Featured Research

from universities, journals, and other organizations

New sickle cell screening program for college athletes comes with serious pitfalls, experts say

Date:
September 21, 2010
Source:
Johns Hopkins Medical Institutions
Summary:
A leading pediatrician is urging a "rethink" of a new sickle cell screening program, calling it an enlightened but somewhat rushed step toward improving the health of young people who carry the sickle cell mutation.

The Johns Hopkins Children's Center top pediatrician is urging a "rethink" of a new sickle cell screening program, calling it an enlightened but somewhat rushed step toward improving the health of young people who carry the sickle cell mutation.

Related Articles


Beginning this fall, all Division I college athletes will undergo mandatory screening for the sickle cell trait. The program, rolled out by the National Collegiate Athletic Association (NCAA), is an attempt to prevent rare but often-lethal complications triggered by intense exercise in those who carry the genetic mutation yet don't have the disease.

Nationwide, newborns are screened for sickle cell disease, but carriers, or people with one mutant and one normal sickle cell gene, do not have symptoms of the disease and may be unaware that they are carriers.

While the program's goal is laudable, its implementation has been hasty and its consequences poorly thought out, warns Johns Hopkins Children's Center Director George Dover, M.D., in a Sept. 9 commentary for The New England Journal of Medicine.

The program is expected to affect nearly 170,000 college athletes and identify anywhere between 400 to 500 new cases each year. Carriers of the sickle cell trait are asymptomatic but are at higher risk for infarction of the spleen caused by lack of oxygen supply to the organ and exercise-induced rhabdomyolysis, a condition marked by the rapid breakdown of injured muscle followed by the release of proteins in the bloodstream that harm the kidneys and can lead to kidney failure. Research has shown that the risk of sudden death during exercise is between 10 and 30 percent higher among those who have the sickle cell trait than those without it. The program stems from the 2006 death of a 19-year-old freshman who died after football practice from exercise-induced rhabdomyolysis.

Dover and co-authors Vence Bonham, J.D., and Lawrence Brody, Ph.D., of the National Human Genome Research Institute, call the program "an enlightened first step by the NCAA toward improving the health of student athletes," but one rife with pitfalls and raising many questions. Such questions include: "Will any positive test results be followed by a second test to eliminate false positives?" and "Who is responsible for counseling students who test positive in order to explain the difference between actual disease and carrier status and the risks associated with each?"

Dover and his co-authors say that the following stipulations should be included in the program:

  • Verifying test result accuracy by follow-up testing to eliminate false positives
  • Post-test counseling
  • Measures to prevent discrimination based on positive test results
  • Making athletic practice safer to reduce or eliminate the risk for death among carriers by instituting proper hydration and avoiding workouts during high humidity and peak heat

Students will be allowed to opt out of screening if they show proof of previous testing or sign a waiver releasing their college of any legal liability. These suggest that the program was designed primarily as a legal defense measure, but its medical, social and psychological consequences remain unaddressed, the authors say.

As the most extensive sickle cell screening program in the past 30 years, this initiative will likely pave the way for other mass screening programs among college athletes, including ones aimed at identifying the carriers of cardiac anomalies, the most common cause of sudden death in athletes.

"The precedent-setting nature of this screening program dictates that we proceed with caution because any subsequent genetic screening programs may be modeled after this prototype," says Dover, a pediatric hematologist and expert on sickle cell disease.

Some 100 million people worldwide and 2 million people in the United States are believed to be carriers of the sickle cell mutation (sickle cell trait) but do not have sickle cell anemia. Named for the unusually sickle-shaped red blood cells caused by an inherited abnormality, sickle cell anemia affects nearly 100,000 Americans, most of them African-American. In sickle cell anemia, the red blood cells become rigid, which reduces their oxygen delivery to vital organs and causes them to get stuck in the blood vessels, leading to severe pain and so-called "sickling crises," which require hospitalization.


Story Source:

The above story is based on materials provided by Johns Hopkins Medical Institutions. Note: Materials may be edited for content and length.


Journal Reference:

  1. Vence L. Bonham, George J. Dover, Lawrence C. Brody. Screening Student Athletes for Sickle Cell Trait — A Social and Clinical Experiment. New England Journal of Medicine, 2010; 363 (11): 997 DOI: 10.1056/NEJMp1007639

Cite This Page:

Johns Hopkins Medical Institutions. "New sickle cell screening program for college athletes comes with serious pitfalls, experts say." ScienceDaily. ScienceDaily, 21 September 2010. <www.sciencedaily.com/releases/2010/09/100908171120.htm>.
Johns Hopkins Medical Institutions. (2010, September 21). New sickle cell screening program for college athletes comes with serious pitfalls, experts say. ScienceDaily. Retrieved February 1, 2015 from www.sciencedaily.com/releases/2010/09/100908171120.htm
Johns Hopkins Medical Institutions. "New sickle cell screening program for college athletes comes with serious pitfalls, experts say." ScienceDaily. www.sciencedaily.com/releases/2010/09/100908171120.htm (accessed February 1, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Sunday, February 1, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Hikers Rescued After Fall from Oregon Mountain

Hikers Rescued After Fall from Oregon Mountain

AP (Feb. 1, 2015) Two climbers who were hurt in a fall on Mount Hood are now being treated for their injuries. Rescue officials say they were airlifted off the mountain Saturday afternoon by an Oregon National Guard helicopter. (Feb. 2) Video provided by AP
Powered by NewsLook.com
Smart Glasses Augment Reality to Help Visually Impaired

Smart Glasses Augment Reality to Help Visually Impaired

Reuters - Innovations Video Online (Feb. 1, 2015) New augmented reality smart glasses developed by researchers at Oxford University can help people with visual impairments improve their vision by providing depth-based feedback, allowing users to "see" better. Joel Flynn reports. Video provided by Reuters
Powered by NewsLook.com
Flu Season Hitting Elderly Hard

Flu Season Hitting Elderly Hard

Reuters - US Online Video (Jan. 31, 2015) The CDC says this year&apos;s flu season is hitting people 65 years of age and older especially hard. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
CDC: Get Vaccinated for Measles

CDC: Get Vaccinated for Measles

Reuters - US Online Video (Jan. 30, 2015) The CDC is urging people to get vaccinated for measles amid an outbreak that began at Disneyland and has now infected more than 90 people. Linda So reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins