The 19th annual report of the National Center for Catastrophic Sport Injury Research says that athletics administrators should pay particular attention to safety concerns in high-school wrestling.

The report noted that wrestling has been associated with 43 direct catastrophic injuries over the past 19 years, 42 of them at the high-school level.

"High-school wrestling coaches should be experienced in the teaching of proper skills of wrestling and should attend coaching clinics to keep updated on new teaching techniques and safety measures," said the report, written by Frederick O. Mueller of the University of North Carolina, Chapel Hill, and Dr. Robert C. Cantu of Emerson Hospital in Concord, Massachusetts.

The report provides an annual assessment of direct and indirect catastrophic injuries and fatalities occurring in high-school and college sports.

The most recent report also stressed that wrestling coaches at all levels need to be aware of the dangers associated with athletes making weight. The authors said that the three deaths that occurred in college wrestling in 1997-98 were the first wrestling deaths associated with weight reduction. However, they also said that no data are available on the number of wrestlers who experienced medical problems related to weight loss but recovered.

"Making weight has always been a part of the wrestling culture," the report said, "but it is dangerous and life-threatening."

Cantu and Mueller also mentioned ice hockey, baseball, and track and field as areas meriting attention.

They said that ice hockey was associated with higher injury rates at both the high-school and college levels. The report said that the overall number of catastrophic injuries in ice hockey is small, but the incidence per 100,000 is high when compared with other sports. "Ice hockey catastrophic injuries usually occur when an athlete is struck from behind by an opponent, slides across the ice in a prone position and makes contact with the crown of his/her head and the boards surrounding the rink," the report said.

The report also said that while the incidence rate for serious injuries in baseball and track has been low over the history of the study, 38 catastrophic injuries have been reported in baseball and 47 more have been reported in track. Most of the baseball injuries have been caused by the head-first slide or by being struck by a thrown or batted ball. The 2001 data revealed one college pitcher being struck in the head with a batted ball during practice, one player being struck in the head with a batted ball during warm-ups and one player being injured in a collision between a shortstop and a second baseman.

In track, most fatal injuries involved the pole vault. The report noted that all pole vault injuries or fatalities over the last two decades involved the vaulter bouncing or landing out of the pit area.

"Whenever there is a pole vaulting death, there are more proponents of eliminating the event," the report said. "The crux of the opposition appears to be the potential liability and also the lack of qualified coaches to teach the pole vault."

The authors said that pole vaulting is estimated to have 25,000 participants across the nation. If that number is correct, they said, it would have the highest catastrophic-injury rate of any sport.

Cantu and Mueller also described track and field deaths involving thrown discuses, shot puts or javelins. "Good risk management should eliminate these types of accidents," they wrote. "These types of injuries are not acceptable and should never happen."

Football continues to be associated with the greatest number of catastrophic injuries, although a number of sports have higher incidences of injury and death. For the 2000 football season, the authors noted 24 high-school direct catastrophic injuries, an increase of three from 1999. College football was associated with five direct catastrophic injuries in 2000, an increase of two compared to 1999.

The authors also noted 12 indirect fatalities in football (10 high school and two college). Eight of the high-school indirect fatalities were heart-related and the other two were heat-related. Both college indirect fatalities were heat-related.

The complete report can be viewed at www.unc.edu/depts/nccsi.