ACSM and CHAMP summit on sickle cell trait: mitigating risks for warfighters and athletes.
BACKGROUND
An estimated 300 million people worldwide have sickle cell trait (SCT). Although largely benign, SCT has been associated with exertional rhabdomyolysis and exercise-related sudden death in warfighters/athletes (WA). The National Collegiate Athletic Association's policy to confirm a student athlete's SCT status during their preparticipation medical examination prompted reaction from some organizations regarding the rationale and ethical justification of the policy.


METHODS
On September 26 and 27, 2011, a summit, composed of military and civilian experts in sports medicine and SCT, was convened at the Uniformed Services University in Bethesda, MD. The expert panel was charged with two objectives: 1) to provide specific recommendations to further mitigate the apparent risk with strenuous exercise in WA with SCT and 2) to develop clinical guidelines to identify, treat, and return to duty/play WA suspected to have incurred nonfatal sickle cell collapse.


RESULTS
New terminology is introduced, areas of current controversy are explored, consensus recommendations for mitigating risk and managing the WA with SCT are reviewed, and important areas for future research are identified.


CONCLUSIONS
Further research is needed before conclusions can be drawn regarding the etiology of the increased death rate observed in WA with SCT, and the possibility exists that SCT is a surrogate for as yet another contributing factor for the unexplained deaths.
Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA. francis.oconnor@usuhs.edu
Francis G
FG
O'Connor
Michael F
MF
Bergeron
Joyce
J
Cantrell
Philippe
P
Connes
Kimberly G
KG
Harmon
Edward
E
Ivy
John
J
Kark
Dave
D
Klossner
Peter
P
Lisman
Bryce K
BK
Meyers
Karen
K
O'Brien
Kwaku
K
Ohene-Frempong
Alexis A
AA
Thompson
James
J
Whitehead
Patricia A
PA
Deuster
D005260:Female; D006801:Humans; D008297:Male; D056352:Athletes; D054874:Athletic Performance; D003645:Death, Sudden / Q000209:etiology / Q000517:prevention & control; D008889:Military Personnel; D005082:Physical Exertion / Q000502:physiology; D040242:Risk Reduction Behavior; D012577:Schools, Medical; D012805:Sickle Cell Trait / Q000150:complications / Q000175:diagnosis; D014481:United States; D017410:Practice Guidelines as Topic