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March 19, 2003
Use of such protective equipment as faceguards and modified "safety balls" can significantly cut the number of injuries to children and adolescents playing organized baseball, a major new University of North Carolina at Chapel Hill study concludes. The equipment cannot eliminate injuries entirely, the investigation shows, but researchers recommend the special balls and face protection even though they say the incidence of serious injuries in the sport is already low.
Conducted by UNC Injury Prevention Research Center-affiliated scientists, the study involved analyzing injury information resulting from three years, or more than 6.7 million "player-seasons," of Little League participation. It is the largest and most comprehensive study of its kind ever done, the scientists say.
"We undertook this study at the request of USA Baseball's Medical and Safety Advisory Committee because it was not known for sure whether these two types of equipment reduced the risk of injury in youth baseball," said Dr. Stephen W. Marshall. "Little League Baseball, which was highly supportive, shared with us extensive data they had on injuries compensated by insurance. We found that one type of 'safety ball,' known as a reduced-impact ball, cut the number of ball-related injuries by some 29 percent, and faceguards reduced the risk of facial injuries by 35 percent."
Marshall, assistant professor of epidemiology and assistant professor of orthopaedics, respectively, at the UNC schools of public health and medicine, was principal author of a report on the findings that appears in the Feb. 5 issue of the Journal of the American Medical Association. Study principal investigator was Dr. Frederick Mueller, professor and chair of exercise and sport science at UNC and Marshall's long-time mentor.
Health behavior and health education doctoral student Jingzhen Yang of UNC and Daniel P. Kirby, director of risk management for Little League Inc. of Williamsport, Pa., were co-authors. Mueller also directs the UNC-based National Center for Catastrophic Sports Injuries and chairs the American Football Coaches' Committee on Football Injuries.
Central to the research was compiling information over the three years on which leagues used and which did not use the optional safety equipment and comparing that data with insurance records of who suffered serious injuries, Marshall said. The team found 4,233 injuries serious enough to have warranted insurance compensation and an injury rate of just over 28 per 100,000 player-seasons.
Faceguards, which are either clear plastic visors or wire mesh devices, clip to baseball helmets and are used during batting and base running.
Reduced impact balls, one of the most commonly used types of safety balls, are made with polyurethane centers rather than the traditional cork and yarn so that they will act like regular baseballs when batted, pitched or thrown, but transmit less force when they hit a child.
"There are different kinds of reduced impact balls -- some softer than others -- but all are engineered to 'play' as much as possible like a standard baseball," Marshall said. "Despite what some people have said, studies have shown that when you remove the manufacturers' labeling, by and large, almost nobody can tell a difference between reduced impact and standard balls when pitching, batting and throwing. Thus, concerns about safety balls' play possibly revolve around perceptions rather than the actual performance of the ball."
The risk of injury increased with the level of competition, whereas the use of safety balls and faceguards dropped as the competition level increased, he said. Data on girls were excluded since there were too few for meaningful analysis in this study. Likewise, too few injuries occurred among special needs children to include them in the analysis either.
"Our work shows that safety balls and faceguards do reduce the risk of injury," Marshall said. "The study makes a contribution to medical science, but more importantly, it makes a contribution to health and safety issues in youth baseball, and that's very important."
About 5 million U.S. youth play organized league baseball each year, the scientist said. About half of those belong to groups affiliated with Little League. Major League Baseball supported the UNC research through a grant to USA Baseball.
A study Mueller, Marshall and Kirby published in 2001 showed that 13 Little League players died from baseball injuries between 1987 and 1996. Mueller said at the time that he believed safety baseballs could have prevented or reduced the severity of some of the more than 15,000 ball-related injuries suffered over that decade.
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