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NCAA examines sickle cell trait guidelines

A committee discusses revisions for dealing with athletes in the wake of FSU LB Devaughn Darling's death.

By BRIAN LANDMAN

© St. Petersburg Times,
published July 7, 2001


The NCAA is looking at revising its guidelines for athletes who have sickle cell trait, partly in response to the death of Florida State linebacker Devaughn Darling.

"It just came up at our last meeting a couple of weeks ago," said Gary Green, an internist at UCLA and a member of the NCAA's Committee on Competitive Safeguards and Medical Aspects of Sports. "We not only considered that case (Darling), but there's about 10 cases over the last 10, 12 years that may be related to the sickle cell trait. We're actively studying it to explore the options."

An increasing amount of anecdotal evidence strongly suggests that sickle cell trait, the inherited presence of one abnormal hemoglobin gene, increases the risk of exercise-associated death.

Darling collapsed and died after a grueling off-season workout Feb. 26. The medical examiner found no "definite morphological cause" but did note that Darling had the rare sickle cell trait. His twin brother, Devard, an FSU receiver, also carries the trait.

NCAA guidelines written in January 1975 and revised in June 1998 say there is "a controversy in the medical literature" about the potential risks of sickle cell trait.

Dr. Randy Eichner, a professor of medicine at Oklahoma who has studied exercise-induced deaths of people with sickle cell trait for more than a decade, told the Times in May that the guideline's warning, though accurate as far as it went, "could be stronger."

He subsequently contacted the NCAA's committee, prompting it to place the topic on the agenda and discuss it during its regularly scheduled meeting. Committee member Melinda Millard-Stafford, a professor of exercise physiology at Georgia Tech, said her group has "commissioned Dr. Eichner to look at the handbook and see what revisions he feels are needed."

Eichner declined to comment last week, but he previously told the Times in an e-mail that screening for sickle cell trait, something the NCAA does not recommend, is a "prudent" measure.

FSU does screen. The Darlings did not know they had the trait until arriving at FSU last summer. The NCAA suggests that if a school does screen, a positive result should prompt "genetics counseling" and an "explanation of a possibly remote and unclear risk" of physical exertion.

"The bottom line is not even so much screening but what do you do with the information," Millard-Stafford said, stressing that someone with the sickle cell trait, particularly in the heat and humidity of summer, may have to be "dealt with differently" by coaches and trainers.

The NCAA guidelines do emphasize that all athletes should avoid dehydration; gradually acclimate themselves to heat and humidity; condition carefully and gradually for several weeks before beginning exhaustive workout programs; acclimate to altitude, and refrain from extreme workouts when sick, especially feverish.

"There's really no reason somebody with the sickle cell trait shouldn't be able to compete," Green said. "But we're looking at it to see whether or not, based on new information, we should be revising the recommendations because there are certain precautions for somebody with it that maybe we should be taking."

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