Letter Testimony from TMA
Senate Committee on Education
House Bill 767
May 19, 2015
We are providing comment on House Bill 767 by Rep. Wayne Smith and Senate sponsor Sen. Juan 'Chuy' Hinojosa. This legislation attempts to address a serious concern about sudden cardiac arrest (SCA) among student athletes. In the United States, an estimated 2,000 patients younger than age 25 die each year of SCA1. Often, patients have displayed no symptoms of heart disease or may have overlooked symptoms before their death. SCA can be caused by disorders affecting the structure or electrical circuitry of the heart. For young adults who have underlying cardiovascular conditions, physical activity can increase the likelihood of SCA.
While electrocardiograms (ECGs) could enhance screening for cardiac disorders, there is a lack of scientific evidence demonstrating whether or how this should be implemented on a broad scale in the United States. The medical evidence does not support mass screening with ECGs, as required by HB 767. Currently, organizations including the American Heart Association and the American Academy of Pediatrics recommend a thorough physical exam including a medical history of the student performed by a licensed medical doctor, as the most efficient method in identifying potential health issues.
Because SCA is only one of several health concerns facing student athletes, we want to ensure students receive a full physical exam based on the most appropriate, evidence-based strategies before implementing new requirements. We want to ensure all athletes are examined appropriately before competing to decrease injuries resulting from concussion or heat illness. We respectfully request your leadership in this area by instead funding Texas research to examine health and safety factors affecting Texas student athletes. This includes identifying ways to better track injuries and deaths. Through this effort, we have a great opportunity to lead efforts in studying the best way to address SCA and make improvements for our student athletes on a multitude of health outcomes.
We would also point out that currently, SB 213 by Senator Birdwell relating to the Sunset of the University Interscholastic League (UIL) includes language that addresses referrals for follow-up care regarding cardiac care.
SB 213 (engrossed version), pages 1-2, lines 20-24 and lines 1-9, includes the following requirements:
"…each student participating in an extracurricular athletic activity must submit a completed University Interscholastic League form entitled "Preparticipation Physical Evaluation--Physical Examination."
(d) An affirmative answer on the "Preparticipation Physical Evaluation--Medical History" form indicating a CARDIAC (emphasis added) or neurological history requires a person signing the "Preparticipation Physical Evaluation-Physical Examination" form, in accordance with rules adopted by the University Interscholastic League, to refer the student to the student's treating physician. The student's treating physician must provide a written statement indicating that, in the physician's professional judgment, it is safe for the student to participate in practice and play in an extracurricular athletic activity."
We thank you for your passion for ensuring the health and safety of our young athletes, and we are ready to work with you on science-based solutions.
1Policy statement: Pediatric sudden cardiac arrest. Pediatrics. 2012. 129: e1094-e1102.