title: Effectiveness of the women's lacrosse protective eyewear mandate in the reduction of eye injuries.
abstract: BACKGROUND
  In an effort to minimize the risk of catastrophic eye injury, US Lacrosse initiated mandatory use of protective eyewear in women's lacrosse in the 2004-2005 season.
  
  
  OBJECTIVE
  The authors compared eye injury rates in girls' scholastic lacrosse before and after implementation of protective eyewear. They also compared head/face injury rates, concussion rates, and overall injury rates before and after the rule change to assess possible unintended consequences of the change.
  
  
  METHODS
  Cohort study; Level of evidence, 3.
  
  
  METHODS
  The study group included female scholastic lacrosse players in the 25 public high schools in Fairfax County, Virginia, during the 2004-2009 spring seasons. Injury rates were compared with those from the same data source for the 2000-2003 seasons. Premandate versus postmandate injury rates were adjusted for athlete exposures, or total opportunities for injury throughout the season.
  
  
  RESULTS
  The rate of eye injuries was reduced from 0.10 injuries per 1000 athlete exposures (AEs) in 2000 through 2003 before the use of protective eyewear to 0.016 injuries per 1000 AEs in 2004 through 2009 (incident rate ratio [IRR], 0.16; 95% confidence interval [CI], 0.06-0.42). The rate ratio of head/face injuries excluding concussion also decreased (IRR, 0.44; 95% CI, 0.26-0.76). There was no change in the rate ratio of total injuries involving all body parts (IRR, 0.93; 95% CI, 0.82-1.1) after introduction of protective eyewear. However, the rate ratio of concussion increased (IRR, 1.6; 95% CI, 1.1-2.3).
  
  
  CONCLUSIONS
  The use of protective eyewear in women's lacrosse was associated with a reduction in the number of eye injuries. The number of head/face injuries decreased in this study group after introduction of protective eyewear, and there was no change in overall injury rates. The reason for the increase in concussion rate cannot be determined conclusively based on this study, but the authors speculate that this increase resulted largely from increased recognition and diagnosis because overall injury rates do not indicate rougher play with introduction of protective equipment.
authors.affiliation: MedStar Sports Medicine Research Center, Baltimore, Maryland, USA.
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Lincoln
authors.forename: Shane V
authors.initials: SV
authors.lastname: Caswell
authors.forename: Jon L
authors.initials: JL
authors.lastname: Almquist
authors.forename: Reginald E
authors.initials: RE
authors.lastname: Dunn
authors.forename: Mark V
authors.initials: MV
authors.lastname: Clough
authors.forename: Randall W
authors.initials: RW
authors.lastname: Dick
authors.forename: Richard Y
authors.initials: RY
authors.lastname: Hinton
mesh_terms: D001924:Brain Concussion / Q000453:epidemiology; D015331:Cohort Studies; D006259:Craniocerebral Trauma / Q000453:epidemiology; D005131:Eye Injuries / Q000517:prevention & control*; D005135:Eye Protective Devices; D005151:Facial Injuries / Q000453:epidemiology; D005260:Female; D006801:Humans; D015865:Racquet Sports / Q000293:injuries*