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Basic Components of Injury Surveillance

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Over the past 40 years, injury data collection has increased the sports injury specialist’s understanding of the nature and frequency of sport injuries. More recently, leaders in ISS data collection have identified the basic variables that are most valuable to enhancing this understanding. Consistent in surveillance systems are discrete variables, such as sport classification/type, activity type (practice/game), and mechanism of injury. Other components, such as defining an injury or determining the number of athlete-exposures (AEs), lack standardization. Although improved, ISS is not entirely uniform across collectors, agencies, or sports. Because of the lack of uniformity and standardization, surveillance systems can lack context.

Surveillance systems collect data that are used to identify risk factors associated with injury.2 It answers the “who, what, where, when, and how” of a sports injury. The most common inquiries are which sport has the highest risk for injury, what are the most common injuries in sport, and what was the cause of the injury. However, deeper questions can be answered, such as the following:

• How do injuries vary based on playing position, gender, or from season to season?

• What types of injuries occur in which sports?

• Does the frequency of injury vary in practice vs game settings?

• Does the facility contribute to or limit injuries (ie, turf surface)?

• Do rules encourage or limit dangerous play?

• Is the use of certain equipment associated with more or fewer injuries?

• Is the physical condition of the athlete limiting or contributing to the frequency or severity of the injury?

Sport Classification

Nomenclature must be precise. Most classifications for surveillance systems are by sport name (ie, soccer, rugby, basketball, cheerleading).2,7,8,12,14 Several classifications used in sport or epidemiology may not be consistently used in surveillance systems or may group sports based on similarities. Some terms include noncontact, contact, or collision sport; team or individual; or equipment-intensive sport. Some classifications come from the application of the surveillance data. For example, low risk, moderate risk, and high risk are used in determining the appropriate medical coverage.28

Type of Activity

Several surveillance systems request specific details about participation. Typically, this refers to variables, such as practice or game and position played.2,7,8,12,14 This requires providing information regarding competition vs training injuries. Match or game exposure is defined as any activity that occurs between different teams or clubs. If a scrimmage is occurring within the same team, this would typically be defined as training or practice, unless specifically defined in the report. Training or practice exposure is team-based, noncompetition sessions. For most systems, a warmup pregame and cooldown postgame are also identified as training or practice. Individual training by the player who is unsupervised by the coach is not considered in surveillance. These injuries are not documented. Furthermore, any training exposure that is part of a player’s rehabilitation is not considered training.3,8,9

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