Cardiac Screening

October 31, 2014

The American Heart Association has once again concluded that sophisticated and expensive heart screening is not practical or appropriate as a precondition for youth and young adults to participate in competitive organized sports.
On Sept. 14, 2014, the AHA online publication Circulation stated:

Sudden death among 12 to 25-year-olds is “a low event rate occurrence.”

“There is insufficient information to support the view that ECGs in asymptomatic young people for cardiac disease is appropriate or possible on a national basis for the United States, in competitive athletics or in the general population.”

“At present, there is no mechanism available in the United States to effectively create national programs of such magnitude, whether limited to athletics or including the wider population of all young people.”

“There is insufficient evidence that particularly large-scale/mass screening initiatives are feasible or cost effective within the current US healthcare infrastructure . . .”

“The ECG . . . cannot be regarded as an ideal or effective test when applied to large healthy populations.”

“An additional, but unresolved, ethical issue concerns whether students who voluntarily engage in competitive athletic programs should have advantage of cardiovascular screening, while others who choose not to be involved in such activities (but may be at the same or similar risk) are in effect excluded from the same opportunity.”

The AHA’s Sept. 14 AHA writing group “does not believe the available data support significant public health benefit from using the 12-lead ECG as a universal screening tool. The writing group, however, does endorse the widespread dissemination of automated external defibrillators which are effective in saving young lives on the athletic field and elsewhere.”

Long-Term Effects?

November 4, 2014

A recent report of NBC News has raised concern for the possibility that prolonged exposure to one of the latest versions of artificial turf might contribute to the chances that a person will contract some forms of cancer. This came as cruel irony to many who have raised funds for and installed the latest facilities that were intended to be much healthier both for participants and our environment.

It is reported that the millions of old tires that have been diverted from landfills and then ground up and spread to soften artificial playing surfaces may release elements that contribute to disease for those who spend enough time on those surfaces. Touted to be softer and protect participants from joint injuries and concussions, and advertised to promote a healthier environment by recycling old tires and avoiding the need to constantly fertilize and water natural grass fields, it’s now being suggested that this artificial product may be the less healthy alternative for participants and the environment.

As of this writing, the health benefits of current generation artificial turf are well documented, while the health risks are unproven – there is anecdotal evidence, for example, that soccer goalies who have spent many hours per week for many years diving and rolling on the new turf may have ingested unhealthy levels of the tiny black rubber pellets that give the artificial turf its soft “natural” feel.

Nevertheless, this situation is a humbling reminder of how difficult it is to assess all of the unintended consequences in the future of our actions in the present. How might a product that solves many obvious problems be anticipated to have a link to a hidden illness many years later? How might a person who plays a single sport many hours each day all year long anticipate the overuse injuries or other illnesses that such an obsession or devotion might cause?

The questions being raised about the long-term effects of long-term interaction with today’s artificial turf remind us once again to seek moderation in how much we do of any one thing and to seek humility when we think we’ve accomplished something. One seldom can be certain of what is good for us and what is not; and sometimes even the long view of things is not long enough to know.