Risk of Injury in Basketball, Football, and Soccer Players, Ages 15 Years and Older, 2003–2007

Abstract

Context: A major challenge in the field of sports injury epidemiology is identifying the appropriate denominators for injury rates. Objective: To characterize risk of injury from participation in basketball, football, and soccer in the United States, using hours of participation as the measure of exposure, and to compare these rates with those derived using population estimates in the denominator. Design: Descriptive epidemiology study. Setting: United States, 2003–2007. Participants: People ages 15 years and older who experienced an emergency department–treated injury while playing basketball, football, or soccer. Main Outcome Measure(s): Rates of emergency department–treated injuries resulting from participation in basketball, football, or soccer. Injury rates were calculated for people ages 15 and older for the years 2003–2007 using the U.S. population and hours of participation as the denominators. The risk of injury associated with each of these sports was compared for all participants and by sex. Results: From 2003 through 2007, annual injury rates per 1000 U.S. population were as follows: 1.49 (95% confidence interval [CI] = 1.30, 1.67) in basketball, 0.93 (95% CI = 0.82, 1.04) in football, and 0.43 (95% CI = 0.33, 0.53) in soccer. When the denominator was hours of participation, the injury rate in football (5.08 [95% CI = 4.46, 5.69]/10 000 hours) was almost twice as high as that for basketball (2.69 [95% CI = 2.35, 3.02]/10 000 hours) and soccer (2.69 [95% CI = 2.07, 3.30]/10 000 hours). Conclusions: Depending on the choice of denominator, interpretation of the risk of an emergency department–treated injury in basketball, football, or soccer varies greatly. Using the U.S. population as the denominator produced rates that were highest in basketball and lowest in soccer. However, using hours of participation as a more accurate measure of exposure demonstrated that football had a higher rate of injury than basketball or soccer for both males and females.