Concern is mounting about brain injuries caused by sports, especially football, from high school to professional ranks. Athletic trainers in Hawaii are sensitive to the problem, but the Legislature should join other states in requiring families to be aware of the risks before young athletes engage in athletic activities.

Concussions can occur in any number of sports, from martial arts to baseball. Even so, football accounted for 83 percent of the 320 concussions reported by Hawaii high school students participating in sports in the 2007-2008 school year. As many as 3.8 million concussions occur yearly in sports- and recreation-related activities in the United States, according to the Centers for Disease Control and Prevention.

Still, Hawaii families may learn about the risks only by happenstance. The Star-Advertiser’s Dave Reardon reports that a father who had received concussions playing high school football made his son read a Time magazine article and watch an HBO special on the subject. The son decided that walking away from the playing field would be "best for my future."

The parents of 13-year-old Seattle-area middle-schooler were not so aware in 2006. After his head hit the ground, Zackery Lystedt struggled to the sideline, went back to the lineup 15 minutes later and saved the game by forcing a fumble, but hit his head again. A brain hemorrhage left Zackery in and out of a coma for three months with permanent brain damage.

While he tried to recuperate, the family successfully led a movement that resulted last year in Washington state’s legislature enacting the Zackery Lystedt Law. It requires each school district to inform coaches, youth athletes and parents about the nature and risk of concussions. The athlete and parents must sign and return a head-injury information sheet prior to the youth’s participation.

In addition, it forbids a youth athlete who has been removed from play because of a head injury from returning to the field without being evaluated by a licensed health care provider. A certified athletic trainer qualifies as a health care provider.

At least eight other states have enacted similar laws, and Hawaii seems to be well-prepared for such a requirement. It is the only state that has athletic trainers at every state or district event, according to Chris Chun, executive director of the Hawaii High School Athletic Association.

The Hawaii Athletic Trainers Association is focusing on when it is safe for an athlete to return to play, following similar efforts at the national level for high school, college and professional sports.

A study last year by the National Athletic Trainers Association found that high school football players sustain more severe concussions than college players, perhaps because they are less muscular.

Concussions can have devastating, life-long consequences for young athletes of all ages. Hawaii should follow the lead of other states and take strong, proactive measures to minimize the risk.