American Medical Society for Sports Medicine
For Immediate Release
May 16, 2006
Sickle Cell Trait Screening by Collegiate Physician
Sickle cell trait (SCT) has been implicated in exercise-associated morbidity and mortality over the last several decades. These rare events are thought to be related to exercise in “extreme” conditions of high temperature, humidity, and high elevation. If the athlete is deconditioned, dehydrated, having an acute fever, or not acclimated to the altitude, their risk is increased in the above environmental settings. Therefore, many sports medicine programs in the NCAA screen for SCT with blood testing during the pre-participation physical examination (PPE). How prevalent SCT screening is in collegiate athletics is unknown; additionally, how sports medicine staff use this data is unknown.
At the Annual Meeting of the American Medical Society for Sports Medicine this month in Miami, Florida, Dr. Ed Clarke presented his research addressing these questions. Ninety-two division 1-A schools participated in the study (77% response rate), and 64% of these have established criteria for sickle cell trait screening at the PPE. Of these schools 91% screen athletes with family history of sickle cell disease or trait, 76% screen African American athletes, and 21% of these screen all athletes. The majority of the time (80%), these schools screen “to initiate preventive measure”. Of the non-screening schools, 72% reported “lack of evidence based data supporting such screening”, and 38% thought it “cost prohibitive.”
Use of the screening tests results involved 1) counseling athletes with SCT about potential risks during exercise (97% of schools), and, 2) genetic counseling (60% of schools). Certified athletic trainers, strength/conditioning coaches, and coaches are notified of SCT test results the majority of the time. When looking at the majority of schools that screen for SCT, 22% have directly treated athletes with a complication of SCT during exercise. No significant relationships in screening were seen in physician demographics or environmental factors (heat, elevation, etc.).
Dr. Clarke concluded that blood testing for SCT is common in division 1-A athletics, and schools are doing a good job of educating SCT athletes about their risks. More research is needed to determine if the practice is cost effective, and to see if interventions will in fact reduce SCT related complications. This research is the first to examine screening frequency and use of data for SCT in universities. Dr. Clarke received one of AMSSM’s research awards for his study. He is a member of AMSSM.
The American Medical Society for Sports Medicine (AMSSM) was organized in 1991 by physicians who recognized the need for an organization within the field of sports medicine that approached athletes, exercising individuals, and teams comprehensively with consultative and continuous care of their orthopedic, medical, nutritional, and psychosocial issues. Although sports medicine concepts are often thought of in conjunction with professional and elite athletes, these concepts apply to athletes of all levels including grade school, high school, college and recreational athletes. AMSSM is comprised of over 1000 Sports Medicine Physicians whose goal is to provide a link between the rapidly expanding core of knowledge related to sports medicine and its application to patients in a clinical setting.
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