Epidemiology of Rare Injuries and Conditions Among United States High School Athletes During the 2005-2006 and 2006-2007 School Years

Context: Although more than 7 million athletes participate in high school sports in the United States, to date no nationally representative studies of rare injuries and conditions (RICs) exist. Rare injuries and conditions include eye injuries, dental injuries, neck and cervical injuries, and dehydration and heat illnesses. Objective: To describe the epidemiology of RICs sustained by high school athletes during the 2005-2006 and 2006-2007 school years. Design: Prospective cohort study. Setting: A nationally representative sample of 100 US high schools using an injury surveillance system, High School Reporting Information Online. Patients or Other Participants: Athletes participating in football, boys' soccer, girls' soccer, volleyball, boys' basketball, girls' basketball, wrestling, baseball, or softball at one of the 100 participating high schools. Main Outcome Measure(s): We reviewed all RICs to calculate injury rates and to identify potential risk factors and preventive measures. Results: A total of 321 RICs were sustained during 3 550 141 athlete-exposures (AEs), for an injury rate of 9.04 RICs per 100000 AEs. This represents an estimated 84223 RICs sustained nationally. The RICs accounted for 3.5% of all high school athletes' injuries. The most common diagnoses were neck and cervical injuries (62.0%, n = 199) and dehydration and heat illnesses (18.7%, n = 60). Football had the highest RIC rate per 100000 AEs (21.2), followed by wrestling (15.2) and baseball (7.60). The RICs occurred at a higher rate in boys (12.4) than in girls (2.51) (rate ratio = 4.93; 95% confidence interval = 3.39, 7.18). The majority of RICs (67.3%, n = 216) permitted athletes to return to play within 1 week of diagnosis. Conclusions: The RIC injury rates varied by sport and sex and represented almost 100 000 potentially preventable injuries to high school athletes. Because of the potentially serious consequences, future researchers must develop and implement more effective preventive measures to aid certified athletic trainers in decreasing the RIC incidence among high school athletes.