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BMJ 2010; 340 doi: (Published 15 June 2010) Cite this as: BMJ 2010;340:c3131

Body checking looks dangerous for young ice hockey players

Many Canadian children and adolescents play ice hockey, and many of them get injured. A drive to make the game safer has focused researchers’ attention on the practice of body checking, which knocks an opponent hard against the boards or the ice. Children aged 11-12 are allowed to body check in Alberta but not in Quebec, allowing a comparison of injury rates between the two provinces. During the 2007-8 season, children in Alberta were three times more likely to be injured playing hockey than children in Quebec (incidence rate ratio for game related injuries 3.26, 95% CI 2.31 to 4.60). Body checking was responsible for the greatest proportion of injuries in Alberta, where head injuries, concussions, and contusions were the most common type of injury.

The researchers studied more than 1000 young players from each province and collected data on exposure to game play, injuries, and mechanisms of injury on standardised forms. The main analyses were adjusted for relevant baseline variables including level of play, player position, and team. All injury outcomes, including concussion and severe concussion, were at least three times more common among players in Alberta. Small players were more likely to be injured than bigger players in a subgroup analysis.

These results have obvious implications for the rules of the game in younger players, say the authors, and they should help researchers design and evaluate strategies to protect these children from serious injury.

Heart attacks fall for a decade in the US

The incidence of myocardial infarction (MI) in northern California in the US has been falling steadily since 2000, according to a population based study. Mortality has also dropped significantly, due to a combination of fewer myocardial infarctions with ST elevation (STEMI) and improving survival after myocardial infarctions without STEMI. In 1999, mortality in the month after a myocardial infarction was 10.5%. By 2008, mortality …

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