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Newsday (New York)
Nearly 1 in 5 teenagers who participate in sports has been diagnosed at least once with a concussion, and nearly 6 percent of them reported head trauma multiple times, medical investigators reported Tuesday.
The statistics provide a broad context to help schools and parents grasp the relatively high rate of sports-related concussions and helps lay the groundwork for safety discussions, researchers said.
The report is the second in just days to highlight concussions among student athletes.
Head trauma is a growing public health concern, but medical investigators say the amount of information on concussion - especially repeated concussions - among student athletes has been limited.
A University of Michigan research team conducted the latest analysis, which involved 13,088 boys and girls in grades eight, 10 and 12 who responded to a questionnaire as part of the 2016 Monitoring the Future survey, an annual in-school assessment of U.S. students.
The research team concluded the prevalence of concussion is much higher than suggested previously by data compiled from emergency departments. The stats also go beyond the number of sports examined in a study published last week by researchers at Boston University's Chronic Traumatic Encephalopathy Center, which focused on youth football. Results of the Michigan analysis are published as a research letter in the Journal of the American Medical Association, which is due out Wednesday.
"While participation in contact sports can provide numerous health benefits and a way to build confidence and leadership, there is always the risk of concussion," said Dr. Robert Glatter, a former sideline physician for the Jets and director of sports medicine and traumatic brain injury at Lenox Hill Hospital in Manhattan. He was not involved in the new research.
"We also know that between the ages of 10 and 12, the brain is undergoing significant maturation and development. Significant and repetitive trauma at this stage may affect not only brain chemistry and structure, but may lead to long-term neurodegenerative change," added Glatter, who also is an assistant professor of medicine at Zucker School of Medicine at Hofstra/Northwell.
"As a result, it's best to limit pure collision sports such as football in this age range, replacing it with flag football, until the brain is more fully developed," Glatter said.
In the new analysis, researchers examined participation across a wide range of activities including contact, semi-contact and no-contact sports, such as swimming and tennis, said Philip Veliz, lead author of the nationwide survey.
Youth athletes were most at risk of repeated concussions when they participated in football, ice hockey and wrestling, Veliz said. Student athletes need to know the importance of getting out of a game and not playing hurt, he said.
"Kids should not be afraid to say, 'I hit my head,' " Veliz said.
His study examined concussion among a variety of populations: 47 percent of respondents were white, 19 percent were Hispanic and 13 percent were black.
Over the past two years, Newsday has examined the issue of head safety at the 116 public and private high schools on Long Island with football programs. The newspaper obtained concussion reports for the 2014 and 2015 seasons via Freedom of Information Act requests.
In 2015, there were 383 suspected concussions reported among the 109 high schools who responded to Newsday's request. There were 373 suspected concussions at 105 schools that responded in 2014. Private schools are not required by law to respond.
Dr. Raj K. Narayan, chief of neurosurgery at North Shore University Hospital in Manhasset, said a single concussion usually is not a worrisome event.
"The majority of people get over it," said Narayan, who also is executive director of the Northwell Health Neuroscience Institute. Headache, dizziness and nausea are symptoms associated with a concussion, he said. Repeated head trauma, Narayan added, is another matter entirely.
"I think it is becoming clearer that multiple injuries can have a cumulative effect," he said.
Although he cited concerns with the current research because it relied on students' recall of a medical diagnosis, Narayan said it is important to understand problems associated with head trauma.
Repeat concussions can increase the risk of chronic traumatic encephalopathy - CTE - according to data from the Centers for Disease Control and Prevention. The degenerative brain disease, which impairs memory and personality, has been reported among former professional football players and boxers.
Narayan said a growing body of research suggests that some people may be genetically predisposed to the condition.
Dr. Robin Smith, a pediatric neurologist at NYU Langone Huntington Medical Group, said the good news for Long Island is that "there is pretty good awareness, in my experience, that a lot of the schools, coaches and parents have an increased level of awareness about traumatic head injury."
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