The commtio cordis death of a Little League batter on May 31, 2011, prompted a comment from a reader of this blog about the effectiveness of safety equipment for children. First, let me say up front that I am not a physician. What knowledge I have about the issue of baseball safety has come from the readings I have done in my research on baseball-related fatalities. Therefore, my opinions are those of an informed layperson, not a medical expert.
There are a number of recent studies on the issue of safety baseballs and chest protectors and the prevention or decrease in incidents of commotio cordis. A 2001 study of safety baseballs published in the May 2002 issue of the journal Pediatrics (“Reduced Risk of Sudden Death from Chest Wall Blows (Commotio Cordis) with Safety Baseballs,” Mark S. Link, et al, pp. 873-877) concluded that “safety baseballs reduced (but did not abolish) the risk of sudden cardiac death. More universal use of these safety baseballs may decrease the risk of sudden death on the playing field for young athletes.” (This study, I might add, was based on an animal model using young pigs, not a human one.)
Similarly, a study published in the Journal of the American Medical Association concerning safety baseballs and faceguards (“Evaluation of Safety Baseballs and Faceguards for Prevention of Injuries in Youth Baseball,” Stephen W. Marshall, et. al, February 5, 2003, pp. 568-574) concluded that “Reduced-impact balls and faceguards were associated with a reduced risk of injury in youth baseball. These findings support increased usage of these items; however, it should be noted that the absolute incidence of injury in youth baseball is low and that these equipment items do not prevent all injuries.”
The news on chest protectors has been much less encouraging. A study of commercially-available chest protectors reported in The American Journal of Cardiology (Joseph J. Doerer, et. al, March 15, 2007, pp. 857-859) found “that almost 40% of commotio cordis deaths in young competitive athletes occurred in the presence of chest barriers”,” concluding that this fact “raises the critical consideration of whether chest protectors that effectively abolish the risk for commotio cordis can be manufactured. Improvements in the design and composition of chest protectors are necessary to enhance the safety of the athletic field for our youth.”
Finally, commotio cordis fatalities are not just a baseball problem. Other sports, including football, hockey, and lacrosse, have had their share of commotio cordis deaths as well. And while it is an event that happens mainly to children under 18, adult fatalities from blows to the heart have also occurred.