A comparison of catastrophic injury incidence rates by Provincial Rugby Union in South Africa.
OBJECTIVE
To compare catastrophic injury rates between the 14 South African Provincial Rugby Unions.


METHODS
A prospective, population-based study conducted among all South African Unions between 2008-2014.


METHODS
Player numbers in each Union were obtained from South African Rugby's 2013 Census. Catastrophic injuries were analysed from BokSmart's serious injury database. Incidence rates with 95% Confidence Intervals were calculated. Catastrophic injuries (Acute Spinal Cord Injuries and catastrophic Traumatic Brain Injuries) within Unions were compared statistically, using a Poisson regression with Incidence Rate Ratios (IRR) and a 95% confidence level (p<0.05).


RESULTS
Catastrophic injury incidence rates per Union ranged from 1.8 per 100000 players (95% CI: 0.0-6.5) to 7.9 (95% CI: 0.0-28.5) per 100000 players per year. The highest incidence rate of permanent outcome Acute Spinal Cord Injuries was reported at 7.1 per 100000 players (95% CI: 0.0-17.6). Compared to this Union, five (n=5/14, 36%) of the Unions had significantly lower incidence rates of Acute Spinal Cord Injuries. Proportionately, three Unions had more Acute Spinal Cord Injuries and three other Unions had more catastrophic Traumatic Brain Injuries.


CONCLUSIONS
There were significant differences in the catastrophic injury incidence rates amongst the Provincial Unions in South Africa. Future studies should investigate the underlying reasons contributing to these provincial differences.
Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, UCT, South Africa; Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and EMGO+ Institute, VU University Medical Center, The Netherlands. Electronic address: marelise@physiomb.co.za.
Marelise
M
Badenhorst
Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, UCT, South Africa; Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and EMGO+ Institute, VU University Medical Center, The Netherlands.
Evert A L M
EALM
Verhagen
Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, UCT, South Africa; Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and EMGO+ Institute, VU University Medical Center, The Netherlands.
Willem
W
van Mechelen
Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, UCT, South Africa; Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and EMGO+ Institute, VU University Medical Center, The Netherlands.
Michael I
MI
Lambert
Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, UCT, South Africa; South African Rugby Union (SA Rugby), South Africa.
Wayne
W
Viljoen
Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, UCT, South Africa; South African Rugby Union (SA Rugby), South Africa.
Clint
C
Readhead
Chris Burger/Petro Jackson Players' Fund, South Africa.
Gail
G
Baerecke
Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, UCT, South Africa; Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and EMGO+ Institute, VU University Medical Center, The Netherlands.
James C
JC
Brown
D001265:Athletic Injuries / Q000453:epidemiology*; D000070642:Brain Injuries, Traumatic / Q000453:epidemiology*; D005538:Football / Q000293:injuries*; D006801:Humans; D015994:Incidence; D011446:Prospective Studies; D013019:South Africa / Q000453:epidemiology; D013119:Spinal Cord Injuries / Q000453:epidemiology*
Brain injuries; Football; Prospective studies; Spinal cord injuries