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Debate Heats Up Over Screening Athletes for Sickle Cell Trait
Date:12/28/2012

t as part of their routine physical examination. Players who were tested at birth as part of newborn screening programs can opt out if they have proof of that test. Athletes also can refuse the test, but if they do, they must sign a liability release form.

If testing detects the sickle cell trait, the NCAA advises the athlete's coaches and trainers to learn the symptoms of potential trouble for someone with the trait. Recommendations include allowing longer periods of rest and recovery, encouraging the athlete to report any symptoms without fear of punishment, adjusting the workout in conditions of extreme heat or high altitude, and emphasizing hydration.

"I want my athletic trainers and coaches to know who to watch early on," Dimeff said. "It just helps to have that information. Our goal is not to exclude athletes. We want to know who has risks and how to minimize those risks. We want you to be able to play in a way that's safe."

Some don't believe, though, that mandatory screening is the best way to accomplish this. According to the American Society of Hematology, "screening for sickle cell trait should be voluntary and should take place in a setting that ensures privacy and is performed by a knowledgeable provider who is able to offer comprehensive counseling."

"Our concern is that this is a mandatory screen in order to play," said Dr. Janis Abkowitz, the society's president-elect and head of the hematology division at the University of Washington in Seattle. "If a player refuses the screen, they have to sign off on a liability waiver, and there's a lot of inconsistency in these waivers from college to college."

And, the fact that the policy is mandatory, she said, has led to some misunderstandings.

"The policy gives a false impression that sickle cell trait is what really counts in these sudden deaths because that's what's screened for," but other conditions can cause sudden death, Abkowitz said.

The top four causes of
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