Context: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of football injury data. Objective: To describe the epidemiology of injuries sustained in high school football in the 2005-2006 through 2013-2014 academic years and collegiate football in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance. Design: Descriptive epidemiology study. Setting: Online injury surveillance from football teams of high school boys (annual average = 100) and collegiate men (annual average = 43). Patients or Other Participants: Football players who participated in practices and competitions during the 2005-2006 through 2013-2014 academic years in high school or the 2004-2005 through 2013-2014 academic years in college. Main Outcome Measure(s): Athletic trainers collected time-loss injury (=24 hours) and exposure data. Injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis were calculated. Results: The High School Reporting Information Online system documented 18189 time-loss injuries during 4539636 AEs; the National Collegiate Athletic Association Injury Surveillance Program documented 22766 time-loss injuries during 3?121 ?476 AEs. The injury rate was higher among collegiate than high school (7.29 versus 4.01/1000 AEs; IRR = 1.82; 95% CI = 1.79, 1.86) athletes. Most injuries occurred during competitions in high school (53.2%) and practices in college (60.9%). The competition injury rate was higher than the practice injury rate among both high school (IRR = 5.62; 95% CI = 5.46, 5.78) and collegiate (IRR = 6.59; 95% CI = 6.41, 6.76) players. Most injuries at both levels affected the lower extremity and the shoulder/clavicle and were diagnosed as ligament sprains and muscle/tendon strains. However, concussion was a common injury during competitions among most positions. Conclusions: Injury rates were higher in college than in high school and higher for competitions than for practices. Concussion was a frequent injury sustained during competitions, which confirms the need to develop interventions to mitigate its incidence and severity.
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