Key result
Using hours of participation as exposure, football had a higher rate of emergency department-treated injuries (5.08 per 10,000 hours) than basketball (2.69) or soccer (2.69).
Why the study?
Does the choice of denominator (U.S. population vs. hours of participation) affect the calculated risk of emergency department-treated injury in basketball, football, and soccer players?
Observational
Does the choice of denominator (U.S. population vs. hours of participation) affect the calculated risk of emergency department-treated injury in basketball, football, and soccer players?
Using hours of participation as the denominator provides a more accurate measure of exposure for sports injuries, revealing that football has a higher injury rate than basketball or soccer.
Hours-based denominators better quantify sport-specific injury risk than population metrics; leaves open effects on prevention priorities.
CONTEXT: A major challenge in the field of sports injury epidemiology is identifying the appropriate denominators for injury rates. OBJECTIVE: To characterize risk of injury from participation in basketball, football, and soccer in the United States, using hours of participation as the measure of exposure, and to compare these rates with those derived using population estimates in the denominator. DESIGN: Descriptive epidemiology study. SETTING: United States, 2003-2007. PARTICIPANTS: People ages 15 years and older who experienced an emergency department-treated injury while playing basketball, football, or soccer. MAIN OUTCOME MEASURE(S): Rates of emergency department-treated injuries resulting from participation in basketball, football, or soccer. Injury rates were calculated for people ages 15 and older for the years 2003-2007 using the U.S. population and hours of participation as the denominators. The risk of injury associated with each of these sports was compared for all participants and by sex. RESULTS: From 2003 through 2007, annual injury rates per 1000 U.S. population were as follows: 1.49 (95% confidence interval [CI] = 1.30, 1.67) in basketball, 0.93 (95% CI = 0.82, 1.04) in football, and 0.43 (95% CI = 0.33, 0.53) in soccer. When the denominator was hours of participation, the injury rate in football (5.08 [95% CI = 4.46, 5.69]/10 000 hours) was almost twice as high as that for basketball (2.69 [95% CI = 2.35, 3.02]/10 000 hours) and soccer (2.69 [95% CI = 2.07, 3.30]/10 000 hours). CONCLUSIONS: Depending on the choice of denominator, interpretation of the risk of an emergency department-treated injury in basketball, football, or soccer varies greatly. Using the U.S. population as the denominator produced rates that were highest in basketball and lowest in soccer. However, using hours of participation as a more accurate measure of exposure demonstrated that football had a higher rate of injury than basketball or soccer for both males and females.
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Carter et al. (2011) conducted an observational in Sports injuries. Sports participation (basketball, football, soccer) was evaluated on Rates of emergency department-treated injuries. Using hours of participation as exposure, football had a higher rate of emergency department-treated injuries (5.08 per 10,000 hours) than basketball (2.69) or soccer (2.69).
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