Priority 2: TBI (Traumatic Brain Injury)

Sports & Recreation:
On average from 2002-2009, nearly 4,000 Ohio youth were treated in emergency departments for sports/recreation (S/R) related TBIs each year, with a dramatic rise from 2,859 in 2002 to 6,040 in 2009, a total increase of 111 percent. Sports-related TBIs alone were associated with both the greatest number of emergency department visits each year as well as the greatest increase, 142 percent from 2002-09.

A concussion is a TBI caused by a blow, bump, or jolt to the head or by any fall or hit that “jars” the brain. Children should be removed from play following a suspected TBI/concussion until they can be evaluated by a qualified medical professional. An appropriate licensed health professional will be able to determine how serious the TBI/concussion is and when it is safe for a child to return to sports and other daily activities. No child should be allowed to return to activity on the same day he/she sustains a TBI/concussion or if he/she has any remaining symptoms.

Returning to play too early and experiencing repeated TBI may cause Second Impact Syndrome (SIS) or Post-Concussion Syndrome (PCS). SIS is a catastrophic condition that occurs when a second blow to the head happens before the child has completely recovered from a concussion. This second impact causes brain swelling, resulting in severe consequences such as brain damage, paralysis, and even death. PCS is the condition of having long-term concussion symptoms; risk for PCS is increased if a person sustains a second brain injury before the first one has healed.

Educating parents, coaches and players on the signs and symptoms of concussion/TBI and the dangers of returning to play too quickly or without medical evaluation is a key activity.

Safe Active Transportation (Bike/Pedestrian)
Each year, about 200 Ohio children between the ages of 5 and 15 are admitted as hospital inpatients for injuries they received while riding a bicycle and thousands more are treated in emergency departments (EDs). An average of five Ohio children in this age range die from bicycle‐related injuries each year. Among Ohio children aged 5 to 14 from 2002 to 2005, falls from skateboards, roller skates and non‐motorized scooters resulted in 10,440 ED visits and 112 hospital inpatient admissions.

From 2002-2009, ED visits for bicycle and wheeled recreation related traumatic brain injury (TBI) increased 64 percent in Ohio. A total of 9,383 Ohio youth were treated in EDs and 723 were hospitalized for bicycle and other wheeled recreation related TBIs from 2002-2009. Bicycle-related injuries were responsible for the greatest proportion of hospitalizations for sports/recreation TBIs. ED visits and hospitalizations for bicycle/wheeled recreation related TBIs from 2002-2009 in Ohio were associated with more than $32.2 million in treatment charges. During this time period, 5 to 14 year olds were responsible for 76 percent of the ED visits and 73 percent of the hospitalizations for bicycle/wheeled recreation-related TBIs.3

Prevention of TBIs is key. Helmets are 85 to 88 percent effective in mitigating head and brain injuries, making the use of helmets the single most effective way to reduce bicycle and other wheeled sports related TBIs. Yet, helmet use among Ohio youth remains low. In 2008, only 46.7% of BRFSS respondents indicated that the oldest child in the household always or nearly always wore a helmet when cycling, while 43.1% indicated that the oldest child seldom or never did.1

Helmet laws and ordinances combined with community helmet distribution and education programs have shown the best results in increasing helmet use and reducing bicycle-related injury.2

1. Ohio Behavioral Risk Factor Surveillance System, 2008
2. Karkhaneh, M., Kalenga, JC. Et al. Effectiveness of Bicycle Helmet Legislation to Increase Helmet Use: A Systematic Review. Injury Prevention 2006; 12:76-82.

Increase number of leagues following Return to Play Law; Increase number of schools following Ohio Concussion Team Model; Increase safe active transportation opportunities