2007 football fatality survey shows decrease of deaths

By Bob Herman

When it comes to gritty, physical, body-pounding sports, few compare with the sport of football.

According to the 2006-07 NFHS High School Athletics Participation Survey, more than 1.1 million high school students participated in football, making it the most popular interscholastic sport in terms of participants.

However, football also presents the most opportunities for a catastrophic injury or, in extremely rare instances, a fatality.

In 1931, the Annual Survey of Football Injury Research was initiated in order to make football a safer and, therefore, more enjoyable sports activity. Every year, the NFHS, the National Collegiate Athletic Association and the American Football Coaches Association collectively sponsor this research study.

"I think it's made a great contribution to football safety, and it needs to continue," said Frederick O. Mueller, Ph.D., University of North Carolina at Chapel Hill and author of the study.

Since 1980, Mueller has headed this study since 1980, which looks at two different types of fatalities: direct and indirect.

A direct fatality directly results from participation in the fundamental skills of football, while an indirect fatality is caused by a systemic failure as a result of overexertion while playing football.

In 2007, there were three direct and six indirect fatalities in high school football.

The three direct fatalities, which are two more than in 2006, stemmed from the simplest faction of the sport - tackling or being tackled.

"Over the years, (tackling techniques) have definitely improved," Mueller said. "In the report, we continue to suggest proper tackling techniques, and coaches are aware that these tackling techniques need to be taught. That's made a big impact on the number of fatalities."

For the past decade, though, direct fatalities have not been the source of a majority of all football fatalities. Indirect fatalities, most due to heat stroke, other heat illnesses or heart-related causes, have made up 68 percent of all high school football fatalities since 1997.

"The heat is always a concern," Mueller said. "I think coaches are making players more aware that they should be drinking water before, during and after practice."

Many believe that there should be zero indirect fatalities because conditions such as heat stroke are entirely preventable. Since 1995, 25 high school players have died from heat stroke alone. Consequently, more emphasis has been put on precautionary measures for heat stroke and heat exhaustion.

"I think it's a really important area," Mueller said. "I know North Carolina starts (football) August 1. Some places start practices so early, so I definitely think a strong emphasis needs to be put on (those precautions)."

Overall, the nine total fatalities from this year are fewer than last year's 13. But as any person involved would say, even one fatality is one too many.

Here are some specific recommendations resulting from the 2007 data:

1.) Mandatory medical examinations and medical history should be taken before allowing an athlete to participate in football. High school coaches should follow the recommendations set by their state high school athletic associations.

2.) All personnel concerned with training football athletes should emphasize proper, gradual and complete physical conditioning.Particular emphasis should be placed on neck strengthening exercises.

3.) A physician should be present at all games and practice sessions.If it is impossible for a physician to be present at all practice sessions, emergency measures must be provided. Written emergency procedures are recommended for both coaches and medical staff.

4.) All personnel associated with football participation should be cognizant of the problems and safety measures related to physical activity in hot weather.

5.) Each institution should strive to have a team trainer who is a regular member of thefaculty and is adequately prepared and qualified.

6.) A cooperative liaison should be maintained by all groups interested in the field of athletic medicine (coaches, trainers, physicians, manufacturers, administrators and so forth).

7.) There should be strict enforcement of game rules, and administrative regulations should be enforced to protect the health of the athlete.Coaches and school officials must support the game officials in their conduct of the athletic contests.

8.) There should be a renewed emphasis on employing well-trained athletic personnel, providing excellent facilities and securing the safest and best equipment possible.

9.) There should be continued research concerning the safety factor in football (rules, facilities, equipment and so forth).

10.) Coaches should continue to teach and emphasize the proper fundamentals of blocking and tackling to help reduce head and neck fatalities. Keep the head out of football.

11.) Strict enforcement of the rules of the game by both coaches and officials will help reduce serious injuries. Be aware of the 2005 rule change to the 1976 definition of spearing.

12.) When a player has experienced or shown signs of head trauma (loss of consciousness, visual disturbances, headache, inability to walk correctly, obvious disorientation, memory loss), that player should receive immediate medical attention and should not be allowed to return to practice or game without permission from the proper medical authorities.

13.) The number of indirect, heart-related deaths has increased over the years, and it is recommended that schools have automated external defibrillators (AED) available for emergency situations.

Bob Herman was a fall semester intern in the NFHS Publications/Communications Department. He is a junior at Butler (Indiana) University, majoring in journalism (news editorial) and minoring in Spanish.