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Bleeding Injuries in Professional Football: Estimating the Risk for HIV Transmission

Lawrence S. Brown, MD, PhD; D. Peter Drotman, MD, MPH; Alvin Chu, MA, MPH; Charles L. Brown, MD; and Donald Knowlan, MD
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From Addiction Research and Treatment Corporation, Brooklyn, New York. Harlem Hospital and College of Physicians and Surgeons and Columbia University, New York, New York. Centers for Disease Control and Prevention and Emory University, Atlanta, Georgia. Tulane University, New Orleans, Louisiana. Georgetown University, Washington, D.C. Requests For Reprints: Lawrence S. Brown Jr., MD, MPH, Addiction Research and Treatment Corporation, 22 Chapel Street, Brooklyn, NY 11201. Acknowledgments: The authors thank the National Football League of the United States, its member teams, the National Football League Physicians Society, and the Professional Football Athletic Trainers Society.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1995;122(4):271-274. doi:10.7326/0003-4819-122-4-199502150-00005
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Objective: To determine the risk for bleeding injuries in professional football and to estimate the risk for transmission of the human immunodeficiency virus (HIV) through such injuries.

Design: A prospective, observational study.

Participants: Professional football players from 11 teams of the National Football League were observed during 155 regular season games from September through December 1992.

Measurements: The frequencies of bleeding injuries were calculated in association with environmental and athletic factors. Using this information, HIV prevalence, and data on transmission of HIV in other circumstances, the risk for transmission of HIV during football games was estimated.

Results: 575 bleeding injuries (average, 3.7 per game for each team) involving 538 players (average, 3.5 players on each team per game) were observed. Approximately 88% of the bleeding injuries were abrasions; the remainder were lacerations. Bleeding injuries were markedly more frequent during games played on artificial surfaces, during games played in domed stadiums, and on teams with a final win/loss percentage of 0.500 or lower. Using data on the prevalence of HIV among college men and rates of HIV transmission in the health care setting, the risk for HIV transmission to each player was estimated to be less than 1 per 85 million game contacts.

Conclusions: Although injuries occur in professional football competitions, bleeding injuries, especially lacerations, occur infrequently. We estimate that the risk for HIV transmission during such competition is extremely remote. The role of artificial playing surfaces on the incidence or severity of bleeding injuries should be investigated.

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