LAUSR

Background Ice hockey is Canada’s most popular winter sport. We have previously demonstrated that injury and concussion risk is reduced >60% in 11–12 year-old players where body checking was disallowed in games nationally in Canada in 2013. Objective: To evaluate the risk of injury and concussion associated with policy change disallowing body checking in games in non-elite Bantam (ages 13–14) ice hockey leagues, compared to body checking leagues. Methods This is a cohort study. Bantam players were recruited from non-elite Bantam teams where policy allowed body checking and following policy change where policy disallowed body checking (2014–2016). A validated injury surveillance system was used to collect preseason, exposure, and injury data. All ice hockey injuries were identified by a team safety designate. Any player with a suspected concussion was referred to a study sport medicine physician. Multivariable Poisson regression analyses controlled for relative age, previous injury, and clustering by team (offset by exposure hours). Findings Forty-nine body checking teams (608 players) and 33 teams non-body checking teams (396 players) participated. There were 123 game injuries [incidence rate (IR)=7.61/1000 hours] and 53 game concussions (IR=3.28/1000 hours). After policy change, there were 27 game injuries (IR=3.19/1000 hours) and 14 game concussions (IR=1.65/hours). Policy disallowing body checking was associated with a reduced rate of all injury [incidence rate ratio (IRR)=0.36 (95% CI; 0.21–0.61)], injury (time-loss >7 days) [IRR=0.35 (95% CI; 0.2–0.62)], concussion [IRR=0.43 (95% CI; 0.21–0.88)], and concussion (time-loss >10 days) [IRR=0.4 (95% CI; 0.18–0.87)]. Conclusion Policy change disallowing body checking in non-elite Bantam ice hockey resulted in a 64% reduction in injury and 57% reduction in concussion rate. Policy implications These findings have important implications for sport policy change informing a reduction in the public health burden of injury.