A new recommendation that college athletics departments test their athletes for the gene that can cause sickle-cell disease is raising some eyebrows in the medical community, the San Francisco Chronicle reports. Elliott Vichinsky, a sickle-cell expert at Children’s Hospital & Research Oakland, in California, says such screening for the condition, which is more prevalent among African-American and Hispanic people, would lead to inadvertent discrimination by athletics officials concerned about liability: “A coach is going to be able to say, ‘Even though this kid is great, do I really want to put him out there as the quarterback … and take the risk of something happening?’”
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2 Responses to Critics Question NCAA’s New Policy on Sickle-Cell Testing for Athletes
trax530 - September 16, 2009 at 12:09 pm
As far as I know there is no legitimate rationale for discriminating against carriers of the sickle cell gene. It is recessive. I strongly suspect that quite a few prominent Olympic athletes from African countries may be carriers. People who are carriers lead normal lives and won’t know that they are/might be carriers unless, for example, a sibling manifests sickle cell. Perhaps there are rare cases in which carriers do have related health issues (genes and environment do interact in complicated ways). Will someone with medical and/or genetic expertise please clarify this? Renee
casmith24 - September 16, 2009 at 6:18 pm
Renee, check out the Centers for Disease Control’s page on this–references the “extreme conditions” in which being a carrier matters:http://www.cdc.gov/Features/Sicklecell/A recent medical journal article by MDs at Yale sums it up (note the reference to exercise-related sudden death):Tsaras G, Owusu-Ansah A, Boateng FO, Amoateng-Adjepong Y. Complications associated with sickle cell trait: a brief narrative review. Am J Med. 2009 Jun;122(6):507-12. Epub 2009 Apr 24.Sickle cell trait occurs in approximately 300 million people worldwide, with the highest prevalence of approximately 30% to 40% in sub-Saharan Africa. Long considered a benign carrier state with relative protection against severe malaria, sickle cell trait occasionally can be associated with significantmorbidity and mortality. Sickle cell trait is exclusively associated with rare but often fatal renal medullary cancer. Current cumulative evidence is convincing for associations with hematuria, renal papillary necrosis, hyposthenuria, splenicinfarction, exertional rhabdomyolysis, and exercise-related sudden death. Sickle cell trait is probably associated with complicated hyphema, venous thromboembolic events, fetal loss, neonatal deaths, and preeclampsia, and possibly associated with acute chest syndrome, asymptomatic bacteriuria, and anemia in pregnancy.There is insufficient evidence to suggest an independent association with retinopathy, cholelithiasis, priapism, leg ulcers, liver necrosis, avascular necrosis of the femoral head, and stroke. Despite these associations, the averagelife span of individuals with sickle cell trait is similar to that of the general population. Nonetheless, given the large number of people with sickle cell trait, it is important that physicians be aware of these associations.PMID: 19393983 [PubMed - indexed for MEDLINE]