NCAA mandatory sickle cell screening program not enough to save athletes' lives

December 12, 2011

In response to a lawsuit after a college football player died from complications due to sickle cell trait (SCT) during a workout, the NCAA implemented mandatory SCT screening of all Division I student-athletes.

A new study evaluated the impact of that policy and found that testing alone will help identify more than 2,000 athletes with SCT, but warns that screening alone will not prevent death.

"Although the policy is well-intentioned, screening is just the first step," says Beth A. Tarini, M.D., M.S., lead author of the study and assistant professor in the Department of Pediatrics and Communicable Diseases at the University of Michigan. "In addition to educating athletes and staff, precautionary measures need to be strictly enforced."

Tarini and her co-authors, M. Alison Brooks, M.D., a pediatric sports medicine physician at the University of Wisconsin, and David G. Bundy, M.D., an assistant professor of pediatrics with expertise in sickle cell disease at Johns Hopkins University, found that without a strictly enforced intervention, approximately seven NCAA Division I athletes would die suddenly as a complication of SCT during a 10-year period.

"In the end, enforcing safe training measures to protect all NCAA student-athletes--not just those in Division I--from sudden death related to SCT will benefit all athletes," says Tarini. "That's a win-win situation from a policy perspective."

The association between SCT and overexertion was first identified by the U.S. military in the 1970s. Instead of implementing a universal screening policy, the military enforced a universal intervention program and was successful in preventing all subsequent sudden death in recruits with SCT.

Tarini, Brooks, and Bundy found that the NCAA screening program requires that 144,181 student-athletes from a four-year cohort would need to be screened to prevent one death--assuming 100 percent intervention --and would cost somewhere between $1.4 and $3 million. A universal intervention policy like the one implemented in the U.S. military could prevent all deaths associated with SCT and overexertion as well as death among other athletes from other life-threatening complications like cardiovascular conditions.

"The culture in sports to push ourselves dangerously beyond our limits is powerful," says Tarini. "Implementing policies to identify those at risk provides a false sense of security if we aren't diligent about monitoring and protecting the health and safety of our student-athletes."

Tarini and colleagues analyzed NCAA reports, population-based SCT prevalence estimates, and published risks for exercise-related sudden deaths. They used these to estimate the number of sickle cell carriers and the number of potentially preventable deaths with mandatory SCT screening of NCAA Division I athletes. Using the most recently published, publicly available NCAA participation rates from academic year 2007, they estimated the number of Division I athletes in a four-year cohort to be 81,073 males and 63,108 females.
-end-
The study, "A Policy Impact Analysis of the Mandatory NCAA Sickle Cell Trait Screening Program," is available online in the journal Health Services Research. It is part of a special issue on "Bridging the Gap Between Research and Health Policy" featuring research articles from current and former Robert Wood Johnson Foundation Clinical Scholars that will be released in print in February 2012. Tarini, Brooks, and Bundy are all former RWJF Clinical Scholars.For more than three decades, the Robert Wood Johnson Foundation Clinical Scholars program has fostered the development of physicians who are leading the transformation of health care in the United States through positions in academic medicine, public health, and other leadership roles. Through the program, future leaders learn to conduct innovative research and work with communities, organizations, practitioners, and policy-makers on issues important to the health and well-being of all Americans. This program is supported in part through a collaboration with the U.S. Department of Veterans Affairs. For more information, visit http://rwjcsp.unc.edu.

University of Michigan Health System

Related Athletes Articles from Brightsurf:

51% of Americans agree paying college athletes should be allowed
More Americans than not believe that college athletes should be allowed to be paid more than what it costs them to go to school, a new national study of nearly 4,000 people suggests.

Menstrual dysfunction is more common among young athletes than among non-athletes
Menstrual dysfunction is more prevalent in young Finnish athletes than it is among non-athletes of a similar age, but athletes experience less body weight dissatisfaction than non-athletes do.

Athletes don't benefit from relying on a coach for too long
Athletes increasingly relying on a coach over the course of a season may be a sign that they aren't progressing in their development, according to new research from Binghamton University.

Olympic athletes should be mindful of their biological clocks
Biological clocks have sizeable effects on the performance of elite athletes.

Female athletes at risk for nutritional deficiencies
Two decades of research among female athletes over the age of 13 years shows that a lack of nutrition knowledge about what they need to eat to stay healthy and compete may contribute to poor performance, low energy and nutrient intake, and potential health risks, according to a Rutgers Robert Wood Johnson Medical School study.

Electrocardiogram shows value in college athletes' screens
Research published today indicates that screenings that incorporate an ECG are more effective at detecting cardiac conditions that put athletes at risk, and more efficient in terms of cost-per-diagnosis of at-risk players, than screenings involving only a physical exam and patient history.

How kirigami can help us study the muscular activity of athletes
Scientists devise an elastic and durable skin-contact patch for measuring the electromyographic activity of the palm muscle inspired by ancient Japanese paper crafts.

Study examines attitudes toward transgender athletes
As several states draft legislation that would force student-athletes to play as their gender identified on their birth certificate instead of on a team that matches their gender identity, a team of political scientists investigated underlying factors that drive public opinion on transgender athletes.

The mind-muscle connection: For aesthetes, not athletes?
The 'mind-muscle connection.' Ancient lore for bodybuilders, latest buzz for Instragram fitness followers.

Sudden cardiac arrest in athletes: Prevention and management
It's marathon season, and every so often a news report will focus on an athlete who has collapsed from sudden cardiac arrest.

Read More: Athletes News and Athletes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.