Epidemiology Of Sports-related Fatalities In High School Organized Sports In Japan

Abstract

Detailed epidemiological data is crucial for development of the evidence-based prevention strategies for catastrophic injuries. Although sports-related fatalities occur every year at the high school level in Japan, the limited literature has examined the incidence rate. PURPOSE: To describe the frequency and incidence rate of sports-related fatalities that happened during school organized sports at Japanese high schools by cause and sports. METHODS: A total of 114 sports-related fatality claims data submitted to Japan Sports Council (JSC) Injury and Accident Mutual Aid Benefit System through 2009 to 2018 were provided to the authors by JSC. Incidents that resulted directly from participation in the fundamental skill of sports (direct cause) and those caused by systemic failure as a result of exertion while participating in the sports (indirect cause) were included for the further analyses (n = 63). Descriptive statistics were calculated with frequency and proportion by cause (direct vs. indirect), sex, and sports. Annual incidence rates per 100,000 athlete-years (AY) by cause and average incidence rates of the study period per 100,000 AY with 95% confidence interval (CI) by sports were calculated, respectively. RESULTS: Sixteen direct (25.4%) and 47 indirect (74.6%) fatalities were reported between 2009 and 2018. The majority of the fatalities were in male student-athletes (n = 60/63, 95.2%). Annual incidence rates of direct and indirect fatalities both declined from 2009 to 2018; direct fatalities from 0.36 to 0.07/100,000AY and indirect fatalities from 0.50 to 0.00/100,000AY. Male baseball (n = 12/63, 19.0%), male judo (n = 9/63, 14.3%), male rugby (n = 7/63, 11.1%), male soccer/futsal (n = 6/63, 9.5%), and male basketball (n = 6/63, 9.5%) were the top five sports that reported sports-related deaths in the study period. Male judo yielded the highest average incidence rate of 4.41/100,000AY (95% CI = 0.68-8.15). CONCLUSION: The annual incidence rates of sports-related direct and indirect fatalities declined through 2009 to 2018. The fatalities affected mostly male student-athletes. Although male baseball reported the greatest number of fatalities in the study period, the risk was highest in male judo when adjusted by participation as indicated by the average incidence rates.