Communication access and contact-related injuries among deaf and hard-of-hearing sports participants: an event-level survey study

Background Deaf and hard-of-hearing (D/HH) individuals participate in both deaf sports and mainstream sports. Access to auditory cues, verbal instructions, and communication may affect safety, particularly during contact with another person or with sports equipment or facilities. This study examined the association between hearing/communication-related circumstances and contact-related injury among sports-related injury events reported by D/HH participants. Methods This retrospective cross-sectional online survey conducted in Japan included D/HH adults aged ≥18 years with sports experience. Injury events reported by participants with at least one sports-related injury were analyzed. Contact-related injury was operationally defined as an injury involving contact with another person or with sports equipment or facilities. Explanatory variables were sport contact category, self-reported hearing/communication-related circumstances at the time of injury, and hearing-device non-use. Hearing/communication-related circumstances were defined as reports of either unavailable auditory information or insufficient communication with others. Logistic regression using generalized estimating equations accounted for multiple injury events per participant. Results Overall, 228 sports-related injuries were reported by 136 participants. Among 191 events with available contact status, 82 (42.9%) were contact-related injuries, and hearing/communication-related circumstances were reported in 37 of 228 events (16.2%). In the adjusted model of 178 events from 106 participants, contact/limited-contact sport was significantly associated with contact-related injury [odds ratio [OR], 10.89; 95% confidence interval [CI], 3.57–33.17; P < 0.001]. Hearing/communication-related circumstances were significantly associated with contact-related injury (OR, 9.57; 95% CI, 2.12–43.10; P = 0.003), whereas hearing-device non-use was not significantly associated with contact-related injury (OR, 1.19; 95% CI, 0.59–2.41; P = 0.623). Conclusion Among reported injury events in D/HH participants, hearing/communication-related circumstances were associated with contact-related injury, whereas hearing-device non-use was not significantly associated. Wide 95% CIs indicate uncertainty in the magnitudes of these associations. This exploratory event-level analysis did not estimate injury incidence, assess determinants of injury occurrence in the broader D/HH population, or establish causality. The findings suggest that sports safety strategies should consider effective information sharing and communication alongside hearing-device use. Generalizability beyond D/HH sporting contexts in Japan remains uncertain.