Committee on Safety in
School Sports (CSSS)
Report on School
Sports Safety
16 Dec 2010
CONTENT PAGE
Main Paper
1.
2.
3.
4.
Chapter
Introduction and background to School Sports
Findings from the Committee on Safety in School Sports
Recommendations to enhance Safety in School Sports
Implementation and conclusion
Annexes
Annex A
Annex B
Annex C
Annex D
Annex E
Members of the CSSS
List of Sports CCAs and Competitions
Current Safety Framework for PE and Co-Curricular Activities in
Schools
Best Practices on Youth Sports Safety from Other Countries
Roles of Stakeholders in Promoting School Sports Safety
Page
2
5
10
16
INTRODUCTION AND BACKGROUND ON SCHOOL SPORTS
INTRODUCTION
1.
In schools, sports and physical activities are an important component of
holistic education, as they develop our students physically, and also provide
opportunities for them to develop discipline, life skills and sporting skills.
2.
In May 2010, the Ministry of Education (MOE) set up the Committee on Safety
in School Sports (CSSS) to review safety practices and issues in the conduct
of school sports, and make recommendations for sustained improvement of
safety in school sports. The composition of CSSS is at Annex A. In the
course of its review, the Committee surveyed current guidelines and practices
governing school sports, studied data on injury rates related to sporting and
physical activities in schools, considered best practices in other countries, and
tapped on views from the sporting community.
BACKGROUND ON SCHOOL SPORTS
3.
Sports and physical education (PE) are integral building blocks in a holistic
education system. Through sports, we can build confidence, resilience,
teamwork and other soft skills that are important for students to excel both in
school and later in life. Students with sporting talents can also be identified
and further groomed to realise their potential.
4.
It is useful to highlight MOE’s guiding principles of PE and sports development
to set the context for the review of sports safety. Specifically, our guiding
principles are:
a.
Participation in PE & sports confers a range of benefits, such as
psychomotor skills, health and fitness, and these benefits contribute to
the holistic development of the students.
b.
Provision for mass participation is our priority. At the same time, we
also aim to provide a range of opportunities catering to students of
different sporting abilities to achieve excellence.
VISION AND PURPOSE OF PE IN SCHOOLS
5.
The vision of PE in Singapore is "Every Child is Physically Educated", with the
aim to develop students’ motor skills and games skills, and equip them with
the skills, knowledge and attitudes to pursue and enjoy a physically active and
healthy lifestyle. The specific objectives of PE in schools are:
a.
To develop and maintain physical health and fitness through regular
participation in physical activities.
b.
To practise safety habits during physical activities.
2
6.
c.
To demonstrate positive self-esteem through body awareness and
control.
d.
To demonstrate the spirit of teamwork, sportsmanship and fair play.
PE is compulsory at all levels. At the primary level, students are taught
fundamental psychomotor skills and games concepts, and are given the
opportunities for structured play, interaction and co-operation. At secondary
level, students extend their psychomotor and games skills, develop more
games concepts, acquire a holistic perspective of health and fitness, and
foster teamwork, sportsmanship and discipline through sports. At Junior
College (JC) level, students refine their sports and games skills and concepts,
develop health-enhancing fitness management skills, and are given
opportunities for leadership in sports.
VISION AND PURPOSE OF CCA IN SCHOOLS
7.
CCAs are an integral part of the curriculum as they provide students with
authentic platforms to live and practice the values and soft skills taught in the
classroom.
8.
CCAs foster social integration and help students develop a sense of
belonging, camaraderie and loyalty. Active participation in CCAs allows
students to develop healthy recreational interests, and improve their physical
and mental well-being. Students with enriching CCA experiences will emerge
from schools moulded in character and equipped with competencies, ready
for the challenges in their adult life.
9.
The purposes of CCA are as follows:
10.
a.
Develop sound values, resilience and character.
b.
Equip pupils with knowledge and skills to manage their mental and
physical health.
c.
Develop bonds of friendship and ability to work effectively in a team.
d.
Develop pupils’ tacit knowledge to be comfortable operating in a variety
of cultures and situations and awareness of a balanced lifestyle by
exposing them to a variety of experiences, including those related to
sports.
Students are introduced to CCAs at Primary 3 and participation is voluntary.
At the secondary level, they must participate in at least one core CCA. There
is a wide range of CCAs in our schools. Students may choose from four main
groups comprising Sports, Uniformed Groups, Performing Arts, and Clubs &
Societies. There are currently a total of 63 Sports CCAs offered by our
schools, ranging from Air Rifle, Cross Country, to Sailing and Tennis (see
Annex B for the full list of Sports CCAs). Schools have the flexibility to
determine which CCAs to offer based on their students’ interests and needs,
and availability of facilities, teachers-in-charge of CCAs, and qualified
coaches.
3
11.
Over the years, with the growing emphasis on sports in Singapore and the
provision of holistic education to our students, MOE has increased the
diversity of sports CCAs and competitions. For example, in recent years, the
range of CCAs and competitions has been expanded to include Wushu
(2005), Floorball (2007) and Taekwondo (2010).
S CHOOL S PORTS C OMPETITIONS
12.
Sports competitions help generate students’ interest in sports and spur the
pursuit of excellence in the respective sports. MOE set up the Singapore
Primary Schools Sports Council (SPSSC) and Singapore Schools Sports
Council (SSSC) in 1959 to oversee and organise inter-school competitions.
Today, national inter-school competitions are organised by the SPSSC for 21
sports in primary schools and the SSSC for 27 sports in secondary schools,
JCs and the Centralised Institute (CI). (See Annex B for the list of sports
CCAs with competitions)1.
13.
Schools compete in a number of co-curricular events at the zonal and national
level each year. These include sports events such as the National Track and
Field Championships. Outstanding athletes are then selected into the
Singapore Schools Sports Teams2 to take part in regional and international
competitions.
.....
1
Two sports – Floorball and Taekwondo – are organized by the respective National Sporting
Associations.
2
Previously known as the Combined Schools Teams.
4
FINDINGS FROM THE COMMITTEE ON SAFETY IN SCHOOL SPORTS
KEY AREAS OF STUDY
1.
To understand the current sporting environment in schools and identify
potential areas for improvement, the Committee conducted a series of studies
in the following areas:
a.
Best practices in youth sports safety in other countries. Best practices
for youth sports safety in the United States, United Kingdom and
Australia, which have established policies and initiatives on sports
safety, and where sports play an important part in everyday life, were
studied.
b.
Benchmarking against international rules and best practices. The
Committee benchmarked the local competition rules and practices
issued by the SSSC and SPSSC for 6 key sports against international
rules and best practices. These sports were: Basketball, Hockey,
Judo, Rugby, Soccer and Taekwondo.
c.
Focus Group Discussions (FGDs) with sporting community. FGDs
were conducted with members of the sporting community to surface
potential areas for improvement.
d.
Assessment of the current safety framework. This covered issues
ranging from leadership, safety education and training to safety
practices in schools.
e.
Governance of school sports competitions. The Committee studied the
governance of the Singapore Primary Schools Sports Council (SPSSC)
and Singapore Schools Sports Council (SSSC) to assess if and how
safety in school sports competitions could be further improved upon.
f.
Injury rates in school sports. The Committee studied the injury rates in
schools to determine if they were reasonable and could practicably be
further reduced and if there were any specific sports or injuries that
required more attention.
K EY F INDINGS
2.
The Committee’s findings are elaborated in the following paragraphs.
Best Practices in Other Countries
3.
In scanning best practices for safety in youth sports, the Committee focused
on the United States, United Kingdom and Australia, where sports play an
important part in the life of their citizens, and regular research and studies on
sports safety are conducted. These countries also have established initiatives
and policies on sports safety. Websites consulted included those of
international multi-sports organizations (e.g. International Olympic Committee
or IOC), national or states sports councils (e.g. Australian Sports
Commission), and non-profit athletic associations (e.g. National Collegiate
5
Athletic Association or NCAA of USA). Peer-reviewed journal articles were
also referred to. (See Annex C for details of the study.)
4.
The Committee notes the following good practices:
a.
Educating and involving not only those who are directly participating in
youth sports events (i.e., youth athletes, coaches and sports
providers), but also relevant parties such as parents, sports officials
and safety personnel.
b.
Strong partnerships between key stakeholders to develop safety
standards and good safety practices for sports providers, coaches and
other relevant parties.
c.
For sporting and physical activities with higher inherent risk of injuries,
significant preventive measures include: modifying rules to be ageappropriate and minimize injury; matching competitors by strength and
skill as well as by age, and ensuring proper use and maintenance of
protective equipment.
d.
Regulation and training of coaches to ensure that coaches are qualified
and competent to train youths to play properly and in a safe way.
e.
Tracking the type, incidence and severity of injuries in selected sports,
especially those with high injury rates (e.g. Basketball, Martial Arts and
Rugby). Based on this data and from existing findings on the aetiology
of injuries in youth sports (i.e. where, when, and what injuries occur),
safety measures and rules of the sport can be reviewed and further
refined.
Benchmarking against International Rules and Best Practices
5.
The Committee undertook a benchmarking exercise of the local competition
rules issued by the SSSC and SPSSC for six sports involving higher levels of
contact or collision and cardiovascular and muscular intensity against
international rules and best practices. These sports were: Basketball,
Hockey, Judo, Rugby, Soccer and Taekwondo.
6.
The Committee found that in general, the local rules follow the
recommendations by international organisations with respect to modifications
for youth participants. These include modifications to the playing area, playing
duration, and playing regulations. Some examples are:
7.
a.
For Judo, certain moves are banned and the duration of bouts is
shortened. Students are also required to attain a certain level of
proficiency (as sanctioned by the Singapore Judo Federation) before
they are allowed to take part in competitions.
b.
For Taekwondo, head kicks are disallowed.
c.
For Soccer, the rules stipulate modified playfield dimensions.
However, the benchmarking exercise highlighted instances when some
specific technical aspects could be improved. For example, the SSSC and
SPSSC rules and regulations largely focus on guidelines on personal
6
protective equipment, and provide fewer guidelines on facilities and general
equipment. In contrast, the rules of the international federations cover
detailed specifications of facilities and general equipment in addition to
personal protective gear.
Feedback from Sporting Community
8.
The Committee consulted members of the sporting community, comprising a
mix of athletes, coaches and sports officials from across a range of sports3,
through Focus Group Discussion (FGD) sessions, to gather feedback on
current safety practices and to obtain suggestions for further improvements.
9.
Overall, the FGD participants were generally of the view that safety standards
and measures relating to sporting and physical activities in schools were
sufficient and appropriate, and were sometimes even stricter than those
applicable to the general public. The FGD participants also identified some
areas where safety measures could be improved, for example, better-fitting
body floatation devices for water sports. The FGD participants further noted
that some students might push themselves beyond their limits in training and
competitions to meet expectations, which could result in higher risk of injuries.
It was also felt that teachers-in-charge of CCAs could be given better training
and support, so as to help them better oversee the conduct of their CCAs and
work in partnership with coaches to ensure the safety of students. The FGD
participants also suggested that awareness of sports safety among parents,
students and teachers could be improved.
Current Safety Framework
10.
The Committee studied MOE’s current safety framework in detail, which
covers the following key aspects:
a.
Leadership. Within MOE HQ, the MOE School Safety Committee was
set up in 2006 to provide leadership on school safety and develop
safety policies and initiatives. Every school also has its own School
Safety Committee, with the Vice Principal as the Chief Safety Officer.
The Committees at the school level are responsible for addressing
school safety concerns; the development of safety practices; planning
and implementing safety training; and incident management.
b.
Safety Practices. MOE provides schools with guidelines on school
safety, including safety measures during PE lessons and CCAs and the
use and maintenance of sports equipment.
c.
Safety Education and Training. The MOE School Safety Unit (SSU)
conducts seminars for schools’ Chief Safety Officers to share best
practices. Training is also carried out through briefings to school
personnel, e.g. Chief Safety Officers and Heads of Department (HODs)
for PE and CCA, on areas such as the MOE Risk Assessment
3
The FGD participants came from the following sports: Contact Sports (Basketball, Hockey, Rugby
and Soccer); Martial Arts (Judo, Taekwondo and Wushu); Water-based Sports (Canoeing, Diving,
Sailing, Swimming, and Water-polo); and High Intensity Sports (Cross Country and Triathlon).
7
Management System (RAMS). The External Safety Validation of
schools’ safety practices, carried out by teams comprising HQ officers
and key school personnel, further serves as a platform to learn about
good practices. All qualified PE teachers are also trained in first aid.
11.
The Committee is of the view that the current safety framework is largely
sound, and the guidelines also address a wide range of aspects for schools to
take note of when conducting sporting and physical-related activities. To
further improve on the current safety framework, the Committee also notes:
a.
There is scope to further emphasise safety awareness amongst
stakeholders (school leaders, teachers-in-charge of CCAs, PE
teachers, coaches, sports officials, parents and students), as well as to
enhance safety training and education, in particular, for teachers-incharge of CCAs and coaches.
b.
There is some variation in implementation of the guidelines by schools.
c.
The levels of proficiency in technical and pedagogical skills amongst
some of our school coaches can be further enhanced.
Governance of School Sports Competitions
12.
The Committee’s assessment is that the overall governance structure for
school sports competitions is sound, with the appropriate checks and
balances already in place to ensure that governance and safety issues are
well looked after. The following summarises the Committee’s assessment of
the key aspects of the governance structure:
a.
Proper oversight from MOE. The Chairmen of the SSSC and SPSSC
are appointed by MOE, and MOE CCA Branch (CCAB) officers are
present at the various Council levels. All members of the SSSC and
SPSSC are Principals in our school system, and are ultimately
accountable to MOE.
b.
Annual review of competition framework and regulations. Each year,
the framework and regulations for school sports competitions are
reviewed by each Convenor4 based on technical advice from CCAB,
and the recommendations are tabled to the SSSC and SPSSC.
c.
Professional expertise. All the Convenors and schools receive support
from CCAB and National Sports Associations (NSAs). The NSAs’ main
contributions come in the form of technical expertise (in particular,
tailoring adult-level sport regulations to suit the needs of our students)
and the provision of qualified referees and officials. Together, MOE
and NSAs work hand-in-hand to provide technical and professional
support for the organisation and conduct of school sports competitions.
d.
Affiliation to larger sporting bodies. The SSSC and SPSSC are
affiliated to the NSAs, which, as the national bodies, are in turn
affiliated to credible international bodies in the sporting field. This
4
In the SSSC and SPSSC framework, each sport is assigned a Principal who serves as the Convenor
and is responsible for overseeing the organisation and conduct of inter-school competitions for the
particular sport.
8
allows the SSSC and SPSSC to tap into the larger network of sporting
and safety best practices.
13.
Moving forward, the Committee recommends that MOE continue to ensure
that there are adequate resources (in terms of school facilities, teachers and MOE
personnel) as we continue to expand school sports and competitions in our
education system.
Injury Rates
14.
Aggregated data on sports injuries provide an important perspective in
analysing and reviewing sports safety practices, by providing information on
aspects such as the nature, incidence rates and severity of injuries. The
Committee conducted a survey to determine injury rates in schools arising
from sporting and physical activities.
15.
85 schools (representing approximately 25% of the total number of 355
mainstream schools) participated in providing data on injuries relating to
sporting and physical activities, for 2008 and 2009. The 85 schools were
randomly selected to provide a good representation across different
educational levels (primary, secondary, JC/CI), clusters, and zones.
16.
Overall, the survey data showed that:
a.
The annual rate of serious injuries sustained during participation in
sporting and physical activities was 1.6 per 1,000 students per annum.
Serious injuries referred to injuries where significant medical treatment
was required, such as fractures, dislocations, and lacerations which
required stitching.
b.
90% of the serious injuries sustained were fractures or dislocations. Of
the serious injuries, 44% were sustained during participation in contact
sports5, 30% during general exercise, and 15% in individual sports.
17.
A rough comparison with publicly available data from other countries suggests
that our injury rates are relatively low. For example, US data indicates injury
rates of between 2.4 to 10 injuries per 1,000 students (no age provided), while
Australian data indicates 12.3 “significant injuries”6 per 1000 children aged
between 0 to 14 years. However, the Committee noted that there are
difficulties in directly benchmarking the Singapore data against those of other
countries, due to differences in surveyed groups and lack of detailed data
definitions (e.g. participating population, definition of injuries). A compilation
of the injury rates in other countries is included in Annex D.
18.
In addition, as part of its study, the Committee also took into consideration the
findings of the Committees of Inquiry (COIs) that were set up to look into two
serious sports incidents in Rugby and Judo, which had taken place in Mar and
5
Of injuries sustained during contact sports, 75% were contributed by soccer, basketball and rugby.
In the study, a ‘serious’ injury was defined as a reported injury that required treatment, interfered
with performance of the activities of daily living, and/or had adverse effects on participation or
performance in subsequent activity.
6
9
Apr 2010 respectively. The findings from the COI for the Judo incident
revealed that there were ample safety measures put in place for the Judo
match and the rules and regulations for the Judo competition were also more
stringent as compared to most international youth championships. There was
no evidence of any illegal moves made by the players. In the case of the
Rugby incident, the COI concluded that the organisation and safety provisions
for the match were consistent with matches played at the National InterSchool Rugby Championships 2010 Police Cup Under-17. The COI also
noted that the referee had carried out his duties in accordance with the
applicable protocols, and was in control of the match.
S UMMARY
OF
F INDINGS
19.
The Committee has studied international best practices and sporting rules,
consulted members from the sporting community, and reviewed MOE’s
internal safety frameworks and injury rates over the course of its study. The
Committee’s assessment is that MOE’s safety framework is largely sound,
and is generally in line with international best practices. For example, as
highlighted in the benchmarking exercise, the local rules had followed the
recommendations by international organisations with respect to modifications
for youth participants. There is also proper leadership and designation of
roles and accountability in the safety framework for schools and governance
for sports competitions. Overall, the sports injury rates in schools are
relatively low, and indicate that our safety framework is generally working well.
20.
In the pursuit of excellence, the Committee nevertheless sought to identify
additional measures to further level up safety across our schools. The
Committee’s detailed recommendations on these areas are outlined in the
following chapter.
.....
10
RECOMMENDATIONS TO ENHANCE SAFETY IN SCHOOL SPORTS
1.
Based on the key findings described in the preceding paragraphs, the
Committee has made its recommendations for continuous improvement,
which are broadly categorised into three key areas:
a.
Safety Education and Training.
b.
Preventive Measures.
c.
Monitoring, Intervention and Follow-up Measures.
I) S AFETY E DUCATION
AND
T RAINING
Continuously Improving Safety Culture, Education and Training in Schools
2.
All stakeholders – schools, teachers, coaches, sports officials, parents and
students – have a role to play in safety. Given its importance, safety must be
maintained as a priority and as a part of all stakeholders’ mindsets. The
Committee recommends that MOE promote greater awareness amongst the
various stakeholder groups of their responsibilities in ensuring safe practices,
and augment the safety training and education of school leaders and
teachers. Some ways this can be done include:
a.
Providing teachers-in-charge of CCAs with more training and support
to enable them to play a stronger role in ensuring school sports safety
and enabling students to better realise the rich learning outcomes from
involvement in CCAs. The Committee recommends strengthening
CCA teacher deployment and handover guidelines (between CCA
teachers) for schools. For example, schools should as far as possible
take into account teachers’ backgrounds, interests and qualifications
when deploying them to CCAs.
For in-service teachers who are already deployed by their schools to
oversee certain CCAs, the Committee recommends that their training
be enhanced through regular briefings on safety rules and the use of
safety checklists specific to these CCAs.
As teachers-in-charge are often the first responder to incidents
involving students, the Committee also recommends that teachers-incharge of sports CCAs maintain current first-aid certifications.
b.
Enhancing the recruitment and training of new PE teachers, as well as
the deployment of qualified PE teachers. As qualified PE teachers
would have the necessary background and interests to conduct PE and
sports CCAs for students and would also have undergone training in
first aid, the Committee recommends that MOE ensure that there are
sufficient numbers of qualified PE teachers deployed in schools even
as MOE increases PE curriculum time in Primary and Secondary
levels. The Committee notes that the recent establishment of the
Physical Education and Sports Teacher Academy (PESTA) will further
support the in-service training and professional development of
qualified PE teachers to strengthen the delivery of PE and sports CCAs
in schools.
11
c.
Better engagement with parents. Parents play important collaborative
and supportive roles in helping to promote and encourage school
sports safety. In this regard, the Committee recommends that schools
can better engage parents through ways such as school briefings, and
providing accessible information on safety practices. Parents may also
be able to provide help and support to schools, teachers or coaches in
increasing sports safety awareness and in the implementation of safety
practices.
d.
Heighten schools’ and students’ awareness of safety issues. The
Committee recommends that MOE heighten schools’ awareness of
safety issues, by continuing to reinforce safety messages at a senior
level and to key personnel in schools.
Currently, prior to the start of any physical activities, students are
asked to alert their teachers and coaches if they feel unwell or have
recently recovered from illness. Some students may, however, not
understand the potential implications of taking part in physical activities
when unwell, and choose not to highlight their conditions for various
reasons. Given these observations, the Committee recommends
reinforcing the awareness of safety among students, through parents,
PE teachers and teachers-in-charge of CCAs.
e.
3.
Instilling a healthy sporting culture that encourages fair play and
playing within the rules amongst all stakeholders (schools, teachers,
coaches, parents, students, sporting associations), in cognisance that
an overly competitive mindset can be detrimental to sports safety.
Annex E summarises the roles that the Committee recommends various
stakeholders can play to enhance sports safety in schools.
II) P REVENTIVE M EASURES
Boosting Safety Standards
4.
The Committee’s findings revealed that MOE’s safety framework is largely
sound, and schools generally adopt MOE’s safety guidelines in the conduct of
sporting activities. There are also benefits to be gained from minimising
variations in implementation across the school system, while increasing the
pervasiveness of safety guidelines. As such, the Committee recommends
that MOE should expand on its existing guidelines to cover areas, where
applicable, such as equipment and protective gear, facilities and environment,
first aid, medical support and pre-participation screening and consent, and
ensure that there is more even and pervasive implementation of these
guidelines across all schools.
5.
Implementation-wise, MOE would need to continue to carry out the necessary
checks for adherence to the safety framework, through a centralised unit in
MOE HQ, with cognisance that the unit will need to be staffed adequately to
perform this role. This unit could also take on the role of promoting a safety
culture, training, and the sharing of best practices across schools.
12
Enhanced Safety Standards for Specific Sports
6.
Beyond the general safety guidelines applicable to all sports, additional safety
measures would probably be beneficial for specific sports. In general, the
risks of injury would depend mainly on three key factors:
a.
Risk of contact or collision;
b.
Cardiovascular and muscular intensity of the activity; and
c.
Specific environment, facility or equipment factors.
7.
The Committee recommends taking a risk management approach to adopt
additional safety measures for different sports. Table 1 reflects the nature of some
sporting activities involving moderate and above levels of contact/ collision and/or
intensity, as well as those involving specific environment/ facility/ equipment factors.
Table 1: Examples of Sporting Activities Involving Moderate and Above Levels of
Contact/Collision; Intensity; Environment / Facility / Equipment
Contact or Collision
Intensity
Basketball
Hockey
Judo
Rugby
Soccer
Taekwondo
Cross Country
Triathlon
Environment / Facility /
Equipment
Archery
Sailing
Shooting
7.
In formulating additional safety measures and classification guidelines for
existing and new sports CCAs, MOE should consult practices established by
international sporting federations, best practices in other countries, the
Singapore National Sports Associations (NSAs), as well as local experience
and injury data.
8.
Based on the Committee’s findings in benchmarking the local competition
rules issued by SSSC and SPSSC for the six sports highlighted in Chapter 2
(namely, Basketball, Hockey, Judo, Rugby, Soccer and Taekwondo), the
Committee recommends that:
a.
The level of detail in documentation be increased for the SSSC and
SPSSC rules and regulations. The current rules and regulations do not
spell out every game-specific rule, although they specify that the rules
from the governing bodies of each sport are to be used in conjunction
with them. The Committee recommends that, as far as possible, the
documentation of the SSSC and SPSSC rules and regulations be selfcontained one-stop reference documents for coaches and teachers-incharge of CCAs, eliminating or minimizing cross-references to other
documents.
b.
The consequence of violations be more particularly spelt out in the
SSSC and SPSSC rules and regulations. The consequences of
violating sporting rules and regulations are generally taken from the
13
penalty norms of the respective International Federations. These
penalty norms could be further refined, especially for the purposes of
adapting them for school sports competitions.
c.
MOE carry out further benchmarking exercises for other sports CCAs.
d.
MOE institute a more robust approval process for new CCAs and
student activities. Currently, schools do their best to accommodate a
wide range of student interests. A more robust and systemic approval
process for offering new CCAs and student activities would be a useful
upstream measure to instil greater awareness among schools of the
need to take into account issues such as the requirement for adequate
expertise / training of their teachers, resources, and ability to sustain
the CCAs.
Uplifting the Capacity of School Coaches
9.
Sports coaches hired by schools play an integral part in the school sporting
landscape. As they spend a substantial amount of time with students during
actual training and gameplay, they can help minimise the chances of injury by
instilling a strong sense of safety consciousness in students, enforcing safety
regulations, and taking timely corrective measures when they spot early
warning signs of injury. By providing proper training and guidance to our
students, coaches help our students build important soft skills, values and
enhance their mental and physical well-being, through participation in sports.
10.
Given the important role that coaches play in school sports, the Committee
recommends that MOE work closely with coaches to enhance coaches’ level
of safety awareness and ownership of safety issues during the conduct of
sports training and competitions. The Committee recommends the following:
a.
Emphasise the importance of safety during sports trainings and
competitions. MOE should make explicit in contracts with school
coaches that they are responsible for the safety and welfare of the
pupils under their charge during training and competitions, and that
safety is paramount. Together with the teachers-in-charge of CCAs,
coaches should make the necessary risk assessments and put in place
appropriate safety measures prior to the conduct of sports activities.
b.
Encourage coaches to upgrade through technical skills qualifications,
for instance, the National Coaching Accreditation Programme (NCAP)
qualifications administered by the Singapore Sports Council and NSAs,
which would allow them to conduct sports activities with greater
confidence and proficiency. MOE will conduct courses for coaches on
safety. MOE will also conduct courses to familiarise coaches on the
desired outcomes of sporting activities in schools, such as the
inculcation of sporting values.
c.
Enhance sharing of information on school coaches across schools,
such as by creating a central register of CCA coaches and instructors
in MOE. This will allow schools to more effectively identify suitable
coaches for their needs.
14
11.
With these recommendations, MOE’s aim is for school personnel, such as our
teachers-in-charge of CCAs, and our coaches to work together more confidently and
effectively to ensure that our students will be able to safely benefit from participation
in school sports.
III) M ONITORING , I NTERVENTION
AND
F OLLOW - UP M EASURES
Enhanced Framework of Tiered Insurance Coverage
12.
The Committee recognises that despite best efforts in enhancing safety
measures, it is not possible to prevent accidents or injuries. Currently,
schools purchase insurance for their students, with coverage including
medical expenses and hospital allowance benefits. The specific amount
varies from school to school, depending on the plan chosen. We have noted
that some insurance plans purchased are personal accident plans, for which
claimable medical expenses could be a few thousand dollars. There may also
be a weekly hospital (ward) allowance included in the plan, up to a cap. These
are comprehensive insurance plans under which all student incidents during
participation in activities in schools, including PE and sports CCAs, are
covered.
13.
While the basic level of insurance coverage is generally adequate for the daily
activities of the majority of students, this may not be the case in the event of
very serious accidents involving intensive medical treatment and/or prolonged
hospitalisation. In such instances, the costs of medical treatment would pose
a significant burden to the families involved.
14.
As the probability of very serious accidents leading to prolonged
hospitalisation and medical treatment is very low, insurance is an effective
means of pooling risks to cushion the financial impact of medical treatment.
The Committee thus recommends a tiered framework of school insurance,
comprising a basic comprehensive insurance coverage for all students, with
enhanced payouts to cover the risks of accidents or injuries. MOE could
examine if centralised purchase of insurance plans for students will allow for
significant economies of scale to be reaped.
Improved Injury Data Collection System
15.
To facilitate regular review and improvements in safety, it is important to have
a robust and comprehensive system to collect data on injuries and when and
how they occurred.
16.
The Committee recommends that MOE require schools to carry out incident
reporting, and establish a repository of specific types of injury data. The
repository could include data on the nature/type/severity of injury and type of
activity that led to the injury. In developing this repository, a balance would
have to be struck between comprehensiveness and level of detail of data,
versus convenient data reporting / entry and timeliness of reporting by
schools.
15
17.
The Committee further recommends that MOE put in place a structured
process to periodically analyse the data, with a view to determining the
effectiveness of existing sports safety measures, proposing refinements
suggested by the data analysis, and track the follow-up actions taken.
C ONSULTATION
18.
WITH
S CHOOLS
ON
R ECOMMENDATIONS
The Committee consulted school principals, Heads of Department, and
teachers-in-charge of CCAs for their views on the recommendations through
FGD sessions. The participants were supportive of the key recommendations
of the Committee, especially the recommendations to uplift the capacity of
school sports coaches, and for better training and support to be given to
teachers-in-charge of CCAs. In particular, teachers expressed strong support
for the recommendations to strengthen CCA teacher deployment and
handover guidelines for schools; provide teachers-in-charge of CCAs with
more training on safety through means such as safety briefings and safety
frameworks; and require teachers-in-charge of sports CCAs to maintain
current first-aid certifications.
.....
16
CONCLUSION
1.
The Committee recommends that MOE set up an implementation committee,
comprising professionals with the expertise in the various areas, to work out
and coordinate the details and implementation of the various
recommendations.
2.
The Committee also recommends that the implementation committee aim to
put in place the majority of the recommendations by end 2011. These include
the expanded safety guidelines, providing teachers-in-charge of specific
sports CCAs with better safety training and support, for example through the
development of safety frameworks for each of these sports CCAs. Some
recommendations such as the additional safety-related training courses for
school coaches may however require more time to be developed and rolled
out.
3.
In conclusion, the Committee notes that PE and sports play an important role
in our schools, by contributing towards developing students’ psychomotor
skills, health and fitness, as well as a lifelong orientation towards managing
one’s health and well-being. They also enhance the development of 21st
century competencies in our students, by providing opportunities for them to
develop life skills such as teamwork, resilience, and discipline.
4.
While MOE’s current safety framework and practices are already sound and
are generally in line with international best practice, the objective of this report
is nevertheless to seek out areas for improvement. The implementation of
these recommendations would require additional effort, resources and
commitment on the part of MOE, schools and other stakeholders, including
the National Sports Associations, parents and students. The Committee’s
view is that these additional measures will help to further ensure that students
can enjoy and excel in PE and sports activities, training and competitions in a
safe environment.
.....
17
Annex A
MEMBERS OF THE COMMITTEE ON SAFETY IN SCHOOL SPORTS (CSSS)
Chairman
Dr Mimi Choong May Ling
Deputy Secretary (Services), MOE
Members
BG Ishak Bin Ismail
Commander, 6th Division
Mrs Shirley Lo nee Shirley Hoo Sok Kuan
Chairman of South View Primary Parents’ Association
Oon Jin Teik
Chief Executive Officer, Singapore Sports Council
Dr Quek Jin Jong
Principal Officer, Office of Director, National Institute of Education
Richard Seow
Chairman, Singapore Sports Council
Dr Ben Tan
Head & Senior Consultant, Changi Sports Medicine Centre
Wong Siew Hoong
Director, Schools, MOE
Ms Sum Chee Wah
Director, Education Programmes, MOE
Chua Kwan Ping
Director, Finance and Development, MOE (up to 11 Oct 2010)
Ms Evelyn Khoo
Director, Finance and Development, MOE (from 12 Oct 2010)
Ms Melanie Martens
Principal, St. Anthony’s Canossian Secondary School and Member of Secondary
Schools Sports Council
A-1
Annex B
LIST OF SPORTS CCAS AND COMPETITIONS
Sports CCAs offered by schools
1.
2.
3.
4.
Adventure Club
Aikido
Archery
Artistic
Gymnastics
5. Athletics
6. Badminton
7. Basketball
8. Boccia
9. Boules
10. Canoeing
11. Cricket
12. Cross Country
13. Diving
14. Dragon Boat
15. Equestrian
16. Fencing
17. Floorball
18. Frisbee
19. Golf
20. Hockey
21. House
22. Ice Skating
23. In-line Skating
24. Judo
25. Karate
26. Lawn Bowls
27. Modular Sports
28. Mountain
Trekking
29. Netball
30. Petanque
31. Rhythmic
Gymnastics
32. Rowing
33. Rock Climbing
34. Rope Skipping
35. Rugby
36. Sailing
37. Sea Sports
38. Sepak Takraw
39. Shooting
B-2
40. Shorinji Kempo
(Japanese Shao
Lin)
41. Silat
42. Snooker
43. Soccer
44. Softball
45. Squash
46. Swimming
47. Synchronized
Swimming
48. Table Tennis
49. Taekwondo
50. Tchoukball
51. Ten-pin Bowling
52. Tennis
53. Touch Football
54. Touch Rugby
55. Track & Field
56. Trampoline
57. Triathlon
58. Volleyball
59. Water Polo
60. Weightlifting
61. Windsurfing
62. Wrestling
63. Wushu
Sports CCAs with inter-school competitions
Competitions for Secondary
Schools and above
(Organised by SSSC)
1 Badminton
2 Basketball
3 Canoeing
4 Cricket
5 Cross Country
6 Golf
7 Gynmastics
8 Hockey
9 Judo
10 Netball
11 Rugby
12 Sailing
13 Sepak Takraw
14 Shooting
15 Soccer
16 Softball
17 Squash
18 Swimming
19 Table Tennis
20 Tennis
21 Tenpin Bowling
22 Track & Field
23 Volleyball
24 Waterpolo
25 Wushu
26 Floorball
27 Taekwondo
Competitions for Primary
Schools (Organised by SPSSC)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
B-3
Badminton
Basketball
Floorball
Golf
Gymnastics
Hockey
Netball
Rope Skipping
Rugby
Sailing
Sepak Takraw
Soccer
Softball
Swimming
Table Tennis
Taekwondo
Tennis
Tenpin Bowling
Track and Field
Volleyball
Wushu
Annex C
BEST PRACTICES FOR SAFETY IN YOUTH SPORTS IN OTHER
COUNTRIES
BACKGROUND AND METHODOLOGY
1.
In carrying out the scan of best practices for safety in youth sports, the
Committee focused on the U.S, United Kingdom and Australia, where sports play an
important part in the life of their citizens, and regular research and studies on sports
safety are conducted. These countries also have established initiatives and policies
on sports safety. Websites consulted included those of international multi-sports
organizations (e.g., International Olympic Committee or IOC), national or states
sports councils (e.g., Australian Sports Commission), and non-profit athletic
associations (e.g., National Collegiate Athletic Association or NCAA of USA). Peerreviewed journal articles were also identified7.
W HAT
ARE THE
F ACTORS
THAT CAN
A FFECT S AFETY
IN
Y OUTH S PORTS ?
2.
Several factors that affect safety in youth sports, for which safety procedures
should be put in place, were identified (Australian Sports Commission, 2005; Reeser,
Verhagen, Briner, et al., 2006; Sport and Recreation Victoria, 2008; Sports Medicine
Australia, 2008; NCAA, 2009a). Please see Table 1:
Table 1: Factors Affecting Safety in Youth Sports
Athlete Factors
 Pre-existing medical
conditions
 Current health
status
 Infectious Diseases
Coach Factors
 Qualifications
 Competency
 Planning /
management of
activity sessions
Sports Factors
 Nature of the sport
 Nature of the risks
involved in the sport
 Adherence to the
rules
Environment Factors
 State of the facilities
/ equipment
 Weather conditions
3.
Athlete Factors. These factors include the current health status of the
participants (e.g., level of physical fitness), their known medical conditions (e.g.,
asthma, epilepsy, etc) and the presence of infectious diseases. Coaches and
officials should be aware of these when making decisions about athletes during
training and competitions.
4.
Coach Factors. These factors include the qualifications of the coach in the
specific sport, as well as his/her competency in effectively training athletes (e.g.,
teaching proper techniques in the game, conveying the right attitudes and values,
etc). The coach’s planning and management of activity sessions (e.g., ensuring
proper warm-up and cool-down, managing the amount and intensity of the activities,
sufficient preparation before competition, etc) also affect safety in youth sports.
5.
Sports Factors. These factors include the nature of the sport and the nature
of the risks involved in the sport. Participation in different sports presents different
7
Information about Asian-oriented sports (e.g., martial arts) was limited.
C-1
levels of risk8 and different types of risks (e.g., different types of injuries to different
parts of the body). In addition, steps taken to ensure adherence to the rules before,
during and after the sport also affect safety in youth sports, particularly for those
involving contact sport and competition.
6.
Environment Factors. These factors include the state of the facilities and
equipment used in the sport (i.e., these should meet standard requirements for
safety in the sport), as well as weather conditions that can impact participants’
physical well-being (e.g., extreme heat or cold, lightning, rain, etc).
W HAT P RACTICES
S PORTS ?
CAN BE
I MPLEMENTED
TO
E NHANCE S AFETY
IN
Y OUTH
7.
Based on the factors described above, best practices implemented in other
countries to help promote and enhance safety in youth sports were identified,
categorized into (i) Education and Public Awareness; (ii) Prevention and (iii)
Intervention.
(I)
Education and Public Awareness
8.
This includes programmes, campaigns and materials to educate the public
and youths so as to raise their awareness of good safety practices in youth sports. In
particular, those who are more directly involved in youth sports (e.g., athletes,
coaches / teachers, sports providers, parents, etc) should be aware of their roles and
responsibilities in promoting safety.
9.
For example, under the National Safe Kids Campaign, the National Athletic
Trainers’ Association (NATA) provides guidelines and checklists for parents and
coaches on what to consider before a child participates in organized sports (physical
examination; ascertaining coaches’ qualifications; reducing the risk of heat illnesses,
dehydration or injury; emergency plans in the event of an injury, etc) (NATA, 2003;
2010). Likewise, the NCAA RESPECT Campaign was embarked on by the NCAA
Committee on Sportsmanship and Ethical Conduct in U.S.A. to raise awareness and
commitment to sportsmanship among members of the association. In line with this,
the RESPECT campaign brochure was produced to provide information for campus
leaders and advisory groups on communication and educational plans in order to
promote sportsmanship in student athletes, student athletes’ family members,
coaches, opponent teams and venue staff (NCAA, 2009b).
(II)
Prevention
10.
Some of the sources reviewed estimated that 50% or more of sport injuries
are preventable (USA’s Centers for Disease Control or CDC, n.d.; Sports Medicine
Australia, 2008). Some preventive measures to promote sports safety before, during
and after games are listed below and summarized in Table 2 (Accident
Compensation Corporation, 2002; Sports Medicine Australia, 2008):
8
For instance, football was found to cause 1,024,022 injuries, soccer led to 368,726 injuries, gymnastics resulted
in 67,542 injuries among U.S. youths under the age of 18 (University of Michigan Health System, 2009).
C-2
Table 2: Preventive Measures to Promote Sport Safety
Before game
 Screening for pre-existing
medical conditions and for
record-keeping
 Proper warm-up, cool-down
procedures, learning right
techniques in sport and
avoiding overexertion
 Conducive environmental
conditions and wellfunctioning equipment
During game
 Abiding by rules (Note: this
may include the need to
review and modify rules to
make the sport safer and
more appropriate for younger
athletes)
 Match competitors by size,
gender, strength, skill or
experience instead of age
 Use of protective equipment
that meet safety standards
After game
 Proper injury management
procedures
Before the game

Screening. Screening aims to identify athletes who have pre-existing medical
conditions that pose as risk factors in sport participation; identify factors that
may predispose athletes to an increased risk of injury; obtain baseline
physical data; assess efficacy of a rehabilitation programme on previous
injuries; and assess lifestyle factors that may affect injury risk or performance.
Screening can be done through questionnaires or medical testing.

Physical training and practice. Proper warming up and stretching procedures
should be done to reduce the risk of injury during training and/or competition.
In addition, physical conditioning is required to prepare the body for the
demands of the game, and includes training in the areas of strength, flexibility,
endurance, balance, speed, and power. Athletes should also be taught the
right techniques as incorrect techniques increase risk of injuries. Coaches
should also guard the athletes against overexertion.

Environment. This involves assessing environmental conditions to determine
suitability for the sport (e.g. not playing during a storm when there is a
possibility of being struck by lightning). Playing fields and facilities should also
be regularly checked to ensure they are safe to use (e.g., not littered with
dangerous materials such as broken glass). A comprehensive checklist
should be developed to note what needs to be done.
During the game

Rules and Fair Play. Following the rules of the sport helps protect oneself
and others from injury. Rules may also be changed or enforced to avoid a
situation where injury often occurs (e.g., by making certain actions illegal9 or
making the use of protective equipment compulsory). In sports involving
children, rules may be modified depending on the needs and abilities of the
young athletes (e.g., using smaller/lighter equipment, reducing size of playing
area, reducing match time to adapt to different levels of physical ability).
9
For example, a research study found that modifying rules in a taekwondo competition such that contact to the
head, face, neck, or groin was prohibited, with the exception of the headgear, led to a reduced injury rate (Burke,
Barfoot, Bryant, et al., 2003)
C-3

Matched Competitors. Competitions should be balanced (i.e., competitors
should be ideally matched by size, gender, strength, skill, or experience
instead of just by age group).

Protective Equipment. This refers to the proper use and maintenance of
equipment. Examples of protective equipment include: mouthguard, helmet,
protective padding (e.g., shin guards), eyewear, and footwear. In addition,
regulatory bodies should oversee and enforce standards for protective
equipment. For instance, in U.S.A., sports equipment that meet a certain
safety standard will be endorsed by the National Operating Committee on
Standards for Athletic Equipment (NOCSAE) (NCAA, 2009a).
After the game

(III)
Injury Management. An injured athlete should be assessed and managed by
qualified personnel (e.g., a sports first-aider or sports trainer). Good injury
management minimizes the consequences of the injury and pain / discomfort
to the individual. An example of a first aid management approach is the
RICED (apply Rest, Ice, Compression, Elevation, & Diagnosis).
Intervention
11.
In the event that injuries occur, it is important that the relevant parties are
aware of the procedures to follow in order to minimize the damage done. The NCAA
Sports Medicine Handbook (2009a) provides guidelines on emergency plans for
practice sessions and competitive events. These include the presence of a qualified
and dedicated person who is able to provide emergency care, access or planned
access to a physician, access to working emergency equipment, planned access to
a medical facility, access to a telecommunication device for communication and
transportation, availability of emergency information about the student athlete, as
well as certification of athletics personnel in cardiopulmonary resuscitation
techniques (CPR), first aid, and prevention of disease transmission. Likewise, the
Australian Sports Commission Junior Sport Guidelines (2005) also emphasizes on
the need for emergency planning.
Sport providers should be familiar with
emergency procedures and possess current first aid qualifications. Medical advice
should be sought when the health and recovery from illness/injury of a student
athlete is uncertain; and when the student athlete is injured while training or during a
competition. The Guidelines recommend the prohibition of the young persons to
participate if medical advice is unavailable.
12.
In addition, a sports injury surveillance system is required to collect
information on the incidence, nature, and severity of injury in a sport, monitor
longitudinal trends in injury, determine the risk and causal factors behind the injury,
and assist in evaluating policy regarding injury prevention by planning preventive
measures to reduce the incidence of injury. For example, the NCAA has a system
which contains data on injury trends in U.S. intercollegiate athletics. Data on injury
and exposure are collected on a yearly basis from a representative sample of NCAA
member institutions. This data is then reviewed by NCAA Sport Rules Committee
and the NCAA Committee on Competitive Safeguards and Medical Aspects of
Sports, to guide them in making appropriate recommendations for safety measures.
One example is the NCAA’s Competitive Safeguards Committee’s recommendation
C-4
of having a championship sports-wide playing rule prohibiting student athletes who
display signs of concussion from returning to play until they are cleared by a
physician or designated health-care professional. Similarly, based on data on areas
where injuries are most likely to occur, the rules of certain sports (e.g., volleyball,
American football, taekwondo) have been modified to prevent / reduce injuries.
L EARNING P OINTS
FOR
S INGAPORE S CHOOLS
13.
The above scan of best practices for safety in youth sports in other countries
has highlighted the following learning points for Singapore schools, based on the
three tier framework of Education and Public Awareness; Prevention; and
Intervention:
Education and Public Awareness
(a) It is important to educate and involve not only those who are directly
affected (i.e., youth athletes, coaches, sports providers), but also relevant
parties such as parents, sports officials and safety personnel.
Prevention
(b) There should be strong partnerships among the key stakeholders (e.g.,
MOE, Singapore Sports Council (SSC) and the National Sports
Associations (NSAs)), to develop safety standards and good practices for
sports providers, coaches and other related parties.
(c) For high-risk sports, important preventive measures that should always
be in place include: ensuring that rules are appropriately modified to
minimize injury and appropriate for youth sports; ensuring matched
competitors (based on criteria such as strength and skill instead of purely
by chronological age group); and ensuring proper use and maintenance
of protective equipment.
(d) A system to ensure the regulation and training of coaches should be
established, to ensure that coaches are qualified and competent to
ensure the youths are trained to play properly and in a safe way.
Intervention
(e) It is important to have an injury surveillance system, to track the
incidence and severity of injuries in selected sports, especially those with
high injury rates (e.g., rugby, football, martial arts, basketball). Based on
such data and from existing findings on etiology of injuries in youth sports
(i.e., how, where, when, what injuries occur), safety measures and rules
of the sport could be reviewed and further refined.
C-5
REFERENCES
Accident Compensation Corporation (ACC). (2002). ACC Sportsmart: Educational
Resource. Retrieved, 30 April, 2010, from http://www.acc.co.nz/preventinginjuries/playing-sport/sportsmart-10-point-plan/index.htm.
Australian Sports Commission. (2005). Making sport safe. Junior sports guidelines.
Retrieved, 30 April, 2010, from
http://www.ausport.gov.au/participating/schools_and_juniors/juniors/resources/ju
nior_sport_framework.
Burke, D., K., Barfoot, Bryant, S., Schneider, J., Kim, H., H., & Levin, G. (2010).
Effects of safety measures in tae kwon do. British Journal of Sports Medicine ,
37I, 401 .
Centers for Disease Control (CDC). (n.d.) Protect the ones you love: Sports injuries.
Retrieved 30 April, 2010, from http://cdc.gov/safechild/Fact_Sheets/SportsInjury-Fact-Sheet-English-a.pdf
Dick, R., Agel, J. & Marshall, S. W. (2007). National Collegiate Athletic Association
Injury Surveillance System Commentaries: Introduction and Methods. Journal of
Athletic Training, 42 (2), 173–182.
International Olympic Committee (IOC). (2009). Olympic Movement Medical Code.
Retrieved 30 April, 2010, from
http://www.olympic.org/PageFiles/61597/Olympic_Movement_Medical_Code_en
g.pdf.
Junge, A., Engebretsen, L., Alonso, J. M., Renstrom, P., Mountjoy, M. L., Aubry, M.
& Dvorak, J. (2008). Injury surveillance in multi-sport events – The IOC approach.
British Journal of Sports Medicine, 42, 413-421.
McInulty, K. (2006). Creating a safe environment for children in sport. UK:
CHILDREN 1st and Sportscotland. Retrieved 30 April, 2010, from
http://www.childprotectioninsport.org.uk/.
Micheli, L., Glassman, R., & Klein, M. (2000). The prevention of sports injuries in
children. Clinics in Sports Medicine, 19(4), 821-834.
National Athletic Trainers’ Association (NATA). (2003). Parents’ and coaches’ guide
to dehydration and other heat illnesses in children. Retrieved May 3, 2010 from
http://www.nata.org/consumer/docs/parentandcoachesguide.pdf
National Athletic Trainers’ Association (NATA). (2010). Sports safety checklist to
help prevent common athletic injuries. Retrieved May 3, 2010 from
http://www.nata.org/youthsports/NATAcheklist9.pdf
National Collegiate Athletic Association (NCAA). (2009a). 2009-10 NCCA Sports
Medicine Handbook. Retrieved May 3, 2010 from
C-6
http://www.ncaapublications.com/p-3937-2009-2010-sports-medicinehandbook.aspx
National Collegiate Athletic Association (NCAA). (2009b). Respect. It’s the name of
the game. Retrieved May 3, 2010 from
http://www.ncaa.org/wps/wcm/connect/45d9e68041ed57dd941694613c9c02ac/
RESPECT_Pamplet_New.pdf?MOD=AJPERES&CACHEID=45d9e68041ed57d
d941694613c9c02ac
National Youth Sports Safety Foundation (NYSSF). (2001). Emotional injuries fact
sheet. Retrieved 30 April, 2010, from http://www.nyssf.org/emotionalabuse.pdf.
Reeser, J., Verhagen, E., Briner, W., Askeland, T., & Bahr, R. (2006). Strategies for
the prevention of volleyball related injuries. British Journal of Sports Medicine,
40, 594-600.
Sport and Recreation Victoria. (2008). Keeping Junior Sport Safe. Australia: State
Government of Victoria. Retrieved 30 April, 2010, from
http://www.sport.vic.gov.au/web9/rwpgslib.nsf/GraphicFiles/Keeping+Junior+Spo
rt+Safe/$file/Keeping+Junior+Sport+Safe+PDF.pdf.
Sport England. (2007). Helping keep your child safe in sport: Child protection leaflet
for parents. Retrieved 30 April, 2010, from
http://www.culture.gov.uk/images/publications/safeinsport.pdf .
Sports Medicine Australia. (2008). Safety guidelines for children in sport and
recreation (2e). Retrieved 30 April, 2010, from
http://www.sport.vic.gov.au/web9/rwpgslib.nsf/GraphicFiles/Safety+Guidelines+f
or+Children+and+Young+People+in+Sport+and+Recreation/$file/SMA+ChildSaf
+bkLRcompFinal.pdf.
University of Michigan Health System. (2009). Youth sports safety: Your child.
Retrieved 30 April, 2010, from
http://www.med.umich.edu/yourchild/topics/sportsaf.htm.
Van Tiggelen, D., Wickes, S., Stevens, V., Roosen, P., & Witvrouw, E. (2008).
Effective prevention of sports injuries: a model integrating efficacy, efficiency,
compliance and risk-taking behaviour. British Journal of Sports Medicine, 42,
648-652.
C-7
Annex D
Summary of Injury Rates in Various Studies
Country
Age Group
United
States
7 to 13 years
United
States
United
States
13 to 18 years
Injury Rate
16.4
(range 10 to 23)
1.94
Remarks
Per 1000 athlete exposure
(averaged over 5 sports)
Per 1000 athlete exposure
0 to 19 years
333.25
Per 1000 children and teenagers
High school
athletes
260
(range 132 to 500)
5 to 14 years
1.38
(Range 0.02 to 5.29)
15 to 24 years
1.23
(Range 0.08 to 5.78)
Per 1000 participants
(averaged over 8 sports)
Per 1000 population
(Product-related injuries,
averaged over 16 sports)
Per 1000 population
(Product-related injuries,
averaged over 16 sports)
United
States
United
States
College students
United
States
High School
athletes
Canada
Canada
Holland
5 to 9 years
10 to 14 years
15 to 19 years
0 to 14 years
15 to 24 years
8 to 17 years
5 to 14 years
Australia
15 to 39 years
5 to 9 years
Australia
10 to 14 years
15 to 19 years
0 to 14 years
Australia
SI
15 to 24 years
Game – 13.79
Practice – 3.98
2.51
Game – 4.63
Practice – 1.69
67.3
270.0
293.0
2.18
1.53
106
22.1
SI
12.3
26.1
SI
9.8
2.68 (2003)
2.81 (2004)
2.52 (2005)
5.59 (2003)
5.70 (2004)
5.72 (2005)
4.85 (2003)
5.01 (2004)
5.21 (2005)
5.43
4.70
5.17
– Significant Injury
D-1
Per 1000 athlete-exposure
Per 1000 athlete-exposure
Per 1000 hospitalisation cases
Per 1000 hospitalisation cases
Per 1000 hospitalisation cases
(hospitalisation) Per 1000 population
(hospitalisation) Per 1000 population
Per 1000 participants
Per 1000 participants
Per 1000 participants
(hospitalisation) Per 1000 population
(hospitalisation) Per 1000 population
(hospitalisation) Per 1000 population
Per 1000 population
Per 1000 population
Per 1000 participants
SN
1.
Reference/ Country/ Sample Size/ Method
Radelet, M. A., Lephart, S. M., Rubinstein, E. N.
& Myers, J. B. (2002). Survey of the injury rate
for children in community sports. Pediatrics,
110 (3), 1-11
United States of America
1,659 children aged 7 to 13 (participating in
community organised baseball, softball, soccer
and football)
Definition of Injury
An jury was defined as
• An injury that brought a coach into
the field to check the condition of a
player.
• An injury which a player was
removed from participation.
• An injury which a player needed
any type of first aid during an event.
Types of Sports
• Baseball (boys)
• Football (boys)
• Soccer
• Softball (girls)
Summary of Findings
Sports injury per 1000 athletes
exposure
• Average 16.4
Type of Sports
• Soccer (girls): 23
• Baseball (boys): 17
• Soccer (boys): 17
• Football (boys): 15
• Softball (girls): 10
Types of injuries:
• Bruises (54%)
• Sprain or strain (15%)
• Laceration/abrasion (8%)
• Fracture (5%)
• Concussion (3%)
• Dislocation (1%)
• Neck Injury (1%)
• Others (13%)
Observational cohort study, data collected
through coaches using an injury survey tool
Circumstances:
• Injury rate for games significantly
higher that injury rate for practice
(except softball, higher but not
significant)
2.
CHIRPP INJURY BRIEF
Canadian Hospitals Injury Reporting and
Prevention Program Injuries associated with
... TEAM SPORTS, 2000-2002
Canada
273, 293 records of ages 5 years and older
Data collected from pediatric hospitals
• No specifications
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Baseball
Basketball
Broomball
European handball
Floor hockey
Football
Hockey
Ice hockey
Lacrosse
Omikin
Ringette
Roller hockey
Rugby
Soccer
Street hockey
Ultimate Frisbee
Volleyball
Water polo
Dodgeball
Soccer-baseball
Hockey
D-2
Sports injury per 1000 CHIRPP cases
• 5 to 9 yrs old – 67.3
• 10 to 14 yrs old – 270.0
• 15 to 19 yrs old – 293.0
• 20 yrs and older – 69.6
Type of sports (top 3 most frequent):
Males (5-9)
Females (5-9)
• Soccer
Soccer
• Ice Hockey
Basketball
• Basketball
Baseball
Injuries do not represent all injuries in
Canada, but only those seen at the
emergency departments of the 15
hospitals in the CHIRPP network.
Under-representation of:
• older teenagers and adults
• native people
• people who live in rural areas
• fatal injuries
Males (10-14)
• Ice Hockey
• Basketball
• Soccer
Females (10-14)
Soccer
Basketball
Volleyball
Males (15-19)
• Ice Hockey
• Basketball
• Football
Females (15-19)
Soccer
Basketball
Volleyball
3.
Backx, F.J. G., Erich, B. M., Kemper, B. A.
& Verbeek A.L. M. (1989) Sports injuries in
school-aged children : An epidemiologic
study. AM J Sports Med 17: 234
• A sports injury was defined as
physical damage caused by a
sports-related incident and reported
as such by the respondent.
Holland
7,468 pupils aged 8 to 17
Questionnaire covering a retrospective period of
6 weeks
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Badminton
Ballet
Basketball
Club gymnastics
Field hockey
Handball
Horse riding
Korfball
Martial arts
Soccer
Swimming
Tennis
Track and field
Volleyball
Others
Sports injury per 1000 participants:
• 8 to 17 yrs old – 106
Type of injuries:
• Contusions (40%)
• Sprains (37%)
• Strains (7%)
• Fractures and dislocations (6%)
• Concussions (2%)
• Other injuries (8%)
Type of sports (top 5 most frequent):
• Badminton
• Field hockey
• Track and field
• Korfball
• Handball
Cause of Injuries:
• Misstep, Twisting motion (31%)
• Falling/stumbling (24%)
• Kick (13%)
• Ball (11%)
• Opponent (10%)
• Tiredness (3%)
• Unknown (12%)
Circumstances:
• Sports club training (29%)
• Sport club matches (33%)
• Physical education classes (21%)
• Non-organised sports (17%)
4.
Borowski L.A, Yard E.E., Fields S.K. and
Comstock R.D. (2008) The Epidemiology of
US High School Basketball Injuries, 20052007. Am J Sports Med (38) 2328-2335
United States of America
780,651 athlete exposures from 100 nationally
representative US high schools (aged 13-18)
An injury was defined as one that met
the following 3 criteria:
• occurred as a result of participation
in an organized high school
basketball practice or competition.
• required medical attention by an AT
or a physician.
• resulted in restriction of the student
athlete’s participation for 1 or more
days beyond the day of the injury.
• Basketball
Sports injuries per 1000 athlete
exposure
• Overall (13 to 18 yrs old) – 1.94
• A sports and recreational injury was
defined as bodily harm caused by
external force to a participant or
spectator or by exposure to a
substance associated with a sports
and recreational activity.
• Not specified
Sports injuries per 1000 children and
teenagers
• Overall (0 to 19 yrs old) – 33.33
Collected from 100 nationally representative
high schools through High School Reporting
Information Online system
5.
Conn J.M., Annest J.L., Bossarte R.M., and
Gilchrist J. (2006) Non-fatal sports and
recreational violent injuries among children
and teenagers, United States, 2001—2003.
Journal of Science and Medicine in Sport 9,
479—489
United States of America
Children and teenagers aged 0 to 19 yrs
Data obtained from the National Electronic Injury
Surveillance System–All Injury Program
(NEISS–AIP)—a national sample of 66 U.S.
EDs
D-3
Circumstances
• Practice (1.40)
• Competition (3.27)
6.
Finch C., Cassell E. (2006) The public health
impact of injury during sport and active
recreation. Journal of Science and Medicine in
Sport 9, 490—497
Latrobe Valley, Australia
1,084 persons from 417 households (aged over
4 years)
Random household telephone survey
7.
Powell, J. W. & Barber-Foss, K. D. (1999).
Injury Patterns in Selected High School
Sports: A Review of the 1995-1997 Seasons.
Journal of Athletic Training, 34(3), 277-284
United States of America
High school athletes on varsity sports rosters
Certified athletic trainers recorded data using a
surveillance protocol
8.
Mitchell R. Boufous S. Finch CF. Sport/leisure
injuries in New South Wales: Trends in
sport/leisure injury hospitalizations (20032005) and the prevalence of non-hospitalised
injuries (2005). Sydney: New South Wales
Injury Risk Management Research Centre, July
2008.
• A sport and active recreation injury
was defined as any reported injury
occurring during this participation,
whether or not it required treatment
or impacted on participation.
• A ‘significant’ injury was defined as
a reported injury that required
treatment, interfered with
performance of the activities of
daily living and/or had adverse
effects on participation or
performance in subsequent activity
•
•
•
•
•
•
•
Australian football
Basketball
Cricket
Netball
Soccer
Tennis
Walking
An injury was defined as
• Any injury that causes cessation of
participation in the current game or
practice and prevents the player's
return to that session.
• Any injury that causes cessation of
a player's customary participation
on the day following the day of
onset.
• Any fracture that occurs, even
though the athlete does not miss
any regularly scheduled session.
• Any dental injury, including fillings,
luxations, and fractures.
• Any mild brain injury that requires
cessation of a player's participation
for observation before returning,
either in the current session or the
next session.
• Baseball (Boys only)
• Basketball
• Field hockey (Girls
only)
• Football (Boys only)
• Soccer
• Softball (Girls only)
• Volleyball (Girls only)
• Wrestling (Boys only)
Sports injury per 1000 participants:
• Average over the different sports –
260 (range 132 to 500)
No consistent definition across
agencies.
Code used with 260
different categories
Sports injury hospitalisations per 1000
population:
• 5 to 9 yrs old
o 2.68 (2003)
o 2.81 (2004)
o 2.52 (2005)
• 10 to 14 yrs old
o 5.59 (2003)
o 5.70 (2004)
o 5.72 (2005)
• 15 to 19 yrs old
o 4.85 (2003)
o 5.01 (2004)
o 5.21 (2005)
New South Wales, Australia
Records of hospitalisation of NSW residents at
NSW-based hospitals from NSW Admitted
Patients Data Collection (APDC)
D-4
Sports injury per 1000 participants:
• 5 to 14 yrs old – 22.1
• 15 to 39 yrs old – 26.1
Significant Injuries
• 5 to 14 yrs old – 12.3
• 15 to 39 yrs old – 9.8
Type of sports (top 5 most frequent):
• Cricket
• Soccer
• Baseball
• Netball
• Tennis
Type of sports (top 5 most frequent):
• Football
• Wrestling
• Soccer (Girls)
• Basketball (Girls)
• Basketball (Boys)
Circumstances:
• Practice (55.5% [range 40.7% to
68.8%]))
• Game (44.4% [range 33.0% to
57.0%])
9.
National Electronic Injury Surveillance
System (NEISS) 2009
Injury cases collected from hospitals.
United States of America
96 hospitals (national probability sample of
hospitals)
CPSC's National Electronic Injury Surveillance
System (NEISS) collects current injury data
associated with consumer products from U.S.
hospital emergency departments across the
country.
10.
Alberta Centre for Injury Control and Research
Children and Youth Injuries in Alberta,
Included sports and
non-sports product/
equipment:
• Baseball & softball
• Basketball
• Boxing
• Football
• Hockey
• In-line skating
• Lacrosse, rugby,
misc. ball games
• Racquet sports
• Skateboards
• Skating (excl. in-line)
• Soccer
• Swimming, pools,
equipment
• Track & field
activities, equipment
• Trampolines
• Volleyball
• Water skiing, tubing,
surfing
Sports-related hospital admission
Estimated rate of product-related
injuries per 1000 population
• 5-14 years old (average of selected
groups) – 1.38 (Range 0.02 to 5.29)
• 15-24 years old (average of selected
groups) – 1.23 (Range 0.08 to 5.78)
Type of Sports (5 to 14 yrs old)
• Football: 5.29
• Basketball: 3.63
• Baseball & softball: 2.69
• Soccer: 2.16
• Skateboards: 1.64
Type of Sports (15 to 29 yrs old)
• Basketball: 5.78
• Football: 4.37
• Baseball & softball: 1.98
• Soccer: 1.91
• Skateboards: 1.34
Sports and recreation related injury
hospitalisation per 1000 population
• 0 to 14 yrs old – 2.18
• 15 to 24 yrs old – 1.53
Retrieved from:
http://acicr.ca/Upload/documents-reports/injuryfactsdata-reports/injury-data-summaryreports/children-and-youth-injuries-in-albertadata-summaryreport/InjuriesChildYouth2009.pdf
Alberta, Canada
11.
Hootman J. M., Dick R. and Agel J.
Epidemiology of Collegiate Injuries for 15
Sports: Summary and Recommendations for
Injury Prevention Initiatives. Journal of
Athletic Training 2007;42(2):311–319
United States of America
Data from National Collegiate Athletic
Association (NCAA) Injury Surveillance System
(ISS)
An injury is defined as a condition
meeting all of the following criteria:
• Occurred as a result of participation
in an organized intercollegiate
practice or contest.
• Injury required medical attention by
a team certified athletic trainer or
physician.
• Injury resulted in restriction of the
student athlete’s participation or
performance for one or more days
beyond the day of injury.
• Baseball (Men)
• Basketball
• Field Hockey
(Women)
• Football (Men)
• Gymnastics
• Ice Hockey (Men)
• Lacrosse
• Soccer
• Softball (Women)
• Volleyball (Women)
• Wrestling (Men)
D-5
Sports injury per 1000 athleteexposures:
• Game – 13.79
• Practice – 3.98
Cause of Injuries (Game):
• Player Contact (58.0%)
• No contact (17.7%)
• Other contact (20.0%)
• Unknown (4.3%)
Cause of Injuries (Practice):
• Player Contact (41.6%)
• No contact (36.8%)
• Other contact (15.4%)
• Unknown (6.2%)
12.
Flood L and Harrison JE (2006). Hospitalised
sports injury, Australia 2002–03 Injury
Research and Statistics Series Number 27.
(AIHW cat no. INJCAT 79) Adelaide: AIHW
An injury was defined as any sport
related injury that was sufficiently
serious to result in admission to
hospital.
Code used with 260
different categories
Australia
Sports and recreation related injury
hospitalisation per 1000 population
• 0 to 14 yrs old – 5.43
• 15 to 24 yrs old – 4.70
Sports and recreation related injury
hospitalisation per 1000 participants
• 15 to 24 yrs old – 5.17
Data from the National Hospital Morbidity
Database compiled by the Australian
Institute of Health and Welfare (AIHW) for
inpatient care in the financial year 2002–2003
Type of sports (top 5 most frequent):
• Football (Australian and
Unspecified)
• Soccer
• Rugby (Union, League and
Unspecified)
• Water Sports
• Cycling
Type of injuries (in order of frequency –
most to least):
• Fracture
• Open wound (excluding eye)
• Dislocation
• Sprain/strain
• Intracranial
• Muscle/tendon
• Superficial (excluding eye)
• Internal organ
• Nerve & spinal cord
• Eye injury
Cause of Injuries (in order of frequency
– most to least):
• Other fall
• Land transport
• Contact with another person
• Fall same level, contact by person
• Fall from slip, trip and stumble
• Contact with sports equipment
• Strikes/struck
• Other transport
• Foreign body
• Contact with animal or plant
13.
Julie A. Rechel, Ellen E Yard, and R. Dawn
Comstock. An Epidemiologic Comparison of
High School Sports Injuries Sustained in
Practice and Competition. J Athl Train. 2008
Mar–Apr; 43(2): 197–204.
United States of America
High school athletes
Collected from 100 nationally representative
high schools through High School Reporting
Information Online system
An injury was defined as a condition
meeting all of the following criteria:
• Occurred as a result of participation
in an organized high school
practice or competition.
• Required medical attention by an
AT or physician.
• Resulted in restriction of the
student-athlete's participation for 1
day or more beyond the day of
injury.
•
•
•
•
•
•
•
Baseball (Boys)
Basketball
Football (Boys)
Soccer
Softball (Girls)
Volleyball (Girls)
Wrestling (Boys)
Sports injury per 1000 AthleteExposure
• Overall – 2.51
o Practice – 1.69
o Competition – 4.63
Type of sports (top 5 most frequent):
• Football (Boys) – 4.36
• Wrestling (Boys) – 2.50
• Soccer (Boys) – 2.43
• Soccer (Girls) – 2.36
• Basketball (Girls) – 2.01
Types of injuries:
• Sprain or strain (52.1%)
• Contusions (12.3%)
• Fracture (9.8%)
• Concussion (9.1%)
D-6
Annex E
ROLES OF STAKEHOLDERS IN PROMOTING SCHOOL SPORTS
SAFETY
Stakeholder
Role in promoting school sports safety
Stakeholders within the MOE / School system
MOE HQ
•
•
•
•
•
•
School
leadership
•
•
•
•
PE / CCA
Teachers
The MOE School Safety Committee (MOE SSC), supported by the
School Safety Unit (SSU), oversees the development, review,
implementation and compliance of school sports safety (as part of the
larger school safety framework) at the MOE level.
The MOE SSC regularly and effectively communicates safety information
to schools.
MOE HQ maintains and reviews regularly an overall risk classification
and baseline safety framework which is mandatory for schools to adhere
to.
[MOE HQ oversees the risk-tiered insurance framework which schools
take guidance from and procure appropriate insurance for students
accordingly, based on the risk levels in their sports.
MOE HQ oversees the incident management system by schools, and
tracks injury data with a clearly specified and standardised set of data
fields.
MOE HQ performs regular analysis of the injury data, proposes
refinements to sports safety measures arising from the data analysis,
and tracks the follow-up actions taken.
The School Safety Committee (SSC), headed by the VP (or a suitable
representative) of each school, oversees the development and review of
sports safety issues at the school level.
The MOE SSC regularly and effectively communicates safety information
to stakeholders at the school level.
School leaders implement MOE HQ’s sports safety guidelines, and
ensures accurate and timely reporting of sports incident data and school
coach issues to MOE HQ.
School leaders ensure that students involved in the respective sports are
covered by the appropriate level of insurance.
Safety education and training
• Most importantly, PE / CCA teachers are responsible for the
achievement of the student learning outcomes during school sports
• Ensure that they possess basic knowledge about sports safety and
possess current first-aid certification.
• Conduct generic safety briefings for students and include safety briefing
specific to the CCA they are in charge of.
Preventive measures
10
• Pre-screen student data for medical conditions. Exempt unwell
students (those with MCs, letters from parents, teachers’ observations)
from physical activities.
• Conduct checks before each CCA to ensure that the equipment and
facilities (fitness stations, courts, fields, availability of water, first aid kit)
are safe for use.
• Conduct robust risk assessment through the Risk Assessment and
Management System (RAMS) prior to activities, if necessary.
During conduct of activities
10
Through data sources such as the Annual Precautionary List, Individual Pupils’ Precautionary
Forms and use the Pupil Medical Record Forms
E-1
Ensure that coaches conduct trainings safely and report unsafe practices
or behaviour of coaches to School SSC.
• During competitions, ensure that there are safety measures in place. For
example, ambulances can be on standby for sports such as Rugby, Judo
and Taekwondo (facilities and equipment are organisers and NSAs’
responsibility).
• Ensure that students follow safety rules and guidelines.
• Be on the lookout for students in need or who needs to discontinue
participation.
Responding to safety incidents
• First responder to safety incidents.
• Perform first aid if necessary.
• Make decision on whether to send student to hospital.
• Report incident to school SSC and inform parents as necessary.
•
Students
•
•
•
•
Understand and obey safety rules and procedures.
Highlight to teacher or coach when there is an incident or when there are
unsafe practices.
Understand when to cease participation in activity when feeling unwell.
Internalise school sports ethics and values, such as integrity, fairness,
respect, good sportsmanship, team spirit, and safety and reinforce them
in teammates and schoolmates.
Stakeholders outside MOE / School system
Coaches
Safety education and training
• Ensure that they meet the minimum requirements in the technical skills,
pedagogical skills, continuing training areas in the school sports coaches
framework.
• Communicate and ensure that students are aware of safety rules and
regulations.
• Establish and promote safety habits for student athletes (e.g. conducting
warm-up before training or events).
Preventive measures
• Conduct regular checks to ensure that the equipment and facilities
(fitness stations, courts, fields, availability of water, first aid kit) are safe
and well-maintained.
• Exempt unwell students from physical activities.
During conduct of activities
• Create an environment that encourages fair play and playing within the
rules.
• Ensure that activities are appropriate for the physical and skill levels of
different students, and be aware of students’ medical conditions.
• Be on the lookout for students in need or who needs to discontinue
participation.
Responding to safety incidents
• First responder to safety incidents.
• Perform first aid if necessary.
• Attend to student and seek medical help if needed.
• Report incident to MOE teacher-in-charge.
• Take note of relevant details and assist in investigations if necessary.
NSAs and
Officials
•
•
Developing safety guidelines and standards for their respective sports.
Ensuring that coaches are properly trained and possess the necessary
qualifications, such as through working with SSC on NCAP.
• Providing national awareness of safety in respective sport.
Preventive measures
• Officials have to ensure that the safety aspects of the event (e.g.
weather, facilities, equipment) are acceptable before allowing the event
E-2
to take place.
During conduct of activities
• During the event, ensure that rules are enforced.
• Officials to identify students in need and assist in seeking medical help
when necessary.
Responding to safety incidents
• Assist in investigations.
• Initiate review of safety SOPs and guidelines if necessary.
Parents
•
Play collaborative and supportive roles in helping to promote and
encourage school sports safety.
o Parents’ awareness and participation in sports safety would encourage
and support a sports safety culture in school and help children to learn
the importance of sport safety measures and practices.
o Inculcate ethics and values in sports, such as integrity, fairness,
respect, good sportsmanship, team spirit, safety amongst others to
students.
o Parents could be engaged to support the school in suitable roles in
helping to ensure sports safety awareness and practices are in place.
E-3