In recent years, public interest has increased surrounding concussions/mild traumatic brain injuries (MTBI). This is due in large part to the recent hypothesis that concussive forces from contact sports may be a risk factor for the development of chronic traumatic encephalopathy (CTE), a disease seen most often in former boxers and professional football players.

Research, legislation, and documentaries have sought to better define the incidence and risks of concussions, its relationship to these 2 diseases, and to increase public awareness of this issue. Currently, legislation is pending in both the U.S. House of Representatives and the Senate that has the potential to further achieve these goals by increasing general awareness about concussions and giving parents and youth the ability to make informed decisions about the sports in which they participate. We as pediatricians can advocate for the safety of our patients by contacting our local representatives and asking them to become cosponsors for the “SAFE PLAY Act” (H.R. 829).

Although concussions have been reported in other sports, American football reigns supreme in both its popularity and in the severity and incidence of the concussions it produces. Approximately 1.1 million high school football players and 250,000 pop warner youth players (5 to 15 years old) participate in this sport nationwide. This is especially significant considering that 40% of sports-related concussions involved children between the ages of 8 and 13 and that 50% of “second impact syndrome” incidents resulted in death. In football specifically, this risk is undoubtedly related to the speed and force at which players often crash into each other, with accelerometers measuring forces >12.2g per impact with a mean of 774 impacts per player per season.

In response to recent developments, the AAP has issued policy statements to increase awareness of the symptoms of concussions, how to manage it, and recommendations on how to reduce its incidence, particularly as it relates to American football. Although these guidelines are important, support from the CDC and our federal government to increase awareness of this disease would be another major step in protecting the lives of our patients both now and in the future.

U.S. House Bill 829 (companion Senate Bill 436) provides an essential part of this support by requiring the CDC to develop a safety and management plan for concussions, requiring public schools to post information about symptoms of a concussion, prohibiting students from re-entering an activity after a concussion, and requiring a concussion management team to ensure the student is cared for according to protocol. In addition, the Bills also address other important topics including awareness and education about energy drinks, heat exposure, and emergency interventions for cardiac conditions in youth.  Pediatricians should call or write their US Representative and their Senators regarding the importance of this legislation.

My hope is that with an increased awareness of this condition and more research into the long-term consequences of repetitive MTBI’s/concussions, we will be able to empower communities to better care for children with concussions and truly give our patients informed consent regarding the sport of American football.

Nick Brown, MD

 

References:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945234/

http://pediatrics.aappublications.org/content/126/3/597

https://www.aap.org/en-us/advocacy-and-policy/state-advocacy/Documents/Concussion.pdf

http://www.aappublications.org/content/early/2015/10/25/aapnews.20151025-1

http://pediatrics.aappublications.org/content/136/5/e1419#ref-35

http://thomas.loc.gov/home/thomas.php