title: Policy change eliminating body checking in non-elite ice hockey leads to a threefold reduction in injury and concussion risk in 11- and 12-year-old players.
abstract: BACKGROUND
  In ice hockey, body checking is associated with an increased risk of injury. In 2011, provincial policy change disallowed body checking in non-elite Pee Wee (ages 11-12 years) leagues.
  
  
  OBJECTIVE
  To compare the risk of injury and concussion between non-elite Pee Wee ice hockey players in leagues where body checking is permitted (2011-12 Alberta, Canada) and leagues where policy change disallowed body checking (2011-12 Ontario, Canada).
  
  
  METHODS
  Non-elite Pee Wee players (lower 70%) from Alberta (n=590) and Ontario (n=281) and elite Pee Wee players (upper 30%) from Alberta (n=294) and Ontario (n=166) were recruited to participate in a cohort study. Baseline information, injury and exposure data was collected using validated injury surveillance.
  
  
  RESULTS
  Based on multiple Poisson regression analyses (adjusted for clustering by team, exposure hours, year of play, history of injury/concussion, level of play, position and body checking attitude), the incidence rate ratio (IRR) associated with policy allowing body checking was 2.97 (95% CI 1.33 to 6.61) for all game injury and 2.83 (95% CI 1.09 to 7.31) for concussion. There were no differences between provinces in concussion [IRR=1.50 (95% CI 0.84 to 2.68)] or injury risk [IRR=1.22 (95% CI 0.69 to 2.16)] in elite levels of play where both provinces allowed body checking.
  
  
  CONCLUSIONS
  The rate of injury and concussion were threefold greater in non-elite Pee Wee ice hockey players in leagues where body checking was permitted. The rate of injury and concussion did not differ between provinces in elite levels, where body checking was allowed.
authors.affiliation: Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Black
authors.affiliation: Faculty of Health, School of Kinesiology & Health Science, York University, Toronto, Ontario, Canada.
authors.forename: Alison K
authors.initials: AK
authors.lastname: Macpherson
authors.affiliation: Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Brent E
authors.initials: BE
authors.lastname: Hagel
authors.affiliation: Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Romiti
authors.affiliation: Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Luz
authors.initials: L
authors.lastname: Palacios-Derflingher
authors.affiliation: Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Jian
authors.initials: J
authors.lastname: Kang
authors.affiliation: Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Willem H
authors.initials: WH
authors.lastname: Meeuwisse
authors.affiliation: Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada Department of Pediatrics, Alberta Children's Hospital Research Institute for Child & Maternal Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Emery
mesh_terms: D000416:Alberta; D001265:Athletic Injuries / Q000517:prevention & control; D001924:Brain Concussion / Q000517:prevention & control*; D002648:Child; D015331:Cohort Studies; D005260:Female; D006291:Health Policy; D006688:Hockey / Q000293:injuries* / Q000331:legislation & jurisprudence; D006801:Humans; D008297:Male; D009864:Ontario; D012307:Risk Factors
keywords: Hockey; Risk factor