ORIGINAL PAPERThe public health impact of injury during sport and active recreation
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
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Sports and active recreation injuries are not a rare event and about 5% of active participants sustain an injury, in a two-week period.
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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.
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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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