Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives.
OBJECTIVE
To summarize 16 years of National Collegiate Athletic Association (NCAA) injury surveillance data for 15 sports and to identify potential modifiable risk factors to target for injury prevention initiatives.


BACKGROUND
In 1982, the NCAA began collecting standardized injury and exposure data for collegiate sports through its Injury Surveillance System (ISS). This special issue reviews 182 000 injuries and slightly more than 1 million exposure records captured over a 16-year time period (1988-1989 through 2003-2004). Game and practice injuries that required medical attention and resulted in at least 1 day of time loss were included. An exposure was defined as 1 athlete participating in 1 practice or game and is expressed as an athlete-exposure (A-E).


RESULTS
Combining data for all sports, injury rates were statistically significantly higher in games (13.8 injuries per 1000 A-Es) than in practices (4.0 injuries per 1000 A-Es), and preseason practice injury rates (6.6 injuries per 1000 A-Es) were significantly higher than both in-season (2.3 injuries per 1000 A-Es) and postseason (1.4 injuries per 1000 A-Es) practice rates. No significant change in game or practice injury rates was noted over the 16 years. More than 50% of all injuries were to the lower extremity. Ankle ligament sprains were the most common injury over all sports, accounting for 15% of all reported injuries. Rates of concussions and anterior cruciate ligament injuries increased significantly (average annual increases of 7.0% and 1.3%, respectively) over the sample period. These trends may reflect improvements in identification of these injuries, especially for concussion, over time. Football had the highest injury rates for both practices (9.6 injuries per 1000 A-Es) and games (35.9 injuries per 1000 A-Es), whereas men's baseball had the lowest rate in practice (1.9 injuries per 1000 A-Es) and women's softball had the lowest rate in games (4.3 injuries per 1000 A-Es).


CONCLUSIONS
In general, participation in college athletics is safe, but these data indicate modifiable factors that, if addressed through injury prevention initiatives, may contribute to lower injury rates in collegiate sports.
Hootman
Jennifer M
JM
Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. jhootman@cdc.gov
Dick
Randall
R
Agel
Julie
J
D001265:Athletic Injuries / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D017410:Practice Guidelines as Topic; D012574:Schools / Q000706:statistics & numerical data*; D013177:Sports / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
Med Sci Sports Exerc. 2005 Aug;37(8):1421-30
16118592
Clin J Sport Med. 2005 Sep;15(5):398
16163002
Am J Sports Med. 1995 Nov-Dec;23(6):694-701
8600737
Med Sci Sports Exerc. 2005 Apr;37(4):635-41
15809563
Arch Orthop Trauma Surg. 2005 Nov;125(9):614-21
15703919
Cochrane Database Syst Rev. 2001;(3):CD000018
11686947
Am J Sports Med. 2004 Sep;32(6):1385-93
15310562
J Athl Train. 1999 Apr;34(2):86-92
16558564
Clin J Sport Med. 2000 Oct;10(4):291-6
11086757
Exerc Sport Sci Rev. 2006 Jul;34(3):135-41
16829741
Sports Med. 1992 Aug;14(2):82-99
1509229
J Athl Train. 2007 Apr-Jun;42(2):173-82
21714302
Am J Sports Med. 2003 Nov-Dec;31(6):831-42
14623646
Neurosurgery. 2006 Feb;58(2):275-86; discussion 275-86
16462481
Arch Dis Child. 1999 Oct;81(4):324-8
10490437
J Athl Train. 2004 Mar;39(1):95-100
15085217
BMJ. 2005 Feb 26;330(7489):449
15699058
Br J Sports Med. 2005 Feb;39(2):111-5
15665210
Sports Med. 2007;37(1):73-94
17190537