SPORTS INJURY PREVENTION RESEARCH - WHAT IS HAPPENING INTERNATIONALLY?

By Caroline Finch, Jenny Blitvich and Claude Goulet report on the 2002 World Conference on Injury Prevention and Control in Montreal

Sports injury prevention is a growing focus of research groups around the globe. In Australia, we have seen increased interest in this area, as evidenced through conference presentations at the annual SMA Conferences. Many of the international sports medicine meetings, such as the ACSM meeting, also include injury prevention papers.

However, another whole network of sports injury prevention researchers and research activity, that is not necessarily mainstream sports medicine or sports science, is also making its mark on the area.

For many years, sports injury prevention has been a focus of many professionals working in the broad area of injury prevention. They come from a range of multidisciplinary backgrounds, including sports medicine, though it would be fair to say that this latter group is poorly represented.

Conference
Australia hosts a national injury prevention conference every 2 years, and sports injury work also has a high profile at that conference. The next meeting will be held in Perth in March 2003 (for further information see www.congresswest.com.au/injury/). We believe that a combination of the more traditional injury prevention and sports medicine and sport science approaches are needed to progress sports safety considerably.

On an international front, injury prevention experts from around the world meet biannually at the World Conference on Injury Prevention and Control. This year's meeting was in Montreal, Canada, in May and included a number of high quality sports and active recreation sessions as this was a major conference theme.

We were all actively involved in that meeting. Claude was Chair of the Scientific Committee which had overall responsibility for the sports safety (and other issues) program. Caroline was also member of the Scientific Committee which developed the sports safety program. Both Caroline and Jenny presented their research at the meeting and Claude and Caroline moderated some sessions. We found the conference very stimulating and consider a number of the sessions to also be of relevance to other Australians who may not have had the opportunity to attend. This article is a summary of the relevant presentations at that conference.

The major feature of the sports injury prevention section at the conference was a "State-of-the-Art" lecture by A/Prof David Chalmers from the Injury Prevention Research Unit, University of Otago, New Zealand. The title of his talk "Injury prevention in sport - not yet part of the game" gives a clear indication of what he talked about. He argued strongly that injuries can be prevented but that we have moved very little along the progress needed to achieve this.

Very little is known about what injury prevention measures are effective and unless we conduct more systematic, formal studies of such measures, we will not be able to significantly inform injury prevention activities. The fact that this conference had a State-of-the-Art lecture is recognition by the International Organising Committee of the importance the sports injury prevention issue in the context of general injury prevention.

A round table session then took up this challenge under the theme: "The challenges of evaluating sports safety measures". Finch reported some of the experience of the Australian Football Injury Prevention Project and the implications of these for conducting real life research with teams of football players. Olsen, representing a group of researchers from Ottawa and Vancouver in Canada, described their approach toward a systematic review of sports and recreation injury prevention among children and youth and identification of best practices. Chalmers summarised the challenges of evaluating a five-year dynamic sports injury prevention program in rugby union in New Zealand. Brunelle gave some good examples of real-world efforts aimed at improving ice hockey injuries in Canada.

In one proffered paper session "Studies and risk factors in sport and leisure injuries”, six papers were presented. Stevenson (from WA) presented the results of the Western Australian Sports Injury Study, the first prospective study of sports injury in community participants in Australia. Sparks, from the UK, discussed a range of factors associated with risk and safety in the leisure worlds and lifestyles of young adolescents. Finch presented the arguments surrounding the recent Australian pregnancy in sports debate. Belechri represented a consortium of European Union countries which had combined sports injury data and presented a profile of sports injuries among adults in European Union countries. Hagel, from Canada, presented some results from his PhD work entitled "Estimated trends in ski patrol reported body region specific injury rates for skiers and snowboarders in Quebec". Finally, the latest information on sport and recreational injuries from the Canadian Hospitals Injury Reporting and Prevention program (CHIRPP) were presented by McFaull.

The six papers presented to the proffered paper session on "Ski and snowboarding injuries" generated considerable interest and audience comment. Laporte began by presenting an evaluation of the efficiency of helmets to prevent injury to children during collision. An Austrian study, presented by Kisser, described the similarities and dissimilarities in injury risk in alpine skiing and snowboarding. Hagel presented data from Canada on the rising proportion of head and neck injuries among skiers and snowboarders. Binet, from France, presented the results of an evaluation of a campaign to promote correct ski binding adjustment in alpine skiers.

Water-related injury
Within the Sport and Leisure Safety stream, one session was dedicated to "Water-related injuries, including boating, swimming, diving and rafting". This session was very well attended and provided some lively debate. Delegates from a wide range of bodies involved in injury or drowning prevention were in attendance and enthusiastically contributed to discussion. Papers presented included an investigation of the effect of alcohol on the risk of death among boaters (Smith); the importance of a multifaceted approach to prevention of shallow water diving spinal cord injury, addressing safe diving skills, awareness, pool design, and legislation (Blitvich.); the need for regulation and accreditation in the white water rafting industry to decrease the incidence of fatalities (Turner); a demonstration of the value of basing injury prevention programs on incidence and risk factors, rather than on anecdotal information, utilising the Canadian Surveillance System for Water-Related Fatalities (Barrs) and the value of using the findings of epidemiological studies in France to target drowning prevention programs to specific needs (Thélot).

The final set of proffered papers was presented in a session entitled "Use of protective equipment in sports and recreational activities". Three papers from the USA (Parkinson, Forjuoh) and Canada (MacArthur) focussed on bicycle helmets; another Canadian study on protective equipment for scooter riders (Macpherson). Finch presented Australian data on barriers towards the promotion and use of protective eyewear in squash and Jones described a preliminary study examining the role of scrum-caps for preventing facial injuries in rugby players in the UK.

Other sessions in the Sport and Leisure Safety area were five proffered papers in a session on "Playground safety"; an 11-poster session on "Water related injuries: boating, swimming, diving and others"; a five-poster session on "Ski and snowboarding injuries"; a seven-poster session on the "Use of protective equipment in sports and recreational activities"; a five-poster session on "Studies and risk factors in sport and leisure injuries"; and a six-poster session on "Playground safety". The quality of these sports injury posters was highlighted in the positive evaluations from conference attendees.

Research quality improving
Taken together, this conference highlighted a range of sports injury prevention activities from across the world. It was also clear from the general quality of the work presented that the quality of sports injury research is continuing to improve. Importantly, there were many instances of studies that did not just present descriptive statistics of injury occurrences.

The seventh meeting will take place in Vienna, Austria, from 6-9 June 2004 (for further information see www.safety2004.info).

It is also worth noting that this regular international conference has recently changed its name to introduce the concept of safety promotion: the World Conference on Injury Prevention and Safety Promotion. We believe that there is potential for Australian activities in this area to be more widely promoted to the international injury prevention community, through this conference and other avenues, as well as the international sports medicine and sports science communities.

Copies of the abstracts can be obtained from the English section of the website of the Institut National de Santé Publique du Québec (National Public Health Institute of Québec). The address is www.inspq.qc.ca/English and "click" on the conference logo to find the abstracts. They will be available on this website from December 2002 until May 2004.

Associate Professor Caroline Finch is from the Trauma and Sports Injury Prevention Research Unit at Monash University, Dr Jenny Blitvich from the School of Human Movement & Sport Sciences at the University of Ballarat and Dr Claude Goulet from the Safety Promotion Unit, Secretariat for Leisure and Sport, Government of Québec.

Breakouts
We believe that a combination of the more traditional injury prevention and sports medicine and sport science approaches are needed to progress sports safety considerably.

There is potential for Australian activities in this area to be more widely promoted to the international injury prevention community