Today, I did something I had never done before. As a member of ASTM International's subcommittee on standards for headgear and helmets, I had the privilege of voting on a proposed helmet standard, in this case a new standard developed for headgear in women's lacrosse.
I voted in favor of the proposed standard (balloting closes today, so the results aren't yet known; if there are objections, they must be addressed before the standard moves to the second and final balloting phase among a larger portion of ASTM membership). But I didn't vote in favor because I necessarily think that introducing helmets into the women's game is a good idea (as anyone who follows the sport of women's lacrosse knows, the issue has been the subject of furious and often heated debate in recent years, well-chronicled in a recent article on the US Lacrosse's website, which also contains a very helpful discussion of how the ASTM standard now being voted on was developed).
Instead, I voted to approve the draft standard because, without an established standard in place to regulate the headgear that has come on to the market in recent years (none of which, according to US Lacrosse, has been developed based on scientific testing, and none of which the organization - the governing body for both the men's and women's game - has endorsed), consumers are essentially "buying a pig in a poke": in other words, without a clue as to whether the product they are buying has any safety value at all.
Whether headgear in the women's game will make the game safer, of course, is open to debate. The data, says Dawn Comstock, PhD, a professor of Epidemiology for the Pediatric Injury Prevention, Education, and Research (PIPER) program at the Colorado School of Public Health, MomsTeam Institute Board of Advisor and a co-author of a 2014 study on injuries in high school lacrosse [1], "is quite clear - boys most commonly sustain concussions (nearly 75%) from athlete-athlete contact, the kind of mechanism we all know helmets don't always do a great job preventing - while girls most commonly sustain concussions (nearly 64%) from being struck by the ball or the stick, the kind of mechanism that helmets are actually quite good at preventing. Thus, this data clearly supports the call to put girls lacrosse players in helmets."
But, as a former college lacrosse and high school field hockey player, I have reservations about whether requiring female lacrosse and field hockey players to wear helmets will make the sports safer, or, as a result of the phenomenon called risk compensation, actually result in more, rather than fewer, head injuries.
But the only way we will know the answer to that question is to make sure that whatever helmets female lacrosse players wear meet standards that are based on science, and have been developed after a deliberative and collaborative process by an independent organization, like ASTM, which is not funded by helmet manufacturers (unlike NOCSAE), and which does not just invite, but requires input from equipment manufacturers, product testing laboratories, researchers and governing bodies, in this case US Lacrosse.
From the numerous conversations (both on the telephone and via email) that both MomsTEAM's Senior Health and Safety Editor, Lindsey Barton Straus, and I have had over the years with our friends at US Lacrosse, especially CEO, Steve Stenersen (who I started talking to way back in 1999-2000), director of health and sport safety, Bruce Griffin (who was one of the principal authors of the draft standard), and Ann Carpenetti, vice president of lacrosse operations and co-chair of the women's lacrosse headgear task group, I am confident that the draft standard is based on sound science.
My hat is off to US Lacrosse (which, by the way, is an organization that I highlighted in my book, Home Team Advantage, for having a Board of Directors, unlike almost all other sports governing bodies, comprised equally of men and women), for providing the funding needed to design testing protocols and conduct the testing which yielded the data and measurements used in shaping the new headgear standard.
US Lacrosse is acutely aware that developing a headgear performance standard that spurs the introduction of protective equipment designed to limit peak head acceleration resulting from an impact to less than 80g of linear force without introducing additional safety hazards (such as by encouraging more stick contact to the head) is a significant challenge.
"It's our hope that developing a women's lacrosse-specific headgear standard that reflects the significant rule and culture differences between boys' and girls' lacrosse will mitigate the focal impact forces that occur from stick-to-head contact in the girl's game while maintaining the integrity of girls' lacrosse. Whether or not that results in a reduction of concussive events in girls' lacrosse is unknown, although we will certainly be studying it," said Stenersen.
At the same time, US Lacrosse has been correct to point out that protective equipment should be viewed as just one essential element in producing a safe playing experience. Months before the Florida High School Athletic Association voted in late September to mandate soft headgear for girls lacrosse for the 2015 season, Stenersen told MomsTEAM that he believed it would be "highly irresponsible" for high school associations and youth leagues to focus solely on requiring increased protective equipment if it meant ignoring what Stenersen viewed as "the most critical component to a safer, more enjoyable lacrosse experience: requiring nationally-standardized, sport-specific training for coaches and officials as a fundamental qualification to assure that the boys' and girls' lacrosse is being taught (and the rules are being enforced) correctly."
Well said, Steve. Well said.
1. Xiang J, Collins C, McKenzie L, R Comstock. Lacrosse Injuries Among High School Boys and Girls in the United States: Academic Years 2008-2009. Am J Sport Med; 2014. DOI: 10.1177/036354651453991 (published online July 22, 2014)
