A study focused on non-traumatic deaths of high school and collegiate football players from 1998-2008 found the majority of deaths did not occur during the regular season.
Instead, the bulk happened during offeason conditioning drills.
Most non-traumatic deaths occurred outside the September to December period in which the bulk of the football regular season takes place, according to the American Orthopaedic Society for Sports Medicine.
August was the most common month for the deaths, the study showed.
During that time, many teams are wrapping up the offseason and preparing for the first game of the year in the heat of the summer. Some teams do begin the regular season in late August.
The intensity of the conditioning sessions were “associated with overexertion or punishment drills,” the AOSSM news release stated.
The study found 187 non-traumatic fatalities during that two-decade stretch.
Fifty-two percent of the deaths were due to cardiac issues, 24% were heat-related and five percent were caused by asthma, according to the study.
The study found three commonalities between all the deaths:
The conditioning sessions were supervised by a coach; workouts were “irrationally intense,” as the release described; and the medical response was not adequate.
While the number of traumatic injuries has decreased since the 1960s, the yearly rate of non-traumatic deaths has remained constant — and is currently two to three times higher than the rate of traumatic deaths, according to the study.
With that said, the number of non-traumatic football deaths in the NCAA has decreased since 2010, when the organization implemented policies regarding sickle cell trait screening.
Sickle cell trait can cause illness and sometimes death due to extreme exertion, according to Hematology. The blood disorder is also more prevalent in some specific ethnicities. For instance, eight to 10 percent of African Americans have the disorder, according to the site.
Since the NCAA guidelines were put into place, the number of sickle cell trait deaths has decreased by 58%, according to the AOSSM study.
Without the sickle cell policies in high school, fatalities have increased 400% since 2010.
“Similar guidelines should be mandated at the high school level,” the AOSSM news release stated.