Original Article

Is It Cost-Effective to Require Recreational Ice Hockey Players to Wear Face Protection?

Authors: Scott E. Woods, MD, MPH, MEd, FAAFP, John Diehl, MD, Eric Zabat, MD, Matt Daggy, MD, Amy Engel, MA, Richard Okragly, MD

Abstract


Objective: The purpose of this study was to determine the cost-effectiveness of requiring all recreational hockey players to wear facial protection.


Methods: The authors randomly surveyed recreational hockey players at two indoor hockey rinks in Evendale, Ohio. Data were collected on face protection, injuries, demographic variables and attitudes about protective gear from 11/2005 to 03/2006.


Results: We surveyed 190 players. The mean age was 34 ± 8.7 years and 99% were male. The average hockey experience was 17 years. Forty-six percent of respondents reported at least one serious hockey injury in the last five years. Twenty-four percent of the surveyed population chose to not wear face protection (46/190). The average cost of face protection was $48. The cost to purchase two shields for the 46 players would be $4416. Individuals with face protection reported significantly more sprains and strains that resulted in significantly more physician office visits and specialty physician visits. The extra physician visits would add approximately $4590 for the 46 people needing face protection. Those with face protection reported significantly fewer facial lacerations and facial bone fractures. Requiring face protection should prevent seven facial lacerations and three facial bone fractures over five years. The savings would be approximately $15,000. The net savings by requiring face protection would be $6,000/5 years. In our population, with 24% choosing to not wear face protection, requiring face protection would save $250/5 years/person needing protection.


Conclusion: It is cost-effective to require facial protection in all recreational hockey players.



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References

1. Lorentzon R, Wedrèn H, Pietilä T. Incidence, nature, and causes of ice hockey injuries. A three-year prospective study of a Swedish elite ice hockey team. Am J Sports Med 1988;16:392–396.
 
2. Sim FH, Simonet WT, Scott SG. Ice hockey injuries: causes, treatment and prevention. J Musculoskeletal Med 1989;6:15–44.
 
3. Stevens ST, Lassonde M, de Beaumont L, et al. The effect of visors on head and facial injury in National Hockey League players. J Sci Med Sport 2006;9:238–242.
 
4. Stuart MJ, Smith A. Injuries in Junior A ice hockey. A three-year prospective study. Am J Sports Med 1995;23:458–461.
 
5. Stuart MJ, Smith AM, Nieva JJ, et al. Injuries in youth ice hockey: a pilot surveillance strategy. Mayo Clin Proc 1995;70:350–356.
 
6. Benson BW, Mohtadi NG, Rose MS, et al. Head and neck injuries among ice hockey players wearing full face shields vs half face shields. JAMA 1999;282:2328–2332.
 
7. LaPrade RF, Burnett QM, Zarzour R, et al. The effect of the mandatory use of face masks on facial lacerations and head and neck injuries in ice hockey. A prospective study. Am J Sports Med 1995;23:773–775.
 
8. Mair SD, Seaber AV, Glisson RR, et al. The role of fatigue in susceptibility to acute muscle strain injury. Am J Sports Med 1996;24:137–143.
 
9. Smith AM, Stuart MJ, Wiese-Bjornstal DM, et al. Predictors of injury in ice hockey players. A multivariate, multidisciplinary approach. Am J Sports Med 1997;25:500–507.
 
10. Bernard D, Trudel P, Marcotto G, et al. The incidence, types and circumstances of injuries to ice hockey players at the bantam level (14 and 15 years old), in Castaldi CR, Bishop JJ, Hoerner EF (eds): Safety in Ice Hockey: Second Volume. ASTM STP 1212. Philadelphia, American Society for Testing and Materials, 1993, pp 44–55.
 
11. Gilbert WD, Trudel P. A profile of rule infractions in Bantam level ice hockey, in Ashare AB (ed): Safety in Ice Hockey: Third Volume. ASTM STP 1341. West Conshohocken, PA, American Society for Testing and Materials, 2000, pp 291–301.
 
12. Marcotte G, Simard D. Fair play: An approach to hockey for the 1990s, in Castaldi CR, Bishop BJ, Hoerner EF (eds): Safety in Ice Hockey: Second Volume. ASTM STP 1212. Philadelphia, American Society for Testing and Materials,1993, pp 103–108.
 
13. Smith AM, Stuart MJ, Fish K, et al. A psychosocial perspective of aggression in ice hockey, in Ashare AB (ed): Safety in Ice Hockey: Third Volume. ASTM STP 1341. West Conshohocken, PA, American Society for Testing and Materials, 2000, pp 199–219.
 
14. Roberts WO, Brust JD, Leonard B, et al. Fair-play rules and injury reduction in ice hockey. Arch Pediatr Adolesc Med 1996;150:140–145.
 
15. Pashby T. Eye protection in ice hockey: A historical review, in Castaldi CR, Bishop JJ, Hoerner EF (eds): Safety in Ice Hockey: Second Volume. ASTM STP 1212. Philadelphia, American Society for Testing and Materials, 1993, pp 159–163.
 
16. Stuart MJ, Smith AM, Malo-Ortiguera SA, et al. A comparison of facial protection and the incidence of head, neck, and facial injuries in junior A hockey players. Am J Sports Med 2002;30:39–44.
 
17. Woods SE, Zabat E, Daggy M, et al. Face protection in recreational hockey players. Fam Med 2007;39:473–476.
 
18. Murray TM, Livingston LA. Hockey helmets, face masks, and injurious behavior. Pediatrics 1995;95:419–421.
 
19. Walsh S. A proposal for the use of the half face, clear plastic visor for National Collegiate Athletic Association Hockey, in Castaldi CR, Hoener EF (eds): Safety in Ice Hockey. ASTM STP 1050. Philadelphia, PA, American Society for Testing and Materials, 1989, pp 55–57.
 
20. McCrory P, Johnston K, Meeuwisse W, et al. Summary and agreement statement of the 2nd International conference on concussion in sport, Prague 2004. Clin J Sport Med 2005;15:48–55.