Eye Protection and Risk of Eye Injuries in High School Field Hockey

Abstract

To determine if injury rates among female field hockey players differ before and after implementation of a national mandate for protective eyewear (MPE). METHODS:We analyzed girls' field hockey exposure and injury data collected from national (High School Reporting Information Online [RIO]) and regional (Fairfax County Public Schools) high school sports injury databases in 2 seasons before (2009/10 and 2010/11) and 2 seasons after (2011/12 and 2012/13) a national MPE. RESULTS:The incidence of eye/orbital injuries was significantly higher in states without MPE (0.080 injuries per 1000 athletic exposures [AEs]) than in states with MPE (before the 2011/12 mandate) and the postmandate group (0.025 injuries per 1000 AEs) (odds ratio 3.20, 95% confidence interval 1.47-6.99, P = .003). There was no significant difference in concussion rates for the 2 groups (odds ratio 0.77, 95% confidence interval 0.58-1.02, P = .068). After the 2011/12 MPE, severe eye/orbital injuries (time loss .21 days) were reduced by 67%, and severe/medical disqualification head/face injuries were reduced by 70%. Concussion rates for field hockey (0.335 per 1000 AEs) rank third among girls' sports included in the High School RIO surveillance program.CONCLUSIONS: Among female high school field hockey players, MPE is associated with a reduced incidence of eye/orbital injuries and fewer severe eye/orbital and head/face injuries. Concussion rates did not change as a result of the national MPE. Concussion remains the most common injury involving the head and face among female field hockey players, prompting further inquiry into potential effects of adopting protective headgear/helmets. WHAT'S KNOWN ON THIS SUBJECT:A previous national study conducted over 2 seasons by this group of authors demonstrated the effectiveness of mandated protective eyewear in reducing eye/ orbital, concussive, and head/facial injuries in high school girls' field hockey.WHAT THIS STUDY ADDS: Data collected from regional/national high school sports injury surveillance databases by certified athletic trainers over 4 seasons has shown that nationally mandated protective eyewear results in a greater than 3-fold reduced risk of eye/ orbital injuries in girls playing high school field hockey.

New Zealand childhood ocular trauma study: Analysis of 75 601 cases of ocular injury from 2007 to 2016

“…In New Zealand, the only sporting activities that currently mandate the use of eye protection are junior squash competitions, clay target shooting and motorsport . A study reporting compulsory eye protection for female high school field hockey players in the United States noted a 3‐fold reduction in the rate of serious eye/orbital injuries after implementation of compulsory eye protection . The use of appropriate protective eyewear for other high‐risk non‐contact sports such as squash, badminton and soccer is likely to reduce the rate of ocular injury in these sporting activities and warrants further investigation.…”

“…National, Accident Compensation Corporation national data; Regional, Accident Compensation Corporation Auckland region data; Hospital, Auckland Hospital data; 95% CI, 95% confidence interval; P diff , P-value for difference in proportions. 27…”

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls' Field Hockey (2008–2009 Through 2013–2014) and National Collegiate Athletic Association Women's Field Hockey (2004–2005 Through 2013–2014)

“…23 It is logical that facial and eye injuries will be minimized with protective eyewear, yet critics of the rule change have expressed concerns that concussions may increase because of collisions due to reduced visibility. 25 However, Kriz et al 26 refuted that theory by noting that the incidence of eye and orbital injuries was lower during time periods in states with the mandate enacted, whereas concussion rates did not differ between time periods in states with and without the mandate. Boden et al 27 recently reported a 52% reduction in the eye-injury rate after the rule change.…”

Preventing penalty corner injuries and head trauma in field hockey: time to consider the power play?

“…Although players may wear protective equipment (eg, face masks) to reduce the risk of eye injury,5 head trauma remains a very real risk during the penalty corner. Additionally, while face masks represent progress for player safety, the use of such protective equipment is not always mandatory, nor are there comprehensive equipment specifications for manufacturers to follow.…”