Evaluation of safety balls and faceguards for prevention of injuries in youth baseball

JAMA. 2003 Feb 5;289(5):568-74. doi: 10.1001/jama.289.5.568.


Context: Safety balls and faceguards are widely used in youth baseball, but their effectiveness in reducing injury is unknown.

Objective: To evaluate the association of the use of faceguards and safety balls and injuries in youth baseball.

Design, setting, and participants: Ecological study using a national database of compensated insurance claims maintained by Little League Baseball Incorporated, combined with data on the number of participants in Little League and data from a census of protective equipment usage for youth aged 5 to 18 years participating in Little League Baseball in the United States during 1997-1999.

Main outcome measures: Rate of injury and injury rate ratio comparing users with nonusers of protective equipment.

Results: A total of 6 744 240 player-seasons of follow-up and 4233 compensated injury claims were available for analysis. The absolute incidence of compensated injury per 100 000 player-seasons was 28.02 (95% confidence interval [CI], 26.76-29.29) for ball-related injury and 2.71 (95% CI, 2.32-3.11) for facial injury. Overall, use of safety balls was associated with a reduced risk of ball-related injury (adjusted rate ratio, 0.77; 95% CI, 0.64-0.93). This reduction was essentially due to 1 type of safety ball, known as the reduced-impact ball (adjusted rate ratio, 0.72; 95% CI, 0.57-0.91). Use of faceguards reduced the risk of facial injury (adjusted rate ratio, 0.65; 95% CI, 0.43-0.98). Metal and plastic guards appeared to be equally effective. Safety balls appeared to be more effective in the minor division (ages 7-12 years) than in the regular division (ages 9-12 years).

Conclusions: Reduced-impact balls and faceguards were associated with a reduced risk of injury in youth baseball. These findings support increased usage of these items; however, it should be noted that the absolute incidence of injury in youth baseball is low and that these equipment items do not prevent all injuries.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Athletic Injuries / epidemiology
  • Athletic Injuries / prevention & control*
  • Baseball / injuries*
  • Child
  • Data Collection
  • Facial Injuries
  • Head Protective Devices
  • Humans
  • Poisson Distribution
  • Protective Devices*
  • Sports Equipment*