CPSC Releases Study of Protective Equipment for Baseball

June 4, 1996
Release # 96-140

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For Immediate Release;
Contact: Kathleen Begala
(301) 504-0580 Ext. 1193

"We want kids outside in the sunshine, not inside in an emergency room," said CPSC Chairman Ann Brown.

WASHINGTON, D.C. The U.S. Consumer Product Safety Commission (CPSC) announced today that safety equipment for baseball could significantly reduce the amount and severity of 58,000 (or almost 36 percent of) baseball-related injuries to children each year.

Baseball, softball, and teeball are among the most popular sports in the United States, with an estimated 6 million children ages 5 to 14 participating in organized leagues and 13 million children participating in non-league play. In 1995, hospital emergency rooms treated 162,100 children for baseball-related injuries.

At a press conference at Camden Yards stadium, home of the Baltimore Orioles, CPSC released the findings from its one-year study on the ability of protective equipment, including softer-than-standard baseballs, safety release bases, and batting helmets with face guards, to reduce injuries to children playing baseball.

"CPSC is the federal agency responsible for overseeing the safety of 15,000 different types of consumer products, including sports equipment and products claiming to reduce injuries and increase safety," said CPSC Chairman Ann Brown. "Parents need to know what options they have in protective equipment so they can make the best decisions for their children playing baseball."

Nick Senter, executive director of the Dixie Baseball League, an organization based in 11 Southern states, and Richard Bancells, trainer of the Baltimore Oriole's baseball team, joined Chairman Brown for today's announcement.

Senter said, "Since we began using batting helmets with face guards in the Dixie League, we've seen a drop in both injury rates and insurance rates."

CPSC collected and analyzed data on baseball, softball, and teeball-related deaths and injuries to children to determine specifically how these children were injured and what safety equipment could prevent such injuries. CPSC also studied voluntary safety standards and reviewed published scientific literature evaluating currently available protective equipment.

CPSC analyzed the 88 reports it received of baseball-related deaths of children between 1973 and 1995. It found that 68 of the deaths were caused by ball impact and 13 were caused by bat impact. Of the 68 ball impact deaths, 38 resulted from blows to the chest while 21 deaths were caused by a ball hitting a player's head.

Of the 162,100 hospital emergency-room-treated injuries in 1995, most of the injuries (almost 75 percent) occurred to older children ages 10 to 14. This age group represents about half of the total number of children playing baseball.

Of the total number of injuries to children, CPSC considers about 33 percent severe, including fractures, concussions, internal injuries, and dental injuries. The remaining 67 percent less severe injuries include contusions, abrasions, lacerations, strains, and sprains. More than 50 percent of the children under age 11 who were injured while playing baseball sustained injuries to the head and neck area, while a larger percentage of older children sustained injuries to their arms and legs.

Based on its analyses, CPSC found that three pieces of safety equipment will help reduce injuries. Softer-than-standard baseballs and softballs, which have a softer, spongier core than standard baseballs and softballs, can reduce ball impact injuries. Face guards that attach to batting helmets and protect the face can reduce injuries to batters.

Safety bases that release from their anchor can reduce sliding injuries. Safety release bases that are based on age, gender, and skill levels of the players provide the best protection.

Conclusions from the CPSC Study:

• Baseball protective equipment currently on the market may prevent, reduce, or lessen the severity of more than 58,000 injuries or almost 36 percent an estimated 162,100 hospital emergency-room-treated, baseball-related injuries occurring to children each year.
  
  
• Softer-than-standard balls may prevent, reduce, or lessen the severity of the 47,900 ball impact injuries to the head and neck.
  
  
• Batting helmets with face guards may prevent, reduce, or lessen the severity of about 3,900 facial injuries occurring to batters in organized play.
  
  
• Safety release bases that leave no holes in the ground or parts of the base sticking up from the ground when the base is released may prevent, reduce, or lessen the severity of the 6,600 base-contact sliding injuries occurring in organized play.
  
  

Study Overview on Baseball Deaths, Injuries, and Protective Equipment

The U.S. Consumer Product Safety Commission (CPSC) is releasing the results of a one-year study on the ability of safety equipment to reduce baseball injuries and deaths. The study found that injuries to children playing baseball could be reduced by the use of softer-than-standard baseballs, face guards on batting helmets, and safety release bases. CPSC's baseball project found that protective equipment could significantly reduce the number and severity of 58,000 or almost 36 percent of baseball-related injuries to children each year.

Baseball, softball, and teeball are among the most popular youth team sports in the United States. CPSC estimates that 6 million children ages 5 to 14 participate each year in organized leagues, while another 13 million children participate in non-league play.

Baseball leads team sports in deaths to children with three to four deaths each year. The sport ranks third in annual injuries to children following basketball and football. In 1995, hospital emergency rooms treated an estimated 162,100 children for baseball-related injuries.

Methodology

CPSC is the federal agency responsible for overseeing the safety of 15,000 different types of consumer products, including sports equipment and products claiming to reduce injuries and increase safety.

CPSC collected and analyzed data on baseball, softball, and teeball-related deaths and injuries to children ages 5-14 to determine specifically how these children were injured and what safety equipment could prevent such injuries. CPSC also studied voluntary safety standards and reviewed published scientific literature evaluating currently available protective equipment, including softer-than-standard baseballs and softballs, face guards for batting helmets, and modified safety bases. This study analyzed injuries to children playing baseball in organized league play and informal recreational backyard, school, and neighborhood play.

Analysis of Death and Injury Data

CPSC collected information on deaths from death certificates, the agency's Medical Examiners and Coroners Alert Project, consumer complaints, and news clips.

From 1973 to 1995, CPSC received reports of 88 baseball-related deaths to children.

• 68 deaths or 77 percent from ball impact
• 13 deaths or 15 percent from bat impact
• 7 deaths or 8 percent cause unknown

The 68 ball impact deaths break down as follows:

• 38 deaths or 56 percent to the chest
• 21 deaths or 31 percent to the head
• 9 deaths or 13 percent to other areas

To obtain information on how baseball-related injuries to children occur, CPSC used injury data from April 1995 to August 1995 from hospital emergency rooms collected by the agency's National Electronic Injury Surveillance System also know as NEISS. CPSC completed a telephone survey of 348 NEISS cases of injured children answering questions (with parental permission) or with parents answering questions about their children's injuries and use of protective equipment.

Hospital emergency rooms treated about 162,100 children ages 5 to 14 for baseball-related injuries in 1995. Most of the injuries, almost 75 percent, occurred to the older children ages 10 to 14, representing about half of the total number of children in this age group.

Of the total number of injuries to children, CPSC considers about 33 percent as severe, including fractures, concussions, internal injuries, and dental injuries. The remaining 67 percent of the less severe injuries include contusions, abrasions, lacerations, strains, and sprains. More than 50 percent of the children under age 11 who were injured while playing baseball sustained injuries to the head and neck area, while a larger percentage of older children sustained injuries to their shoulders, arms, and legs.

• 162,100 hospital emergency-room-treated, baseball-related injuries to children ages 5-14
  
  
• Almost 75 percent of injuries occur to children ages 10-14
  
  
• 33 percent of injuries were severe
  
  

Based on the telephone survey of 348 hospital emergency-room cases, CPSC identified the causes of the 162,100 baseball-related injuries to determine whether protective equipment could prevent injuries.

Analysis of Baseball Protective Equipment

Ball impact injuries to the head and chest are the most severe and frequent of all baseball injuries. Ball impact to the chest accounted for 38 deaths, while ball impact to the head accounted for 21 deaths. Of the 88,700 ball impact injuries, which account for 55 percent of all hospital emergency-room-treated baseball injuries, 54 percent (or 47,900 ball impact injuries) were to the head and neck. 35,200 ball-impact injuries to the face occurred during organized play.

Official major and youth league standard baseballs have a core of cork or rubber, which is wound with natural or synthetic fibers, such as wool or cotton, and covered with two pieces of leather sewn together with 108 stitches. Softer baseballs have a much larger core made of soft, spongy natural or synthetic substances, such as soft polyurethane, rubber, or kapok, with no winding, and a cover. Softer-than-standard softballs have a spongier core than standard softballs.

Softer-than-standard baseballs and softballs may reduce the risk and severity of 47,900 hospital emergency-room-treated injuries to children being hit by the ball, particularly to the head and neck. CPSC found that 97 percent of ball impact injuries where the child identified the type of ball involved a standard ball. The percent of hospital emergency-room-treated injuries involving softer balls were lower than their share of the market, and injuries from softer balls were less severe than those from standard balls. Softer-than-standard baseballs and softballs are available nationwide at prices that are competitive with standard baseballs and softballs.

CPSC studied all available scientific literature on the softer-than-standard baseball, including published articles suggesting that softer balls may increase the risk of death from ball impact to the chest. CPSC commissioned expert reviews of these articles, which found that the biological and biomechanical models used to mimic chest impact deaths in children were not accurate representations of the way death occurs to children on the baseball field. The agency has found no convincing evidence that softer balls increase the risk of chest impact death. In contrast, an expert review determined that softer-than-standard baseballs can reduce head injuries.

Face Guards for Batting Helmets

In 1995, children received an estimated 3,900 hospital emergency-room-treated injuries to the face while at bat. Face guards attach to batting helmets to protect the face, including the eyes, nose, mouth, jaw, and cheeks.

The face guards currently on the market must be installed or attached to a batting helmet. They are made from clear polycarbonate plastic or plastic coated wire and retail for about $10. CPSC found that none of the injured players it studied received facial injuries while wearing batting helmets with face guards.

CPSC has determined that the current ASTM voluntary standard for face guards is effective in preventing facial injuries. According to the standard, the face guard must prevent the ball from touching the face. Although youth leagues generally require children to use batting helmets, only one league requires batting helmets with face guards.

Safety Release Bases

In 1995, sliding injuries accounted for about 13,000 hospital emergency-room-treated injuries or 8 percent of the total number of injuries to children playing baseball. Of these sliding injuries, about 8,200 or 63 percent were caused when children slid into the base with 80 percent or 6,600 of these base-contact sliding injuries occurring during organized play. Girls appear to be at a higher risk of injury from base-contact sliding injuries than boys.

CPSC studied several styles of modified safety bases to determine which would reduce the risk of injury from sliding into the base. For reducing the risk of sliding injuries, CPSC recommends one style of a safety base with the following characteristics: releases from its anchoring system upon impact; leaves no holes in the ground or parts of the base sticking up from the ground when the base is released. Since girls appear to be at higher risk, models based on age, gender, and skill levels of the players may provide the greatest level of protection.

The list price for a set of safety release bases ranges from $300 to $595 compared with $150 for a standard three-base set, although these safety bases tend to outlast regular bases. In addition, currently available safety release bases with the recommended characteristics require permanent installation in the ground.

Conclusions

• Baseball protective equipment currently on the market may prevent, reduce, or lessen the severity of more than 58,000 injuries or almost 36 percent of an estimated 162,100 hospital emergency-room-treated, baseball-related injuries occurring to children each year.
  
  
• Softer-than-standard balls may prevent, reduce, or lessen the severity of the 47,900 ball impact injuries to the head and neck.
  
  
• Batting helmets with face guards may prevent, reduce, or lessen the severity of about 3,900 facial injuries occurring to batters in organized play.
  
  
• Safety release bases that leave no holes in the ground or parts of the base sticking up from the ground when the base is released may prevent, reduce, or lessen the severity of the 6,600 base-contact sliding injuries occurring in organized play.
  
  

Bibliography

1. Viano, D.C., McCleary, J.D., Andrzejak, D.V., and D.H. Janda, "Analysis and Comparison of Head Impacts Using Baseballs of Various Hardness and a Hybrid III Dummy", Clinical Journal of Sport Medicine 3: 217-228, 1993.

2. Janda, D.H., Wojtys, E.M., Hankin, F.M., and M.E. Benedict, "Softball Sliding Injuries: A Prospective Study Comparing Standard and Modified Bases", Journal of the American Medical Association 259: 1848-1850, 1988.

3. Sendre, R.A., Keating, T.M., Hornak, J.E., and P.A. Newitt, "Use of the Hollywood Impact Base and Standard Stationary Base to Reduce Sliding and Base-Running Injuries in Baseball and Softball", American Journal of Sports Medicine 22: 450-453, 1994.

4. Viano D.C., Andrzejak, D.V., and A.I. King, "Fatal Chest Injury by Baseball Impact in Children: A Brief Review", Clinical Journal of Sport Medicine 2: 161-165, 1992.

5. Viano, D.C., Andrzejak, D.V., Polley, T.Z., and A.I. King, "Mechanism of Fatal Chest Injury by Baseball Impact: Development of an Experimental Model", Clinical Journal of Sport Medicine 2: 166-171, 1992.

6. Janda, D.H., Viano, D.C., Andrzejak, D.V., and R.N. Hensinger, "An Analysis of Preventive Methods for Baseball-Induced Chest Impact Injuries", Clinical Journal of Sport Medicine 2: 172-179, 1992.

7. Estes, N.A.M., "Sudden Death in Young Athletes (editorial)", New England Journal of Medicine 333: 380-381, 1995.

8. Maron, B.J., Poliac, L.C., Kaplan, J.A., and F.O. Mueller, "Blunt Impact to the Chest Leading to Sudden Death from Cardiac Arrest During Sports Activities", New England Journal of Medicine 333: 337-341, 1995.

Sources

Lyle J. Micheli, M.D., Director, Sports Medicine, The Children's Hospital, 300 Longwood Ave., Boston, MA 02115; (617) 355-6534

Barry J. Maron, M.D., Director, Cardiovascular Research Division, Minneapolis Heart Institute Foundation, 920 East 28th St., Suite 40, Minneapolis, MN 55407-3984; (612) 863-3996/3984

Flaura Winston, M.D., Ph.D., The Children's Hospital of Philadelphia, 34th Street & Civic Center Blvd., Room 2426, Philadelphia, PA 19104; (215) 590-5208

Christine Branche-Dorsey, Ph.D., Epidemiologist, National Center for Injury Prevention and Control, Centers for Disease Control, 4770 Buford Highway, NE, Chamblee, GA 30341;
(770) 488-4652