A few thoughts on DWI

I wish to make a brief comment about the deadly incident in Times Square last week.  All were horrified by the violence committed by an individual captured and charged with that awful crime( I refuse to publicize the alleged perpetrator’s name and give him even small satisfaction of notoriety).  So many people felt a somewhat understandable sense of relief when it was determined that there was no apparent link to any extremist terrorism.  It was “only” DWI.

Who are we kidding?  Of course all are concerned and fearful of the risk of terrorist violence in our society.  However, in reality, from 2004-13 there have been a total of 80 Americans killed in such incidents–36 on US soil.  Tragic, sickening, no doubt.  But for comparison, in 2014 alone there were 9967 Americans killed in drunk driving incidents; this is 28 people/day and one every 53 minutes.  19% of children 0-14 killed in auto accidents (total 209 that year) involved alcohol impaired drivers and over 1/2 who died riding in cars were operated by an impaired driver.  There are approximately 1.1 million DWI arrests yearly.

Other shocking statistics regarding DWI can be found here.

So let’s get real.  Our society has made major strides in DWI over the past generation or so but the above demonstrates that it is still a much greater public health problem in comparison to terrorism.

Obviously its extremely complex to address, but here are just a few simple policies that we as a society could adopt to help better control this terrible scourge:

  • Raise the alcohol tax–the American Journal of Public Health estimates that doubling the tax would reduce DWI mortality by 35%.  Many pundits argue generally about raising taxes with the claim that “if you tax something you will have less of it.”  It is mostly an arguable point at best .  But less DWI?  Sign me up.
  • Reduce the number of alcohol retail outlets.  The American Journal of Preventive Medicine reports that fewer liquor stores results in less alcohol related mayhem.  There is a “Goldilocks” effect here–too much or too few are both problematic.  But stricter licensing standards would likely be helpful.
  • Studies from the RAND Corporation strongly suggest that outlawing the purchase of liquor by people convicted of alcohol related crimes would cut into these numbers quite dramatically.  The program could be implemented with special bracelets and/or breathalyzers to monitor compliance.
  • RAND also found that state controlled–as opposed to privately operated–liquor stores are much safer and more protective against alcohol related criminal activity.

I believe that these are sensible and nonpartisan initiatives that all concerned citizens could support.  I encourage everyone to consider these policies and to encourage your elected representatives to advocate on their behalf.  Our society and especially our children will very likely be safer and healthier for your efforts.

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Baseball Arm Injuries

So we spent some time talking about warm weather and girls’ knees.  Let’s give equal time now to boy’s arms–pitchers’ injuries generally.  This is a huge topic, easily filling a textbook or weekend lecture series.  Let’s summarize some risk factors identified by researchers from the American Sports Medicine Institute.  These can guide us to develop safer training/competition schedules.

Firstly, a negative–number and age of breaking balls thrown had little positive correlation with injury.  Injured vs non-injured pitchers all threw on average 60% fastballs, 15%change ups, and 25% breaking balls.  There was also no difference in injured vs non-injured in relief appearances or for those who stayed in the game at another position after being relieved.

The 2 groups differed in size, with the injured group tending to be, on average, 4 cm taller and 5 kg heavier.  This may reflect the bigger boys throwing harder or having somewhat different mechanics.

The injured group threw more warm ups.  Possibly this may reflect a tendency of boys who are already “at risk” taking more time–and more throws–to “get loose.”

The injured group, not surprisingly, used ice and anti-inflammatories like ibuprofen more often and in greater amounts.  Again, this suggests boys with already stressed arms, and tells us a lot about  the folly of “playing through the pain” in kids.

9-14 year olds who lift weights had greater injury risk, possibly due to the strain on skeletally immature bones and joints in younger boys.  Probably best to avoid this until the boy has enough beard to shave somewhat regularly.

Competition issues are the big ones.  Injured pitchers competed at least 8 months/year  (5x risk of surgery) compared to boys pitching 5.5 months/year.  The Institute recommends refrain from all throwing activities(not all sports) for minimum 3 months/year.  Inured pitchers threw 6 innings/game and 88 pitches (2.8x risk of surgery) compared to non-injured at 4 innings, 66 pitches.  One study demonstrated a clear risk of a specific overuse shoulder injury with >100 pitches/week.  Velocity played a role–injuries were more frequent at 88 mph compared to 85 mph.  “Arm fatigue” is key.  67% of injured pitchers admitted to throwing with a “tired arm”–52% regularly– with 36x greater risk of needing surgery.  The non-injured group numbers were 42% and 11% respectively.  I’m sorry, but “toughing it out” in this age group is just crazy.

Finally “showcase” competitions caused greater risk of pitcher injury.  Injured players participated in an average of 4 of these events compared to just one in the non-injured group.  Showcases tend to be held in the off season when boys are not at peak conditioning and places added physical(and MENTAL) strain on young pitchers.  I recommend limiting the number of times boys participate here (if they cannot be avoided entirely) and closely monitor when throwing in this type of competition.

As always, I end by urging parents and coaches to remember the priorities for all youth sports: firstly–have fun and make friends; secondly–fitness, competition, and learning valuable lessons like persistence and commitment; and lastly–win games and glory.  College scholarships, should they occur, are icing on the cake.  Making the majors??–go buy a lottery ticket.

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