College students may be at an increased risk of concussion off the playing field than on

Whilst investigating concussion incidence among college students, a team of researchers discovered that non-sport-related concussion outnumbered sport-related concussions.

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According to a recently published paper in the journal JAMA Network Open, concussion prevalence is twice as high among college students than previously believed and are more likely to occur off the playing field than on.

the team of researchers from The University of Colorado Boulder (CO, USA) were the first to assess rates among the general population and track concussion diagnosis during the academic year. Data was taken from August 2015 to May 2018 through their sports medicine department.

After evaluating their student health data, the team discovered that concussion incidence is slightly higher in females. Among varsity athletes 54 females and 26 males sustained a concussion across two of the academic years.

This is supported by another recent paper, which found that female concussion increased by six-fold from 2003–2013, whilst male concussions increased by less than four-fold. It is still unclear why females may be more susceptible to concussions; however, it has been suggested that hormonal differences and reduced neck strength may play a role.

 Across all the 3 years, August had the highest concussion incidence. Though the data does not explain why, anecdotally it is known that August is a time of lower academic demand, which could lead to more risk-taking behavior.

The team reported that out of a total of approximately 30,000 undergraduates, about 340 concussion were diagnosed annually, with the incidence rate calculated to be about one in 75 students per year.

Further, 41% of students with a diagnosed concussion reported that they had already sustained up to three concussions and 5% reported five or more.

Surprisingly, across all years, whether varsity athletes were included or not, non-sport-related concussion outnumbered sport-related concussions. A total of 64% concussions were non-sport related, while the remainder where sustained during organized sport competitions.

"This study shows how common head injuries are among this population and that concussions are not restricted to the athletic field," commented John Breck (University of Colorado Boulder), study co-author. "Student health centers around the country should be training their staff in concussion recognition and putting systems in place to help concussed students get the evaluation and treatment they need."

When varsity athletes were included sport-related concussion incidence was 51 per 10,000 students per year and non-sport-related concussions was 81 per 10,000 students per year.

"There is a widely held perception that most concussions are sport-related. Our study shows it can happen to anyone, male or female, engaged in a variety of activities," commented co-author, Matt McQueen (University of Colorado Boulder).

In prior research WHO reported rates for the general population to be around 60 concussion per 10,000 people per year, whilst the current study discovered rates much higher than that.

The authors concluded that collegiate students, including the general population and varsity athletes, may be at an increased risk of concussion. They noted that previous studies relied on either self-reports, emergency room visits or focused on varsity players, which could have led to the under-estimation. Having a greater awareness of the risks could encourage more students to seek medical care.

"Missing class and falling behind due to a head injury can be a significant detriment to a student's academic success," explained Breck. "It's critical that they get high quality, evidence-based care as soon as possible so they can return to learning in a safe way with as little disruption in their education as possible."

Source: University of Colorado Boulder. Concussions common among college students, more prevalent off the field than on. Press release: https://www.colorado.edu/

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Kimberley Ndungu

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