunch rate, and history of musculoskeletal injury, a lower FAS score was associated with concussion history (adjusted odds ratio = 0.79; 95% CI = 0.64, 0.96; P = 0.019). Concussion and musculoskeletal injury were not associated with school-level markers of socioeconomic status.

Conclusion

Lower individual measures, but not school-level measures, of socioeconomic status were associated with a history of concussion in our sample of adolescent athletes.

Relevance for Patients

Enhance providers' understanding of how socioeconomic factors may impact concussion history and empower providers to adequately screen for and provide concussion education to mitigate disparities.

How to help runners steer clear of injury

Assess risk factors, then work to address modifiable ones, such as wearing the right running shoes and building up slowly. Don't let overweight or OA dampen enthusiasm.