Girls’ study findings: US Lacrosse report shows that protective eyewear has reduced injuries to eye, head and face

Phillylacrosse.com, Posted 12/13/11
From US Lacrosse

The use of protective eyewear in girls’ lacrosse was associated with a reduction in the number of injuries to the eye, head, and face, according to a study funded by US Lacrosse and recently published in The American Journal of Sports Medicine.

“The findings suggest the mandated protective eyewear in girls’ lacrosse achieved the desired goals of reducing eye injury,” wrote Andrew E. Lincoln, ScD, MS, of the MedStar Sports Medicine Research Center in Baltimore and a member of the US Lacrosse Sports Science and Safety Committee, and coauthors in the study “Evaluation of the Women’s Lacrosse Protective Eyewear Mandate.” “Overall injury rate did not change over the study period, suggesting that the change in equipment did not result in generally rougher play.

“This addresses one of the major concerns involved with introducing protective equipment to sport — whether players will play more aggressively as a result of the protective equipment they are wearing. This result suggests that the protective eyewear did not have that effect.”

The rate of eye injuries was reduced from 0.10 injuries per 1000 athlete exposures (AEs) in 2000-03 before the use of protective eyewear to 0.016 injuries per 1000 AEs in 2004-09 (incident rate ratio [IRR], 0.16; 95% confidence interval [CI], 0.06-0.42). The rate ratio of head/face injuries excluding concussion also decreased (IRR, 0.44; 95% CI, 0.26-0.76). There was no change in the rate ratio of total injuries involving all body parts (IRR, 0.93; 95% CI, 0.82-1.1) after introduction of protective eyewear. However, the rate ratio of concussion increased (IRR, 1.6; 95% CI, 1.1-2.3).

The reason for the increase in concussion rate cannot be determined conclusively based on this study, but the authors speculate that this increase resulted largely from increased recognition and diagnosis of concussions because overall injury rates do not indicate rougher play with the introduction of protective eyewear.

However, this increase may reflect the increased awareness and diagnosis of concussion that was observed in 12 scholastic contact and non-contact sports over the past decade. Given the collective increase across all sports in the concussion rate in the absence of rules or equipment changes, it appears likely that the increase seen in girls’ lacrosse was not associated primarily with the use of protective eyewear, according to the authors.

The study group included female scholastic lacrosse players in the 25 public high schools in Fairfax County, Va., during the 2004-09 spring seasons. Injury rates were compared with those from the same data source for the 2000-03 seasons. Pre-mandate versus post-mandate injury rates were adjusted for athlete exposures, or total opportunities for injury throughout the season. There were a total of 3864 player-seasons in the pre-eyewear mandate group and 5566 player-seasons in the post–eyewear mandate group.

In the early 2000s, US Lacrosse focused on eye injury as a potentially preventable catastrophic injury in women’s lacrosse. Based on research and recommendations by the American Academy of Pediatrics and the American Academy of Ophthalmology, US Lacrosse recommended the use of protective eyewear meeting current ASTM lacrosse standards for 2004 and mandated the use of eyewear in the women’s game at the youth, scholastic, and collegiate levels in 2005. The effect of this mandate on eye injury in the women’s game had not been previously studied.

This study was sponsored by the US Lacrosse and is one of the few efforts to formally evaluate the effectiveness of an injury prevention intervention, such as a rule change or introduction of protective equipment. Very few studies have documented the effectiveness of an intervention in the prevention of sports injuries at the youth amateur, collegiate, and professional levels.

“The resources our generous members and donors provide us allow US Lacrosse to fund injury studies like these that help provide the data we can continue to use to establish or adjust policies that foster safer play in lacrosse,” said Ann Carpenetti, managing director of game administration at US Lacrosse.

“Previous studies demonstrate that girls’ lacrosse enjoys a favorable injury profile when compared to other sports, and this research by Dr. Lincoln and his team indicates that the sport has been made safer since US Lacrosse’s rule change to mandate protective eyewear,” said Dr. Margot Putukian, director of athletic medicine at Princeton University, head team physician for the U.S. men’s national lacrosse team, and chair of the US Lacrosse Sports Science and Safety Committee.

Lacrosse is one of the fastest growing sports in the U.S. According to research by US Lacrosse and the National Federation of State High School Associations (NFHS), participation in high school girls’ lacrosse included 105,914 players in 2010, up from 90,914 in 2009 and a five-year growth rate of 48.4 percent among NFHS-member states.