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Sports concussions in youth a public health issue: paper

kidsoccer.jpgSept. 3, 2014 – Sports-related concussions in children and youth constitute a significant public health issue that requires serious reform in public policy to address the harm associated with them, a new Canadian paper argues.

The article, which appeared in Neurosurgeon, an online publication of the American Association of Neurological Surgeons, suggests there is an ethical responsibility to take action on the issue.


September 3, 2014
By Diana Mehta The Canadian Press

Topics

“It’s not a sport issue, it’s not just a medical issue, it’s a public
health issue which affects the population as a whole and it’s been
identified that way – it’s research based, it’s epidemiologically backed
and it has facts behind it,” said Dr. Paul Echlin, who runs a sports
medicine clinic in Burlington, Ont.

Echlin, who co-authored the
article with Dr. Ross Upshur, director of clinical research at Toronto’s
Bridgepoint Health, said there’s a need to make an “urgent statement”
on sports-related concussions in children and youth, which the World
Health Organization classifies as minor traumatic brain injuries.

“We
really have to move on this now,” said Echlin. “There’s no helmets or
mouth guards or safety devices that can change this, it is about a shift
in the way that we allow our youth to play games.”

The article
notes that the U.S. Centers for Disease Control labelled sports-related
concussions a public health problem in 2003, but youth continue to
suffer “often preventable brain injuries” while playing sports.

“If
you know what’s going on and you refuse to do anything major or
significant about it, then you’re ethically wrong,” said Echlin.

“It
shouldn’t be silent anymore, it is an epidemic in our youth culture, in
sport. Sport was made to… improve the culture of fitness, and
socially, but not to cause long-term impairment, not to promote violence
which is the underlying factor of a lot of these head injuries.”

To
deal with concussions as a public health issue, the article suggests
“dramatic rule changes” be made to games children play to “eliminate all
purposeful and intentional head contact” while also minimizing
incidental head contact.

It also suggests increasing the size of
playing surfaces to lower the chances of collisions in sports,
decreasing the number of participants on a field of play and considering
the elimination of the use of the head in games like soccer.

The
article goes on to suggest enforcing significant suspensions to
participants or supervising adults who are involved in games in which
head injuries occur. Youth who do suffer concussions must also be given
appropriate time to recover, Echlin added.

The paper further
underlines the importance of publicly funded education on concussions
for the next generation of athletes, parents and educators, highlighting
an example in Ontario, where the province’s education ministry has
mandated publicly funded schools to institute concussion curriculum
education from all students Grade One to 12.

“You’re going to
educate the 10-year-old to say ‘yes there is a big problem here’ and to
give them the ability to advocate for themselves and others to say ‘I
got hit, I don’t feel well, I’m going to take myself off the field,’”
said Echlin.

“Handing out pamphlets and stuff, it doesn’t work.
But what does work is getting the kids involved and getting them to make
their own decisions, and also continuing dialogue with parents.”

Alison
Macpherson, an assistant professor of kinesiology and health sciences
at York University in Toronto, agreed that sports-related concussion in
children and youth requires action, but urged parents not to pull their
children from sports altogether.

“We need to protect kids, we
also have to be very careful not to scare parents and kids away from
sports,” she said. “Learning how to play sports is also part of healthy
child development.”

Macpherson drew a parallel to smoking, saying
it often takes a long time to alter people’s perceptions about the risk
of certain activities.

“Health behaviours take a long time to
change but I think we have the obligation as professionals to continue
to work at this in every setting.”


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