Sickle Cell Testing, Unless Athletes Balk

The Division I Legislative Council of the National Collegiate Athletic Association approved a new rule Tuesday mandating that all athletes be tested for the sickle cell trait. The rule, however, allows athletes to opt out of testing if they sign a waiver “releasing an institution from liability."

The sickle cell trait is found in about 8 percent of African-Americans, and in less than 1 percent of white Americans. During intense exercise, the red blood cells of those with the trait can elongate and change shape, blocking blood flow in vessels and damaging muscles such as the heart. Eight college football players have died from acute rhabdomyolysis, as a result of carrying the sickle cell trait, in the past decade. Some of these players were unaware that they had the trait.

An initial measure requiring that all athletes be tested for the trait – without the option of self-exemption – failed to garner the requisite two-thirds majority vote of the Legislative Council at the NCAA convention in January. The measure was brought forth by Conference USA as the result of a legal settlement between Rice University and the family of Dale Lloyd II, a 19-year-old football player with the trait who died in 2006 during a workout – never knowing he had the sickle cell trait.

Some conferences expressed concern that athletes who test positive for the trait “might be denied opportunities” and discriminated against. Therefore, the Ivy League sponsored an amendment to the measure allowing for students to decline sickle cell testing. A compromise measure with this change was overwhelmingly approved in Tuesday’s meeting of the Division I Legislative Council.

Joe D’Antonio, chairman of the Division I Legislative Council and senior associate commissioner of the Big East, said he “felt very confident after taking the vote” that the new rule provided “the greatest flexibility both for member institutions and student-athletes.”

A breakdown of which conferences voted for and against the measure was not available by the NCAA late Tuesday; however, officials from some major conferences such as the Pac-10, noted that they were opposed to the original proposal because they would prefer that a doctor, and not the NCAA, determine whether such a test was needed.

Scott Anderson, head athletics trainer at the University of Oklahoma and chairman of the Inter-Association Task Force on Sickle Cell Trait and the Athlete, said he would prefer that athletes not have the ability to decline the test – calling the new rule “mandatory voluntary testing” – but noted that it was “a good first step.” Still, he argued that more needs to be done to ensure that the trait does not lead to the death of more athletes.

“Even had there been mandatory, across-the-board screening, that doesn’t become an end solution,” Anderson said. “It just provides you with a piece of information. If you don’t take that knowledge, identify the condition and educate that it creates a risk and institute precautions, then you’ve gained nothing. It’s incumbent upon every institution to create a safe environment for their student-athletes. Screening isn’t enough alone. There needs to be education.”

Anderson also takes issue with the argument of some conferences, which contributed to the measure-weakening amendment, that those who are identified as having the trait are likely to be the targets of discrimination.

“That’s flawed logic,” Anderson said. “I don’t think discrimination is a legitimate concern. Screening has been around for decades and there just hasn’t been that pattern. For instance, athletes with the sickle cell trait are found in comparable numbers in the NFL. Sport just comes down to, can you play or not. If you’ve got one arm and can throw strikes, somebody’s going to find a spot on their team for you.”

Eugene R. Egdorf, lawyer for the Lloyd family, whose settlement with Rice started the push to have the NCAA require testing, expressed similarly mixed feelings about Tuesday’s move by the Division I Legislative Council. Though admitting that athletes are “better off than they were yesterday” with the passage of this new testing rule, he remained upset by the amendment.

“I’m particularly concerned – and I know the Lloyds are – with the opt-out position,” Egdorf said. “If an athlete has been tested before and knows his or her status, that’s OK. But, if an athlete doesn’t know his or her status and is given the right information about the sickle cell trait, I don’t know why he or she would opt out of the test. For instance, everyone should be told that this won't keep them from playing. I agree with the concept that folks should have a free choice over what’s done with their bodies and so forth, but what are we going to do when some kid dies from this in six months and we find out he wasn’t tested?”

Sixty-four percent of Football Bowl Subdivision (formerly Division I-A) institutions already screen their athletes for the sickle cell trait. The NFL scouting combine does the same. Still, the report from the Anderson-led task force acknowledges that there is “no evidence-based proof yet that screening saves lives.”