Burden of Sport Injuries in the European Union - Safety in Sports

23
3 | February 2012
the promotion of physical activity could not be justified, at least not from the standpoint
of health economy (Engbretsen & Bahr 2009).
Therefore it is surprising how little scientific attention was paid up till now to the
question: What is the balance between the benefits of sport (e.g. in terms of saved
health costs) and the losses due to the unwanted side-effects (e.g. in the terms of additional
health costs due to injuries). Sometimes, the health costs of injuries were estimated,
in order to justify sport safety measures, sometimes the health costs of lack
of physical activity were estimated, in order to justify the promotion of sport. Both
these one-sided approaches do not answer the fundamental question: Is the health
cost balance of sport (or all physical activities) positive or not?
Beside phenomena like doping, violence related to sport events, or the misuse of
young sportspersons, the most obvious negative side-effect are acute and chronic
injuries as well as long-term damages to health due to prolonged overloading. Although
most sport injuries can be cured without a reasonable time, also long-term
damages are quite frequent. Fatalities are relatively rare compared to other areas of
live as road transport. Accidental deaths are exceptional events in usual team sports
or gymnastics, and only a few sporting activities produce most of the fatal sport injuries:
water sport, aviation sport, motor sport, bicycling and mountaineering.
In principle, all negative effects can be calculated in monetary terms as loss of investments,
additional promotion costs, loss of income expectation, or additional direct
expenditures. Usually it is distinguished between direct and indirect costs: Direct
costs are expenditures, where a transfer of money takes place, which in principle can
be observed. Indirect or societal costs are losses of productivity which can be estimated
but hardly observed. A comprehensive balance of benefits and losses in sports
might be desired, but is not available yet.
Nevertheless, there are first results available regarding the balance of health gains
and losses, as here the same indicators like medical treatments, days of hospital care,
life years or healthy life years can be used. Such attempts have been made by Weiß
(2000) and BASPO (2002). Both studies make use of the wealth of studies on health
gains due to physical activity and applied the reported findings e.g. on reduced incidences
on average treatment costs. Biggest savings are to reductions of cardiovascular
diseases, dorsopathies and discopathies, as well as general mortality. These
two studies indicate that sport injuries do not entirely annihilate the positive health
effects of sport, but reduce the health benefit significantly (table/figure 3).