title: Violence in Canadian amateur hockey: the experience of referees in Ontario.
abstract: OBJECTIVE
  To determine the perceptions and roles of referees about violence and injury in hockey games.
  
  
  METHODS
  Questionnaire.
  
  
  METHODS
  Web-based survey.
  
  
  METHODS
  We contacted referees across Canada from various leagues and all levels of play, with the majority of respondents from Ontario (92%).
  
  
  METHODS
  We gathered demographic information anonymously and posed questions on aggression and experience in hockey games.
  
  
  RESULTS
  The majority of referees (n = 632) indicated that violence is a serious concern to both players and referees at all levels of hockey. More than 90% of referees responded that they were the recipients of aggression and anger (92.1%, 95% confidence interval, 90.0-94.2), 55% had been involved in hockey games where aggressive behavior resulted in the referee losing control of the game, and 71% said that this increased aggression leads to injury. Referees' opinions are that the coach is the most responsible for managing on-ice safety (63%). To improve hockey safety, referees suggest education and more rigorous enforcement of discipline for all participants.
  
  
  CONCLUSIONS
  Referees are important for hockey safety and need to be appropriately supported. Referees believe that increased aggression can lead to injury and that rules need to be enforced more diligently. Referees recommend that increased education about safety is needed to guide parents, coaches, and players to make hockey safer.
authors.affiliation: Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. alun.ackery@utoronto.ca
authors.forename: Alun D
authors.initials: AD
authors.lastname: Ackery
authors.forename: Charles H
authors.initials: CH
authors.lastname: Tator
authors.forename: Carolyn
authors.initials: C
authors.lastname: Snider
mesh_terms: D000328:Adult; D000374:Aggression; D000786:Anger; D056352:Athletes; D005260:Female; D006688:Hockey / Q000293:injuries*; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009864:Ontario; D012449:Safety; D011795:Surveys and Questionnaires; D014705:Verbal Behavior; D014754:Violence / Q000706:statistics & numerical data*