Fatalities from head and cervical spine injuries occurring in tackle football: 40 years' experience.

Football head and cervical spine fatalities have been related to 84.6 per cent of all football fatalities from 1945 through 1984. The decade from 1965 through 1974 was responsible for the greatest number and percentage of head and cervical spine fatalities, and the decade from 1975 through 1984 was associated with the smallest number and percentage. The data reveal that the majority of head and cervical spine fatalities are related to high-school football players either tackling or being tackled in a game. The majority of head fatalities are subdural hematomas, and almost all of the cervical spine fatalities are fractures, dislocations, or fracture-dislocations. There has been a dramatic reduction in these types of fatalities during the last decade, 1975 through 1984, and the preventive measures that have received most of the credit have been the 1976 rule change that prohibits initial contact with the head and face when blocking and tackling, the NOCSAE helmet standard that went into effect in colleges in 1978 and high schools in 1980, better coaching in the techniques of blocking and tackling, and improved medical care. There has been a reduction of head and cervical spine fatalities, but the analysis of data for the next decade, 1985 through 1994, will reveal the effects of the preventive measures discussed and continued research efforts.