Effect of bodychecking on injury rates among minor ice hockey players.

BACKGROUND In 2002, Hockey Canada changed the age classifications for minor ice hockey. Previously, 10- and 11-year-old children played at the Atom level (no bodychecking), and 12- and 13-year-old children played at the Peewee level (bodychecking allowed). After the policy change, 11-year-old players were placed in the Peewee division with 12-year-old players; the Atom division included 9- and 10-year-old players. The objective of this study was to examine the effect that the policy change had on injuries to 11-year-old players and compare this information with injury trends among 10- and 12-year-old players. METHODS The study location was the Capital Health region, which serves the greater Edmonton area in Alberta. Capital Health maintains a database of all emergency department visits in the region. A search of the database identified 10-, 11- and 12-year-old players admitted to 7 emergency departments with hockey-related injuries during the 2 years before and the 2 years after the policy change. We also conducted a chart review for the 11-year-old players, extracting detailed information on the nature and circumstances of their injuries for the same period. RESULTS The rate of injuries sustained by 11-year-old children playing at the Peewee level (with bodychecking) increased significantly compared with the rate among 11-year-old players at the Atom level (rate ratio [RR] 1.9, 95% confidence interval [CI] 1.4-2.4). The rate of severe injuries was more than 2 times greater among 11-year-old Peewee players than among 11-year-old Atom players (RR 2.4, 95% CI 1.6-3.6). Injury rates among the 10-year-old players (bodychecking never allowed) and the 12-year-old players (bodychecking always allowed) changed little over the study period. INTERPRETATION The introduction of bodychecking to 11-year-old players was associated with a large increase in injury rates. From a public health perspective, the age at which bodychecking is introduced in minor hockey should be raised.