When does an advantage become unfair? Empirical and normative concerns in Semenya's case.

There is a fundamental tension in many sports: human sex is not binary, but there are only two categories in which people can compete: male and female. Over the past 10 years, the International Association of Athletics Federations (IAAF) regulations have been at the centre of two notable legal disputes. The Court of Arbitration for Sport (CAS) reached two contradictory rulings: in the first case (Dutee Chand vs Athletics Federation India and IAAF), the IAAF regulations for the eligibility of athletes to compete in the female category were suspended (24 July 2015) on grounds of "discrimination against the female category"; in the latter (Caster Semenya and Athletics South Africa vs IAAF), the regulations were reaffirmed (1 May 2019) on grounds that although discriminatory, they are necessary to maintain a "level playing field" and to "protect" the female category. Although Semenya's case has paved the way for questioning existing gender norms in sport, a new stable norm has yet to emerge from her case. The pharmacological solution put forward by IAAF to the tension between fairness and inclusivity of bodies non-conforming to two sexes is not, however, the only possible solution/resolution to the case, as I aim to show in this paper. Here I present some reflections on this topic and suggest how CAS should approach the case if it hopes to resolve it.

Dramatic impact of using protective equipment on the level of hurling-related head injuries: an ultimately successful 27-year programme.

BACKGROUND: Major head injuries are not uncommon in the Irish national game of hurling. Historically, helmets were not worn. METHODS: We report a multistage campaign to facilitate and encourage the use of appropriate headgear among the estimated 100 000 hurling players in Ireland. This campaign lasted for 27 years between 1985 and 2012, and involved a number of different stages including: (1) facilitating the establishment of a business dedicated to developing head protection equipment suitable for hurling, (2) placing a particular emphasis on continual product enhancement to the highest industrial standards, (3) engaging continually with the game's controlling body, the Gaelic Athletic Association (GAA), with the ultimate objective of securing a mandatory usage policy for protective helmets and faceguards, (4) longitudinal research to monitor hurling injury, equipment usage and players' attitudes and (5) widely communicating key research findings to GAA leaders and members, as well as to 1000 clubs and schools. RESULTS: One of our three relevant studies included 798 patients and identified a dramatic association between the type of head protection used by a player, if any, and the site of the injury requiring treatment. While 51% of the injured players without head protection suffered head trauma, this rate was only 35% among the players wearing helmets and 5% among players who were wearing full head protection (both a helmet and faceguard). CONCLUSION: The GAA responded in three stages to the accumulating evidence: (1) they introduced a mandatory regulation for those aged less than 18 years in 2005; (2) this ruling was extended to all players under 21 years in 2007 and (3) finally extended to all players irrespective of age, gender or grade from January 2010. The latter ruling applied to both games and organised training sessions.

Injuries to junior club cricketers: the effect of helmet regulations.

OBJECTIVE: Despite the popularity of cricket at the junior community level, few studies have described injuries for this level of play. This study describes the epidemiology of cricket injuries in junior club cricket across three playing seasons to identify priorities for prevention. DESIGN: Prospective on-field injury data collection during match observation of acute injuries. Pre and post observational evaluation of mandatory helmet wearing. SETTING: The Sutherland Shire Junior Cricket Association, New South Wales, Australia during the 2002-03, 2003-04 and 2004-05 playing seasons. PARTICIPANTS: All junior teams (Under 8 (U8)-U16). INTERVENTION: Compulsory headgear introduced for all batters before the 2004-05 season. MAIN OUTCOME MEASURES: Frequency of injury according to age level, grade of play and playing position, and injury rates per 100 registered players. RESULTS: 155 injuries were reported. No U8 player sustained an injury, and injury frequency increased with age. Traditional cricket was associated with more injuries than modified cricket. At each age level, the most skilled players had the lowest frequency of injury. Overall, batting accounted for 49% of all injuries and 29% occurred when fielding; contact with a moving ball was responsible for 55% of injuries. The most commonly injured body region was the face (20%), followed by the hand (14%). In batters, the frequency of head/neck/facial injuries fell from 62% in 2002/03 to 35% in 2003-04 to just 4% in 2004-05 after headgear use was compulsory. CONCLUSIONS: Injury rates in junior players are low, but increase with age and level of play. Use of protective headgear, particularly by batters, leads to a significant reduction in injuries.

Caffeine consumption amongst British athletes following changes to the 2004 WADA prohibited list.

This study was undertaken to examine self-reported caffeine consumption and reasons for its use, amongst UK athletes, following its removal from the 2004 World Anti-Doping Agency (WADA) Prohibited List. A convenience sample of track and field athletes (n = 193) and cyclists (n = 287) completed a postal or Web-based questionnaire. Messages were posted on athletics and cycling club Web sites and mailing lists to direct athletes to the Web-based questionnaire. Postal questionnaires were distributed at domestic sporting events. A higher proportion of cyclists (59.9 %) compared with track and field athletes (32.6 %) consumed caffeine to enhance performance (p < 0.001). A higher proportion of elite as opposed to sub-elite athletes representing cycling (p = 0.031) and athletics (p = 0.010) used caffeine to enhance performance. Of all caffeine containing products used, coffee, energy drinks, pharmaceutical preparations and caffeinated sports supplements were most prevalent. Results revealed that amongst UK athletes, the intention to use caffeine as an ergogenic aid was high, and that use was more widespread and accepted in competitive sport, especially at elite level, when compared to recreational sport.