Recently Troy Polamalu of the Pittsburg Steelers was fined $10,000 by the NFL for using a cell phone during a game for reassuring his wife he was OK after a tackle. He was held out of the game because he might have suffered a concussion. He passed all tests and played the following week.

Traumatic brain injuries have increased dramatically. Compared with adults, younger persons are at higher risk for traumatic brain injuries with increased severity and prolonged recovery. During the period from 2001 to 2005, there were an estimated 201,830 emergency department visits for concussions and other traumatic brain injuries related to sports in this country; 65 percent of these were to children 5 to 18 years old. From 2001 to 2009, the number of traumatic brain injuries-related emergency department visits increased from 153,375 to 248,418, with the highest rates being males aged 10 to 19 years. Much of this has come from increased awareness of traumatic brain injuries risks from sports and recreation.

Of course there are a whole host of injuries that occur during sports and recreational activities. In fact, from 2001 to 2009, 2.5 million children under age 19 were treated annually for sports and recreational activities injuries, with 6.5 percent of these suffering with traumatic brain injuries. Males account for 71 percent of all traumatic brain injuries and over 70 percent were to children 10 to 19. The number of traumatic brain injuries has increased by 57 percent since 2001.

It does not take a rocket scientist to figure out which activities are related to children under 19 suffering atraumatic brain injuries. For females, it was playground, bicycling, soccer, basketball and horseback riding in that order. When you remove the younger children, bicycling drops out and gymnastics joins the list as well as softball. Overall, soccer is ranked slightly ahead of basketball. On the male side, its football, bicycling, playground, basketball and baseball. The older boys change the listing by dropping playground and baseball and adding soccer and ATV riding to the hit list.

Participants suspected of having a traumatic brain injuries should be removed from play, never returned to play the same day and allowed to return only after an evaluation and clearance by an experienced provider. Robeson County’s high schools have been fortunate to have trainers assigned to their sports, but there are a lot of activities not covered. I did note that nationally, 153 children received a traumatic brain injuries while bowling. I wonder if my buddy Scott McLean at Lumberton Bowling Center is on top of this?

n Bill Smith is director of the Robeson County Health Department.