ArticleOrthopaedic journal of sports medicine2021
Incidence of Head Contacts, Penalties, and Player Contact Behaviors in Youth Ice Hockey: Evaluating the "Zero Tolerance for Head Contact" Policy Change.
Article in Orthopaedic journal of sports medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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4 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Prevention strategies and modifiable risk factors for concussion: a systematic review and meta-analysis for the Female, woman and girl/or Athlete Injury pRevention (FAIR) consensus.British journal of sports medicine · 2025Pooled it
- Evaluating the Use of In-Game Rule Changes as a Primary Prevention Approach to Reduce Injury Risk in Invasion Team Sports: A Scoping Review.Sports medicine (Auckland, N.Z.) · 2026Article
- Whistleblower: the front line and critical facilitator for injury prevention policy?Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2025Article
- Oral health status, on-ice and off-ice test performance, and match performance in elite male ice hockey players: a pilot study.Frontiers in oral health · 2025Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo reduce the risk of concussion in youth ice hockey, Hockey Canada implemented a national "zero tolerance for head contact" (HC) policy in 2011. A previous cohort study revealed higher concussion rates after this implementation in players aged 11 to 14 years. However, it is unknown whether the elevated risk was due to higher HC rates or factors such as increased concussion awareness and reporting. PURPOSE: To compare the rates of primary and secondary HCs and HC policy enforcement in elite U15 ice hockey leagues (players <15 years) before (2008-2009) and after (2013-2014) the zero-tolerance policy change. STUDY
designCohort study; Level of evidence, 3.
methodsA total of 32 elite U15 games before (n
resultsA total of 506 HCs were analyzed, 261 before HC policy implementation (IR, 16.6/100 team minutes) and 245 after implementation (IR, 15.5/100 team minutes). The HC1 rate (IRR, 1.05; 95% CI, 0.86-1.28) and HC2 rate (IRR, 0.74; 95% CI, 0.50-1.11) did not significantly differ before versus after implementation. Only 12.0% and 13.6% of HC1s were penalized pre- and postimplementation, respectively. Before implementation, HC1s were commonly penalized as roughing or elbowing penalties (59%), while after implementation, HC1s were penalized with the HC penalty (76%), and only 8% as roughing or elbowing.
conclusionDespite implementation of the "zero tolerance for HC" policy, there was no difference in the rate of HC1s and HC2s or the proportion of HC1 penalized from before to after implementation. This research is instrumental in informing Hockey Canada's future referee training and rule enforcement modifications.
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