MedicalResearch.com Interview with:
Jingzhen (Ginger) Yang, PhD, MPH
Associate Professor, Center for Injury Research and Policy
The Research Institute at Nationwide Children’s Hospital
Dept. of Pediatrics, College of Medicine, The Ohio State University
Columbus, Ohio 43205
MedicalResearch.com: What is the background for this study?
Response: From 2009-2014, all 50 states and the District of Columbia passed their state TBI laws, more commonly known as concussion laws, to mitigate severe consequences of concussions.
These laws often include 3 core components:
(1) mandatory removal from play following actual or suspected concussions,
(2) requirements to receive clearance to return to play from a licensed health professional, and
(3) education of coaches, parents, and athletes regarding concussion symptoms and signs.
Our study aimed to evaluate whether the laws achieve the intended impact.
MedicalResearch.com: What are the main findings?
Response: The main findings showed that:
- The rates of new and recurrent concussions initially increase significantly after a law goes into effect. This is likely due to more people – athletes, athletic trainers, coaches, and parents – becoming aware of the signs and symptoms of concussion and actually reporting a potential or actual concussion. Lack of knowledge about concussion signs and symptoms may have resulted in underreporting of concussions during the prelaw period. This trend is consistent across sports in our study and other studies looking at youth sports-related concussions.
- The rate of recurrent concussions shows a significant decline approximately 2 ½ years after the law is in place. This demonstrates that the laws are having an impact. One of the core function of these laws is to reduce the immediate risk of health consequences caused by continued play with concussion or returning to play too soon without full recovery. The decline in recurrent concussion rates in our study is likely the results of the laws requirements of mandatory removal from play or permission requirements to return to play.
- Football had the highest average annual concussion rate, followed by girls’ soccer and boys’ wrestling. Males had a higher average annual concussion rate than females. However, when comparing the rates in gender comparable sports (basketball, soccer, baseball/softball), females had almost double the annual rate of concussions as males. These results are consistent with findings from other studies. It is possible that girls have higher risk of concussions than boys or are more likely to report injuries. Future studies are needed to look specifically at these disparities.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: The laws are getting people to report initial concussions and are reducing the rate of recurrent concussions. Our results, along with those of others, can be used as evidence for the need of more public health efforts that focus on preventing concussions in the first place, such as preventing or reducing initial head or body impact.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: As teams and school districts continue to implement state concussion laws, we expect the number of recurrent concussions to continue to decrease, and the number of “new concussions” to increase until full awareness is reached, then we expect them to begin a decrease, much like we’ve seen in recurrent concussions
We are comparing the content of these laws and concussion data between states to determine which laws seem to be strongest and which states have seen the most success in keeping their youth athletes healthy. As a result of these future studies, we hope to make recommendations to states on how to strengthen their concussion laws.
Disclosures: This study was funded by a grant from the Robert Wood Johnson Foundation’s Public Health Law Research program. Authors have no disclosures.
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Jingzhen Yang, R. Dawn Comstock, Honggang Yi, Hosea H. Harvey, Pengcheng Xun. New and Recurrent Concussions in High-School Athletes Before and After Traumatic Brain Injury Laws, 2005–2016. American Journal of Public Health, 2017; e1 DOI: 10.2105/AJPH.2017.304056
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