User:SarahProudman/Price to play? Australia’s sports Injuries Epidemic

Sport is more than just a pastime within the Australian community; it has shaped the growth and identity of the Australian population and has been known as the nation’s religion. Daily, Australian sporting heroes are celebrated for their new feats but should we really be celebrating something that is contributing to one of the most costly health problems the Australian community has seen?

Injuries from sport and exercise are undoubtedly Australia’s most under-appreciated and costly health problem, affecting the elite gold medal winning, right down to those involved at grass roots level participation. The Australian Sports Commission has reported that over 12 million people aged 15 and over do some form of exercise at least once a week, with 5.2 million of these participants suffering a sports injury, varying from cuts and bruises to serious fractures and hospital stays. Taking into account treatment, rehabilitation, recovery time and absence from work, sports injuries are estimated to cost the community a small figure of $2 billion each year! If this reported figure is correct the total cost to the economy is on par with the current cost of obesity.

This article will discuss the past attempts to alleviate the growing problem and address the fact that there is currently no national agency in Australia to guide sport safety policy and to consider provision of infrastructure. Recommendations will be thoroughly addressed based on investigation of international models of sport injury prevention schemes.

Presentation - A Price to Play: Australia's Sports Injuries Epedemic
Attached is the link to my presentation. This is designed to provide further information regarding the topic of the Australia's Sports Injury Epidemic. It adds supplementary information to the report followed and follows the same structure. All information has been taken from the report, and reference can be found in the associated area within the report. On the final slide all photo links have been acknowledged and provided. The presentation provides a single point of view of the topic, and addresses the growing concern of sports injuries in Australia. The key point of the presentation is that Australia is far behind in the area of injury prevention in sport, when comparing with many international campaigns and schemes. Australia’s past attempts to combat the issue are dismal and something must be done now! Australia needs to establish some form of injury prevention scheme/initiative in order to combat the issue before things get out of hand and the cost of sports injuries overtakes that of obesity. I hope the presentation is found to be informative and interesting, and please read on for a greater understanding of this controversial issue.

Link: http://www.youtube.com/watch?v=zDJUCL4oIlM&feature=youtube_gdata

Introduction: Setting the scene
Sport has long played an important cultural role in Australia, and has led to the growth and identity of the Australian community and will continue to do so into the future years. We are often seen as a sport-obsessed nation, our society besotted with watching and playing sport. It would be safe to say that we have all participated in a sport or recreational activity at one stage or another within our lives. The Australian Sports Commission’s most recent Exercise, Recreation and Sport Survey (ERASS) certainly supports this statement by reporting that 12.2 million people aged 15 and over, or 69.4% of the population living in occupied private dwellings, participated at least once per week in physical activity for exercise, recreation or sport in the year of 2010.

It is impressive that these figures are present for Australian society as it is a known fact as stated by Orchard & Finch that a lack of exercise is an established major risk factor for many chronic illnesses and premature mortality. However we begin to see a catch 22 as injuries from sport and exercise are undoubtedly Australia’s most under- appreciated and costly health problem, affecting the elite gold medal winning, right down to those involved at grass roots level participation. Since the mid to late 1990s, there has been a shift with sports injuries increasingly being recognised as a significant public health issue and one that needs a strong preventive approach. Accordingly, sports injury prevention has become an issue of concern to many Government agencies. However the full extent is certainly unclear as there is a lack of research undertaken in this area; however the closest and most recent report ‘Sport Safe Report’ was published in 2006 by Medibank Private. The report stated two major findings: (Medibank Private, 2006)
 * 1) Sports injuries in Australia cost the community $2 billion each year – this figure takes into account treatment, rehabilitation, recovery time and absence from work
 * 2) 5.2 million Australians suffer sports-related injuries annually  - with the highest risk age group for injuries being 18-24 year olds – The common injury types and there  approximate cost are shown in the table below

The main issue underlying this billion dollar problem is Australia’s lack of efforts in establishing a national body to guide sport safety policy and injury prevention schemes. In order to establish what is imperative for the future we must first understand what has occurred in the past. Therefore Australia’s past dismal attempts to alleviate the growing problem will be addressed, with a specific discussion of the Australian Sports Injury Prevention Taskforce (ASIPT), The National Sports Safety Framework, Sportsafe Australia, The National Injury Prevention Plan and the New South Wales Sporting Injury Prevention Scheme. Subsequently an investigation will then be presented on international models, including a brief look at an American injury prevention initiative - STOP (Sports Trauma and Overuse Prevention) Sports Injuries and a thorough investigation on New Zealand’s Accident Compensation Corporation (ACC) as possible models for sports injury surveillance to undertake in Australia in the future.

The Australian Sports Injury Prevention Taskforce (ASIPT)
The Australian Sports Injury Prevention Taskforce (ASIPT) was established in 1995 by the Australian Sports Commission through the then Commonwealth Department of Human Services and Health. The taskforce was purely an advisory and coordinating body with its main aim to promote a national perspective on sports injury prevention. The taskforce continued its efforts in providing a foundation for the future direction of sports injury in Australia, until ceasing to exist in 1998. The taskforce was never intended to exist for any substantial amount of time.

National Sports Safety Framework
In 1997 the taskforce released the National Sports Safety Framework, which as stated by the Department of Health and Aging, ‘recognised that sports injuries are a cost burden on both individuals and society with respect to the duration/nature of treatment, the amount of sport/working time lost, permanent damage/ disability, reduced quality of life and other monetary costs’. Since the late 1990’s the framework has still existed however there has been a notable lack of national leadership to implement this framework.

SportSafe Australia
Sportsafe Australia was established as a collaborative national initiative by the ASC and the Commonwealth Department of Health and Aged Care in 1996, with its main aim to progress sports safety at the national level in Australia through the development of educational material and resources. For its first two years it was based with the Participation Division at the ASC, in its later two years the ASC outsourced the work to Sports Medicine Australia. A lack of infrastructural support for sports safety action and ownership of the problem both at a local and state level was a huge issue. Funding ceased at the end of 2000 and since there has been no national sports safety initiative present.

National Injury Prevention Plan
The National Injury Prevention Plan has been the final and most recent initiative to emerge in the realm of injury prevention. The Strategic Injury Prevention Partnership, representing health departments in all jurisdictions was responsible for implementing the plan in August 2000. However, the plan is irrelevant to the sports injury prevention sector as the list does not include the prevention of sports injuries, as little is known about sports injuries and the risk factors associated.

New South Wales Sporting Injury Prevention Scheme
Sports injury prevention has also been a concerned focus to State Government agencies within Australia. The New South Wales Government formed a committee, the NSW Sporting Injuries Committee; with the main objective to combat and prevent sports injuries. The Sporting Injuries Insurance Scheme was enacted in 1978 by the committee to specifically compensate those involved in serious sporting injuries where more than 35% permanent loss to a body part occurred. The scheme is still current and has become a successful, non compulsory, non-profit government insurer for sports participants sustaining catastrophic sports injuries. Through the scheme the committee has been able to fund a variety of sports injury activities in NSW. These including: However, the scheme does not come without limitations. The NSW Scheme is not compulsory for all sports, therefore when research is conducted there is a lack of complete data being assessed resulting in questionable findings. Also although subjective evidence would suggest that the scheme has impacted in some areas, there has been no reported assessment of the impact the scheme has had on sports injuries across the state and this has not been pertained due to the lack of complete data surrounding the scheme.
 * Research
 * Injury Surveillance
 * Health Education
 * Health Promotion
 * Capacity building initiatives

American Initiative: STOP (Sports Trauma and Overuse Prevention) Sports Injuries
The STOP (Sports Trauma and Overuse Prevention) Sports Injuries campaign is a comprehensive public outreach program with the importance of sports safety-specifically relating to overuse and trauma injuries being the focal point. The initiative not only aims to raise awareness but also provides education on injury reduction, but highlights how playing safe and smart can enhance and extend a child's athletic career, improve teamwork, reduce obesity rates and create a lifelong love of exercise and healthy activity.

The development of the STOP (Sports Trauma and Overuse Prevention) Sports Injuries campaign was initiated by the American Orthopedic Society for Sports Medicine (AOSSM) in early 2007. The Board of Directors decided that the issue of overuse injuries in young athletes was becoming critical and needed to be addressed. Research was undertaken to highlight the main sports with high incidence of injury and specific resources, including fact sheets and brochures, for each sport were developed. Other educational initiatives include public service announcements, posters, DVDs, electronic newsletter, interactive website and other social media. Having a nationwide impact the program has used various media outlets and partnerships to increase awareness to the community and the local grassroots sector.

The lack of government involvement and the non-compulsory nature of all sports to be involved are the main two issues surrounding this initiative. However, there has been a great response from the community and at least there is something in place to combat the issue. Certainly a step above where Australia is in the scheme of injury prevention campaigns on a national level.

The New Zealand Accident Compensation Corporation (ACC): The Gold Standard
New Zealand undoubtedly holds the forefront for injury prevention, with an astounding infrastructure to monitor sports injuries. The New Zealand Accident Compensation Corporation (ACC) began operation on 1 April 1974 as a universal, government funded scheme, recommended by a Royal Commission Report know as the Woodhouse Report, the scheme was based on an insurance model that aimed to provide cover for all. As stated on the website, ‘One of ACC's major goals is to reduce the number and severity of injuries and keep New Zealanders playing and engaging in the activities we enjoy’. Orchard and Finch have stated that from a public health viewpoint,’ New Zealand’s system of maintaining a government body that monitors, compensates and seeks to prevent sports injuries is superior to Australia’s lack of any comparable system’.

Due to the scheme covering the medical bills of all those injured playing sport, the ACC has the capacity to accurately determine the cost of treating sports injuries in New Zealand and a precise depiction can occur of the severity of injury and determine the high risk sports. Furthermore, the dense information available to the New Zealand authorities has enabled them to cut the incidence of serious sports injury. An example in Rugby includes the use of mouthguards, this has increased from 67% to 93% and convincingly the related dental claims have fallen by 43%! . It must be noted that in Australia there is no organised body paying dental claims, and therefore no strong financial motivation to encourage mouthguard usage. Due to the ACC having a fundamental financial interest in seeing the number of injuries decline, New Zealand are far more active in assembling prevention programs. As the New Zealand system carries the advantage of being a ‘no fault’ insurance scheme it prevents sports participants from taking common law action against those associated with sporting events. Similar liability restrictions are needed in Australia to remove the fright of lawsuits that is developing among volunteers who cover sporting events.

Conclusion
Australia’s passion for sport, recreation and exercise will never cease to exist and in turn the injury epidemic will follow hand in hand. With the incidence of sports injuries in Australia reaching an alarming level, it is more than apparent that Australia is lacking in the Injury Prevention initiative department. With New Zealand and, to a certain extent, America running circles around the Australian system, offering world-class and groundbreaking initiatives to combat the ever increasing concern. Something must be done in order for the Australian community to cease suffering from this rising economic burden. Therefore from the evidence collected it can be concluded that Australia possesses the approach of having no overall plan.

It is imperative for Australia to employ all or, at the current predicament, any of the strategies mentioned following:
 * Establish a national lead body with responsibility for sports safety and injury surveillance and consider the provision of infrastructure. In doing so, explore the option of employing a New Zealand or American style system
 * Form greater cooperation between the sport and health departments in Canberra to address cause and effect of sport injury and allow for a more coordinated approach to the issue
 * Develop a nationwide database on injuries occurrence from sport, involving as many sport organisations, hospitals and health professionals as possible
 * Implementation of compulsory rules regarding mouthguards and protective equipment for the required sports
 * National and lead health and sport agencies, sports clubs and organisations, sports facilities and individuals need to all be articulated in the delivery of future sports injury prevention activities
 * Accredited coaching and sports training personnel in order to contribute to sports safety through limiting training mistakes and knowledge of appropriate injury prevention and management techniques
 * Formal training for volunteers involved in sporting clubs and events in order to widely promote safe sport awareness initiatives