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Sickle cell testing for athletes increases

MU athletes do not have to be tested, but they can opt for test.
Friday, July 13, 2007 | 12:00 a.m. CDT; updated 7:53 a.m. CDT, Tuesday, July 22, 2008

It’s been two years since MU football player Aaron O’Neal died during a voluntary practice at Faurot Field.

O’Neal’s death was initially attributed to lymphocytic meningitis by then-Boone County Medical Examiner Valerie Rao. A University Hospital neuropathologist who examined O’Neal’s brain later said sickle cell trait could have played a role.

WHAT IS SICKLE CELL TRAIT?

Sickle cell trait is the inheritance of one gene for normal hemoglobin and one gene for sickle hemoglobin. It is most common among people of African descent and affects 8 percent to 10 percent of African Americans. People with sickle cell trait who undergo intense physical exertion sometimes collapse — and, in some cases, have died suddenly — as a result of the rapid breakdown of muscle tissue, known as “sickle collapse.”


As a result, the sickle cell trait might factor into the wrongful death lawsuit brought by O’Neal’s parents against 14 current and former members of the athletic department.

In the two years since O’Neal’s death, the number of MU student athletes who have asked to be tested for sickle trait has increased tenfold — from five to almost 50.

But MU’s athletic department has not instituted mandatory testing for the trait, nor does the NCAA require it.

“Testing is still not mandatory, and I don’t think that it is ever going to be mandatory,” said Rex Sharp, MU’s director of sports medicine. “I just don’t see that happening right now.”

Sickle cell trait is a condition that can cause red blood cells to logjam in veins and arteries and block the vital flow of oxygen to muscle tissue during strenuous exercise.

“Athletes have the option of testing themselves for sickle cell trait on a year-round basis,” Sharp said.

Sharp, who is named in the O’Neals’ lawsuit, said the athletics department pays for any athlete who wishes to undergo the $25 test. He said at least three current MU athletes are known to carry sickle cell trait.

Susan Even, director of the Student Health Center, said last year was the first time players were given a voluntary testing form for sickle cell trait during their routine pre-participation physical examination.

The form contains two paragraphs: one that briefly describes the difference between sickle cell trait and sickle cell anemia, and another which states that if an athlete tests positive, he or she will meet with an MU team physician to discuss any further implications. At the bottom of the form, athletes are asked to circle if they “agree” or “disagree” with being tested.

In February, representatives from the NCAA, physicians and medical experts reviewed evidence of sickle cell trait deaths as part of a special task force for the National Athletic Trainers Association.

In its report, released last month, the task force recommended that schools screen all athletes for sickle cell trait as part of their pre-participation physical examinations.

The NCAA, however, does not endorse the group’s report.

“The NCAA’s current policy will continue to be one that supports institutional autonomy when deciding the medical care and clearance of its student-athletes,” said Gail Dent, a spokesperson for the NCAA, through e-mail..

“It’s important that an athlete knows if they have sickle cell trait because of the risk associated with sustained intense exertion,” said Scott Anderson, head athletic trainer at the University of Oklahoma and co-chair of the sickle cell trait task force.

According to the report, “exertional sickling,” the blood-vessel blockage caused by sickle cell trait, has killed at least 15 college football players, including Aaron O’Neal, over the past seven years. Sickle collapse was listed as the No. 3 cause of sports deaths among high school and college athletes behind heatstroke and cardiovascular conditions.

A survey conducted by researchers from the University of Arizona last year found that 66 percent of Division I-A schools screen blood samples of all incoming athletes for sickle cell trait.

Currently, six Big Twelve schools require every incoming or transfer athlete to test for sickle cell trait as part of their pre-participation physical exam. The University of Colorado screens at-risk players based on their ancestry, and Baylor screens every athlete participating in football and men’s and women’s basketball.

If an athlete tests positive at Mizzou they are asked to sign a medical release for the team doctor to discuss their results with anybody he thinks is necessary to divulge it to, such as a coach, or a trainer.

“Most athletes usually know by the time they are in college if they are sickle cell trait or not,” said Eric McDonnell, one of the athletic trainers named in the lawsuit. But there is a possibility that some athletes may have the trait and not know it, he said.


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