ORIGINAL PAPER
The public health impact of injury during sport and active recreation

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Summary

Injuries can be an adverse outcome of participation in sport and recreational activities. The aim of this study was to determine the public health impact of injury during sports and active recreation injury in a select population in Australia. A random household telephone survey was conducted quarterly over a 12-month period in a well-defined geographic region, the Latrobe Valley, Australia. Information was collected on participation in sport and active recreation and associated injuries over the previous 2 weeks for all household members aged over 4 years. Injury rates were calculated per 10,000 population and per 1000 sports participants. Data were collected on 1084 persons from 417 households. Overall, 648 people reported participating in at least one sport or active recreation and 34 (5.2%, 95% CI: 4.8, 5.6%) of these sustained an injury during this activity. Overall, 51.4% of injured cases had a significant impact: 26.5% sought treatment, 34.4% had their activities of daily living adversely affected and 36.0% had their performance/participation limited. Cricket (51 injuries/10,000 population), horse riding (29/10,000 population) and basketball (25/10,000 population) had the highest injury rates. After adjusting for participation, cricket (242 injuries/1000 participants), horse riding (122/1000 participants) and soccer (107/1000 participants) had the highest injury rates. Cricket and soccer were the sports most associated with ‘significant’ injuries. Injury prevention efforts should be aimed at team ball sports (especially cricket, soccer and netball) because of their comparatively high rate of both overall and ‘significant’ injury.

Introduction

Sports injuries have been identified as a major public health problem in Australia and internationally.1, 2, 3, 4, 5, 6, 7, 8 However, national coordinated efforts to prevent these injuries have been hampered by the lack of accurate and comprehensive incidence data at the broad population level. The use of injury frequency data alone to assess the relative risk of injury across different sports leads to erroneous conclusions.9, 10 Sports with the highest number of participants will tend have the highest frequency of injury, especially in communities where a small number of sports dominate.2, 6, 11 A more accurate comparison of sports injury risk at the population level needs to utilise rate data, preferably using only community members that are active sports participants in the denominator.

Exposure-adjusted injury rates have the potential to provide substantial guidance for the development, targeting and prioritisation of specific sport and active recreation injury prevention programs.9, 10 Currently, sports injury data that takes account of participation levels are sparse even though epidemiological studies should, by definition, provide information on the population at risk. In Australia, population-based studies of sports injuries have often not calculated exposure-adjusted rates. Two studies reporting state-level population sports injury rates are the exception. Mummery et al.1 surveyed a representative sample of Queenslanders about their rate of medically treated injuries resulting from sport and active recreation. Gabbe et al.3 used trauma registry data to describe the incidence of serious injury in Victoria. However, neither study considered the incidence of injuries that did not lead to treatment but which still impacted significantly on the injured people. From a public health point of view, it is important to consider these other impacts because non-participation due to injury can lead to lifelong reduction in physical activity, an inability to perform activities of daily living (ADLs) and reduced quality of life.12

This paper estimates the rate of sport and active recreation injury in a defined population in Australia, as well as their public health impacts. Population-based and population-adjusted sports injury rates are then used to identify priority sports for injury prevention.

Section snippets

Geographic region

A geographically defined area, the regional area of the Latrobe Valley situated in the Gippsland region of Victoria, was chosen as the target for this study. The study was restricted to households in the region covered by the six major postcodes that fell wholly with the catchment area of the Latrobe Regional Hospital to enable comparison of the survey results with injury data routinely collected in the hospital catchment area by the local hospital and general practitioners. The medically

Response rate

Over the 12-month survey period, 417 household telephone surveys were completed. The response rate among contacted households was 67.9%. The mean number of calls required to successfully complete a telephone interview was 6.7.

Population participation rates

Data were collected on a total of 1084 people aged 5+ years, of whom 48.1% were male (Table 1). A total of 648 (60.2%, 95% CI: 58.8, 61.6) people participated in at least one sport or recreation activity in the 2 weeks prior to the survey; slightly more males than females

Discussion

One of the major challenges in epidemiological research into sports injuries is the definition and collection of meaningful participation and exposure data.9, 10 In order to make comparisons between sports and active recreation pursuits on their relative risk of injury appropriate denominator data are needed to calculate injury rates.9 This survey simultaneously collected participation data, along with injury data, in a well-defined population in Australia and used these data to estimate injury

Practical implications

  • Sports and active recreation injuries are not a rare event and about 5% of active participants sustain an injury, in a two-week period.

  • Not all sports and active recreation injuries require medical treatment but they may have other significant impacts including affecting the ability to perform activities of daily living and limiting future performance or participation in the chosen sport or active recreation pursuit.

  • Prevention efforts should be targeted towards children aged 5–14 years because

Acknowledgements

This study was jointly funded by a research grant from the Victorian Health Promotion Foundation, the Commonwealth Department of Health and Aged Care and the Australian Sports Commission. All fieldwork and data collection was undertaken whilst CF was at the Monash University Accident Research Centre (MUARC). CF was supported by an NHMRC Principal Research Fellowship for the paper writing phase. The following MUARC staff are thanked for their contributions to this project: Joan Ozanne-Smith,

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