title: Concussion Characteristics in High School Football by Helmet Age/Recondition Status, Manufacturer, and Model: 2008-2009 Through 2012-2013 Academic Years in the United States.
abstract: Football helmets used by high school athletes in the United States should meet the National Operating Committee on Standards for Athletic Equipment performance standards. Despite differences in interior padding and exterior shells, all football helmets should provide comparable protection against concussions. Yet, debate continues on whether differences in the rates or severity of concussions exist based on helmet age/recondition status, manufacturer, or model.
  
  
  
  To investigate whether high school football concussion characteristics varied by helmet age/recondition status, manufacturer, and model.
  
  
  
  Descriptive epidemiological study.
  
  
  
  High school football concussion and helmet data were collected from academic years 2008-2009 through 2012-2013 as part of the National High School Sports-Related Injury Surveillance Study. The certified athletic trainers of participating schools submitted athlete-exposure (AE) and injury information weekly.
  
  
  
  Participating schools reported 2900 football concussions during 3,528,790 AEs for an overall rate of 8.2 concussions per 10,000 AEs. Concussion rates significantly increased from 2008-2009 through 2012-2013 overall (P = .006) as well as in competition (P = .027) and practice (P = .023). Characteristics of concussed football players (ie, mean number of symptoms, specific concussion symptoms, symptom resolution time, and time until return to play) were similar among players wearing new helmets when compared with reconditioned helmets. Fewer players wearing an old/not reconditioned helmet had concussion symptoms resolve within 1 day compared with players wearing a new helmet. Despite differences in the manufacturers and models of helmets worn by all high school football players compared with players who sustained a concussion, the mean number of concussion symptoms, specific concussion symptoms, symptom resolution time, and time until return to play were similar for concussions sustained by football players wearing the most common helmet manufacturers and models.
  
  
  
  Overall, for new and reconditioned football helmets, the most common helmet manufacturers and models on the market today appear to provide high school football players with similar protection against concussions.
  
  
  
  Concussions can have serious acute and long-term effects. An understanding of concussion patterns in high school athletes can drive targeted preventive measures, including improvements to and/or better use of protective equipment, to reduce the incidence and/or severity of sports-related concussions.
authors.affiliation: OhioHealth Research and Innovation Institute, Columbus, Ohio, USA christy.collins@ohiohealth.com.
authors.forename: Christy L
authors.initials: CL
authors.lastname: Collins
authors.affiliation: Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio, USA Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Lara B
authors.initials: LB
authors.lastname: McKenzie
authors.affiliation: Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Amy K
authors.initials: AK
authors.lastname: Ferketich
authors.affiliation: Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Andridge
authors.affiliation: Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Huiyun
authors.initials: H
authors.lastname: Xiang
authors.affiliation: Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, USA Pediatric Emergency Medicine, School of Medicine, University of Colorado Anschutz, Aurora, Colorado, USA.
authors.forename: R Dawn
authors.initials: RD
authors.lastname: Comstock
mesh_terms: D000293:Adolescent; D056352:Athletes / Q000706:statistics & numerical data; D001924:Brain Concussion / Q000453:epidemiology* / Q000209:etiology; D005538:Football / Q000293:injuries*; D006260:Head Protective Devices / Q000592:standards*; D006801:Humans; D008297:Male; D012574:Schools; D013334:Students / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
keywords: adolescent; concussion; football; helmet