51711 Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
Department of Pediatrics, College of Medicine and Department of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA.
Public Health Rep. 2021 Nov-Dec;136(6):745-753. doi: 10.1177/0033354920988611. Epub 2021 Feb 24.
Studies that evaluate the effectiveness of concussion laws often use only a single variable (ie, presence of the law), failing to account for law complexity. We examined the association between multiple design elements of state concussion laws and rates of sports-related concussion reporting among US high school athletes.
We derived 3 design elements of concussion laws from the 2009-2017 LawAtlas database: (1) strength of law, (2) number of law revisions, and (3) speed of law adoption. We examined the association between these design elements and rates of new and recurrent sports-related concussion reporting from the 2009-2010 through 2016-2017 academic years in a nationally representative sample of high school athletes participating in High School Report Information Online, an online data collection tool.
A total of 7064 sports-related concussions (6332 [89.6%] new and 732 [10.4%] recurrent concussions) were reported during the study period, with an overall rate of 39.7 sports-related concussions per 100 000 athletic exposures (eg, game or practice). Rates of new concussion reporting were higher among high schools in states with medium- or high-strength concussion laws than in states with low-strength concussion laws and in states with at least 1 concussion law revision than in states with no concussion law revisions. Rates of recurrent concussion reporting were lower among high schools in states with ≥2 concussion law revisions than in states with <2 concussion law revisions. Early law adoption was associated with higher rates of new and recurrent concussion reporting, and late law adoption was associated with lower rates of new and recurrent concussion reporting.
Our findings may help inform legislators of the public health effect of concussion laws.
评估脑震荡法律有效性的研究通常仅使用单一变量（即法律的存在），而没有考虑到法律的复杂性。我们研究了州脑震荡法律的多个设计要素与美国高中运动员运动相关脑震荡报告率之间的关系。
我们从 2009-2017 年的 LawAtlas 数据库中得出了脑震荡法律的 3 个设计要素：（1）法律力度，（2）法律修订次数，和（3）法律通过速度。我们在一个全国代表性的高中运动员样本中检查了这些设计要素与 2009-2010 年至 2016-2017 学年期间通过 High School Report Information Online 在线数据收集工具报告的新的和复发性运动相关脑震荡报告率之间的关系。
在研究期间共报告了 7064 例运动相关脑震荡（6332 例[89.6%]为新的脑震荡和 732 例[10.4%]为复发性脑震荡），总体发生率为每 100000 例运动暴露（例如，比赛或练习）39.7 例运动相关脑震荡。与低强度脑震荡法律相比，中高强度脑震荡法律的州的新脑震荡报告率更高，与没有脑震荡法律修订的州相比，至少有 1 次脑震荡法律修订的州的新脑震荡报告率更高。与修订次数<2 次的州相比，修订次数≥2 次的州的复发性脑震荡报告率较低。早期的法律通过与新的和复发性脑震荡报告率较高相关，而晚期的法律通过与新的和复发性脑震荡报告率较低相关。
我们的发现可能有助于向立法者告知脑震荡法律的公共卫生影响。
