Comparative analysis of state-level concussion legislation and review of current practices in concussion

Abstract

<jats:sec> <jats:title>Object</jats:title> <jats:p>Forty-two states and the District of Columbia have passed legislation based on the Lystedt law of Washington state, enacted in 2009 to protect young athletes who have sustained a concussion. The aim of this study was to note the several similarities and differences among the various laws.</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Concussion legislation was compared for 50 states and the District of Columbia. Evaluation parameters of this study included stipulations of concussion education, criteria for removal from play, requirements for evaluation and return to play after concussion, and individuals required to assess young athletes. Other parameters that were not consistent across states were also noted.</jats:p></jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Forty-three states and the District of Columbia have passed concussion legislation, and an additional 4 states have pending legislation. All states with existing legislation support concussion education for coaches; however, only 48% require coaches to undergo formal education. Athletes must be educated on concussion in 86% of states and parents in 88.7%. Suspicion of concussion is a criterion for removal from play in 75% of states; signs and symptoms of concussion are criteria for removal from play in 16% of states. The individuals allowed to evaluate and clear an athlete for return to play differ greatly among states.</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Injury prevention legislation holds historical precedent, and given the increasing attention to long-term sequelae of repeated head trauma and concussion, concussion legislation has been rapidly passed in 43 states and the District of Columbia. Although the exact stipulations of these laws vary among states, the overall theme is to increase recognition of concussion in young athletes and ensure that they are appropriately cleared for return to play after concussion.</jats:p></jats:sec>

Legislative Efforts to Reduce Concussions in Youth Sports: An Analysis of State Concussion Statutes

“…The keywords used in the search included youth sport concussion, concussion state laws, traumatic brain injury and sport, concussion protocols and guidelines, concussion and school sports, and concussion and student athletes. To cross-reference the search results, published studies (Harvey, 2013;Lowrey, 2014;Tomei et al, 2012) and publicly available information on youth sport concussion laws (Public Health Law Research, 2015) were reviewed. Once the identified statutes were cross-referenced and reviewed, the researchers identified the most relevant contents of legislation with possible ambiguities in language and jurisdictional inconsistencies between the statutes.…”

“…Given the variation among the state concussion legislation, the purpose of this study was to conduct a comprehensive analysis of concussion statutes in 51 states. In addition to the language that was analyzed by previous researchers (Harvey, 2013;Lowrey, 2014;Tomei et al, 2012), the current study expanded and added new categories for analysis. Understanding the components of these laws is an important step in assisting law and policy makers to further improve the content and implementation of such legislation.…”

“…Analysis of the concussion statutes in several previous studies identified considerable variations between states (Harvey, 2013;Lowrey, 2014;Tomei, Doe, Prestigiacomo, & Gandhi, 2012). In addition, adhering to state concussion statutes can often be challenging due to its ambiguous language.…”

“…Seventy-five percent of the states required removing athletes with concussion-suspected symptoms. Individuals with an authority to evaluate, treat, and clear a concussion-sustained athlete for RTP varied greatly among states (Tomei et al, 2012).…”

“…Tomei et al (2012) reviewed and compared concussion statutes in 43 states and the District of Columbia (7 states had pending legislation at the time the review was conducted). The selected categories of legislative components in that review included the legislation's targeted population, education requirement, removal-from-play criteria, clearance for RTP stipulation, and noncompliance procedures.…”