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Most Physical Activity Carries Low Injury Risk, Study Finds

The chance of serious injury from most sports and exercise is "exceedingly low" when compared with the health benefits of staying active, according to a UK study, which set out to estimate the relative hazards of dozens of popular physical pastimes.

Quantifying risk could lead to targeted prevention for the most high-risk activities, reduce hospital admissions, and boost safer sport and participation in physical exercise, researchers at the University of Bath said.

The study, published in the journal Injury Prevention, drew on data for people aged 16 years and over who were treated by the NHS for sport-related or physical activity-related major trauma injuries in England and Wales between 2012 and 2017. The findings were used to determine the cumulative incidence rate of adult major trauma injury in activities with highest national participation.

Study Examined 61 Types of Sport and Exercise

The registry-based cohort study examined 61 sports and other physical activities undertaken nationally, irrespective of their popularity, to provide a comparable estimate of the risks to participants.

The population-based Active Lives Survey was used to estimate national sport and physical activity participation, and the cumulative injury incidence rate was estimated for each activity. 

The researchers identified 11,702 trauma injuries resulting from sport or exercise over the 5 years, equivalent to an overall annual injury incidence rate of 5.40 injuries per 100,000 participants. Incidence was higher in men than women – 6.44 versus 3.34 injuries/100,000 participants/year – and was highest for 16 to 24 year olds, followed by 45 to 54 year olds.

The mean length of hospital stay was 9.4 days, and around one in 100 (1.3%) injuries was fatal. 

The incidence rate was higher for sporting activities (9.88 per 100,000) than cycling (2.81 per 100,000), fitness (0.21 per 100,000) or walking (0.03 per 100,000). 

Fitness activities, including running, golf, dance classes, and gym sessions, were the least likely pursuits to result in injury. Running resulted in 0.70 injuries, golf 1.25 injuries, gym sessions 0.23 injuries, and fitness classes 0.10 injuries, per 100,000 participants/year.

At the opposite end of the scale, motorsports, equestrian activities, and gliding were found to be the riskiest activities, with motorsports resulting in 532.31, equestrian pursuits 235.28, and gliding 191.81, injuries per 100,000 participants/year.

Participation was highest in walking (59.1%), sport (34.7%), and fitness activities (29.7%). By individual activity, participation was highest in running (15.3%), fitness classes (14.3%), and gym sessions (12.8%).

Among sports with the highest participation, football had the highest injury incidence rate at 6.56 injuries per 100,000 participants/year, while the incidence rate for golf was 1.25, and badminton 0.82.

Injury severity was highest in boxing, followed by abseiling, surfing sports, and gliding sports.

All fitness activities had a lower incidence than the overall sport and physical activity incidence, with sporting activities having a higher injury incidence than cycling, walking, fitness, or dance.

Measures Needed to Reduce Injury Risk

A "sustained and higher incidence of sport-related major trauma in the UK in recent years is indicative of the absence of coordinated reduction efforts", according to the researchers. Dr Madi Davies, first author and former post-doctoral researcher at the University of Bath, said "more people are getting injured", and that it was important that the data were used to "make activities safer".

The authors hoped that targeted prevention in high-risk activities might reduce hospital admissions and their associated burden, facilitating safer sport and physical activity participation.

Dr Sean Williams, senior lecturer in applied statistics and research methods, who led the study, said: "While no physical activity is entirely without risk, the chance of serious injury is exceedingly low when compared to the myriad health and wellness advantages gained from staying active."

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