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446 Incidence of head contacts, penalties and player behaviour in youth ice hockey: evaluating the ‘zero tolerance for head contact’ policy change
  1. Rylen A Williamson1,
  2. Ash T Kolstad1,
  3. Maciej Krolikowski1,
  4. Luc Nadeau6,
  5. Claude Goulet6,
  6. Brent Hagel1,2,3,4,5,
  7. Carolyn A Emery1,2,3,4,5
  1. 1Sport Injury Prevention Research Centre, University of Calgary, Calgary, Canada
  2. 2Alberta Children’s Hospital Research Institute, Calgary, Canada
  3. 3Departments of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
  4. 4Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
  5. 5O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
  6. 6Department of Physical Education, Faculty of Education, Université Laval, Québec City, Canada


Background Concussion risk in ice hockey is amongst the highest for youth sport. To reduce this burden, in 2011 Hockey Canada implemented a national ‘zero tolerance for head contact (HC)’ policy mandating referees to penalize all player HCs; however, higher concussion rates have been observed following this policy in players aged 11–14.

Objective To compare HC rates and HC-policy enforcement in U15 (previously Bantam) ice hockey leagues before (2008–09) and after (2013–14) the ‘zero tolerance for HC’ policy implementation.

Design Prospective cohort.

Setting Calgary, Alberta, Canada.

Participants Thirty-two elite (upper 30% by division, allow body checking) U15 games pre (n2008–09=16, n=510 players) and post (n2013–14=16, n=486 players) HC-policy implementation.

Assessment of Risk Factors The 2011 HC-policy change mandates the penalization of any intentional or unintentional player/direct HC.

Main Outcome Measurements Dartfish video-analysis software with validated criteria for identifying HC types [direct HC (HC1), indirect HC (e.g., boards) (HC2)] and other player-to-player contact behaviours were used. Univariate Poisson regression [adjusted for cluster by team-game, offset by game length (minutes)] was used to estimate HC incidence rates (IR) and incidence rate-ratios (IRR) between cohorts.

Results A total of 506 HCs (n2008–09=261, n2013–14=245) were analyzed (IR2008–09=16.6/100 team-minutes; IR2013–14=15.5/100 team-minutes). The rate of HC1 (IRR=1.05, 95% CI: 0.86–1.28) and HC2 (IRR=0.74, 95% CI: 0.50–1.11) did not differ with the implementation of the HC-policy. Only 12.0% and 13.6% of HC1s were penalized pre- and post-policy respectively. Pre-policy, HC1s were commonly penalized as roughing or elbowing penalties (59%), while post-policy HC1s were penalized with the HC penalty (76%).

Conclusions Despite policy implementation for mandatory enforcement of direct HCs, there was no difference in the rate of HC1s and HC2s, or the proportion of HC1 penalized pre- and post-HC-policy enforcement. This research will be instrumental to inform Hockey Canada’s future referee training and rule enforcement modifications.

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