Protective baseball gear used to prevent injury on the playing field may not reduce the risk of injury, according to a study appearing in the July issue of the Clinical Journal of Sports Medicine.

Over the last decade, at least 25 children hit in the chest by baseballs have died. The study found that soft core baseballs and chest protectors designed to reduce injury failed to provide a significant benefit and in some cases actually increased the risk of injury.

Conducted by the Institute for Preventative Sports Medicine, Ann Arbor, Michigan, the study tested eight types of baseballs and nine types of chest protectors. Researchers fired the baseballs at a crash dummy previously used to test auto safety. The balls were fired at 80 mph and 90 mph, the speed at which previous studies consistently produced cardiac arrest in a model of a ten year old. In Little League, pitchers average speeds of 60 mph.

"While chest impact at 60 mph will not consistently result in cardiac arrest, there is still a risk," says David H. Janda, M.D., Director of the Institute and lead author of the study. "Furthermore, the largest number of deaths have occurred in pitchers hit by a batted ball, which typically reaches speeds one and one half times that of a pitched ball, which translates into speeds up to 90 mph."

Based on the data collected, the researchers concluded that using a chest protector may actually increase the amount of momentum and force delivered to the chest. Furthermore, using softer core baseballs does not have a significant effect on reducing the amount of momentum or force delivered to the chest.

"In one case, a softer baseball used with a generic chest protector increased the amount of force delivered by over 50 percent," said Dr. Janda. "Furthermore, some of the softer core baseballs increased the risk of injury by up to 19 percent."

The researchers found that some of the softer core baseballs actually were heavier and more resilient than the standard baseball and thus bounced off the chest further than the standard baseball. This rebound characteristic of the softer core baseball results in it transmitting greater energy than the standard baseball.

"The softer core baseball and chest protector do reduce the sting of the ball, but may not provide a substantial benefit against fatality," says David Viano, Ph.D., co-author of the study. Dr. Viano has conducted ongoing research on the effects of impact and safety in children.

Further research needs to be developed and funded to find a solution to this problem, according to Dr. Janda. "There is very little testing of manufacturers' claims," he says. "Standards have to be set to establish that a product is truly protective. In addition, there needs to be independent testing of products to ensure they meet minimum standards."

Until industry develops effective protective gear, Dr. Janda recommends teaching youth how to avoid being hit by a ball as a preventative measure. He suggests kids be taught these skills in Little League and when they first learn the game. "Parents should insist coaches be certified and that they institute a fundamentals program focusing on the skills which could prevent these needless injuries," says. Dr. Janda.

THE INSTITUTE FOR PREVENTATIVE SPORTS MEDICINE INJURY PREVENTION FACT SHEET

Injuries are an enormous public health problem that continues to use up our limited health care resources. The following statistics demonstrate the depth of the problem.

• Injuries kill more than 142,000 Americans each year and result in more than 62 million persons requiring medical attention annually.
• Injuries of individuals ages 1-44 cost the nation approximately 5133 billion each year.
• Accidental injury remains the leading cause of death in youth and sports injuries constitute an important number of these.
• The United States Consumer Product Safety Commission (CPSC) has reported that as many as five million medically treated injuries associated with fifteen of the most popular sports occur in a one-year time period.
• The CPSC has estimated that softball and baseball are the number one sport leading to emergency room visits in the United States (2,655,404 injuries between 1983 and 1989). This does not include non-hospitalization physician visits.
• A 1981 CPSC study of sports injuries to children between the ages of 5 and 14 years of age found more fatalities in this age group related to baseball than any other sport. From 1973 to 1983, the CPSC reported 51 baseball-related deaths in children. The most frequent fatality, impact of a ball to the child's chest, occurred in 21 cases. (The number actually may be higher since the Consumer Product Commission bases its estimates of fatalities due to baseball chest impact on the monitoring of only 91 emergency rooms across the United States.)
• A 1985 Wayne State University study of 23 baseball-related chest impact deaths found that the most frequent victims were batters, particularly those who turn to bunt (6), pitchers (8) and catchers (2).