Concussion among college students more likely off sports field than on

By Sally Robertson, B.Sc.Dec 18 2019

Rates of concussion among college students are more than twice as high as previously thought and are much more likely to happen off the sports field than on, according to a new study recently published in JAMA Network Open.

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The research, which assessed student health data from the University of Colorado Boulder, also found that concussion is slightly more prevalent among females and that it occurs most frequently in the month of August.

Study author, John Breck, says the findings show how common head injuries are among this population and that concussions are not restricted to the athletic field: "Student health centers around the country should be training their staff in concussion recognition and putting systems in place to help concussed students get the evaluation and treatment they need."

What did the study involve?

The study is one of the first to assess concussion rates among the overall college-age population. The researchers monitored diagnoses made during the academic year at the Wardenburg Student Health Center between August 2015 and May 2018 and also used data from the CU Sports Medicine department for varsity athletes who were treated between 2016 and 2018.

The team found that among approximately 30,000 public university undergraduates, about 340 concussions were diagnosed every year, giving an incidence rate of around one in 75 students annually.

Forty-one percent of students who were diagnosed said they had already sustained between one and three concussions, and 5% said they had already sustained at least four.

Non-sports-related concussions were more common than sports-related ones

Across all three years assessed and whether varsity athletes were included or not, concussions unrelated to sports were more common than sport-related ones.

When varsity athletes were not included, 64% of concussions were found to be unrelated to sports, and the rest occurred during organized competitive sports sessions. Thirty-eight percent of concussions resulted from falls, 8.5% were caused by hits to the head, and 6.5% were the result of motor vehicle accidents.

When varsity athletes were included, the incidence of sport-related concussion was 51 per 10,000 students per year, and for concussion unrelated to sport, it was 81 per 10,000 students per year.

In total, the incidence of concussion was 132 per 10,000 students per year.

There is a widely held perception that most concussions are sport-related. Our study shows it can happen to anyone, male or female, engaged in a variety of activities."

Co-author Matt McQueen, University of Colorado

Concussion incidence soared in August

Across all the years assessed, concussion was found to be more common in August than in any other month.

"These data do not tell us why August had such high numbers, but anecdotally we know that August is a time of lower academic demand and higher risk-taking behavior," says Breck.

Females appear to be more susceptible to concussion

Among the varsity athletes, concussion rates were higher among females. Across two academic years, 54 females and 26 males sustained concussions, a finding that is consistent with other recent research that reported a 6-fold increase among females between 2003 and 2013 and only a 3.6-fold increase among males over the same period.

While it is not clear precisely why females seem to be more likely to sustain concussions, differences in neck strength, head mass, and hormones may contribute, suggests Breck.

Concussion rate may be more than twice as high as previously thought

Previous concussion research by the Centers for Disease Control and Prevention found that the incidence rate among individuals aged 9 to 22 years was approximately 98 per 10,000 per year. The World Health Organization has reported that the rate among the general population is approximately 60 per 10,000 people.

The current study, however, pegged the rate at more twice that.

"Our findings suggest that collegiate students, including the general population and varsity athletes, may be at an increased risk of concussion," concludes the team.

The researchers note that other studies have been based on self-reports or emergency room visits or focused only on varsity athletes, which could generate underestimates.

Another explanation is that more awareness about concussion could be prompting students to seek help, which is positive, says the team.

"Missing class and falling behind due to a head injury can be a significant detriment to a student's academic success," says Breck. "It's critical that they get high quality, evidence-based care as soon as possible so they can return to learning in a safe way with as little disruption in their education as possible."