Body-checking rules and childhood injuries in ice hockey.

BACKGROUND Body checking is the predominant mechanism of youth ice hockey injuries. The Canadian Hockey Association has allowed body checking from ages 12 to 13 (peewee level) and up. One Canadian province (Ontario) introduced body checking at ages 10 to 11 (atom level) in the competitive leagues, whereas in Quebec body checking has only been allowed at ages 14 to 15 (bantam Level). The purpose of this study was to compare body-checking injuries, fractures, and concussions in boys' minor hockey between jurisdictions in which checking is allowed and jurisdictions in which body checking is not allowed. METHODS Data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) were used to characterize children's ice hockey injuries from September 1995 to the end of August 2002. Children treated at CHIRPP hospitals in areas in which checking was allowed were compared with children in areas in which checking was not allowed. RESULTS Of the 4736 hockey injuries, 3006 (63%) were in Ontario and 1730 (37%) were in Quebec. Most of the injuries occurred in areas in which checking was allowed (3618 [76.4%]) [corrected] At ages 10 to 13, players had significantly greater odds of suffering a checking injury where checking was allowed (odds ratio [OR]: 2.65 [corrected]; 95% confidence interval [CI]: 2.21[corrected]-3.18 [corrected]). Players in this age group were also more likely to suffer a concussion (OR: 1.53 [corrected]; 95% CI: 0.93 [corrected]-2.52 [corrected]) or fracture (OR: 1.20 [corrected]; 95% CI: 1.00 [corrected]-1.47) where checking was allowed. Among older players, when checking was allowed in both provinces, there were higher odds (OR: 1.1 [corrected]; 95% CI: 0.94 [corrected]-1.33 [corrected]) of receiving a checking injury in the province that had introduced checking at a younger age, suggesting that there is no protective effect from learning to check earlier. CONCLUSIONS Increased injuries attributable to checking were observed where checking was allowed. This study supports policies that disallow body checking to reduce ice hockey injuries in children.