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Prep Voices : A periodic forum examining controversial issues in Orange County prep sports : TODAY: THE BLOOD RULE : In Case You're Wondering

September 29, 1993

About the transmission of HIV/Hepatitis B?

Giving the answers:

--Chris McGrew, assistant team physician for the University of New Mexico and member of the NCAA's committee on competitive safeguards and medical aspects of sports and chairman of the NCAA's drug testing and education subcommittee.

How many teen-agers in the U.S. carry HIV?

Specific numbers are difficult to come by. There are 1.15 million carriers in the country, but there are no specific numbers for adolescents, though they are the fastest growing group.

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How is HIV transmitted?

HIV is transmitted through predictable behaviors: unprotected intercourse, the sharing of IV needles, and also from mother to fetus in some cases. In the past it has been transmitted through contact with blood products, such as blood transfusions, but screenings have virtually eliminated that problem.

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Could someone transmit HIV through their sweat or saliva?

No.

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How do we know that HIV cannot be transmitted in other ways?

At least 10 years of experimental research has narrowed it down to those four possibilities of transmission. HIV is transmitted through intimate contact with intimate bodily fluids.

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Is it possible, at least theoretically, to get HIV through athletics?

There is probably some possibility, but only theoretically. From a practical sense, the risk is as close to zero as you can calculate.

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If that's so, then why the concern?

HIV transmission is the volatile topic that illuminated this issue in the sporting arena, but the real concern is Hepatitis B. It's different because it's a sturdier virus and more concentrated in the blood.

If we look at household contact studies--people who live with others with Hepatitis B in close but not intimate contact--there have been transmissions. There has been no transmission of HIV.

In the health care field, if you suffer a deep needle stick with an HIV-infected needle, you have a .3% chance of infection. If you are stuck with a Hepatitis B-infected needle, your chances of infection are close to one in three or one in five. Hepatitis B is far more easily transmitted.

Finally, if you look at sports literature, there are no well-documented cases of HIV transmission. The case involving the Italian soccer players has been disproved and discounted by the medical and scientific community. For Hepatitis B, there is a well-documented case of transmission among a group of sumo wrestlers in Japan in 1982.

Hepatitis B is extremely hard to catch by this means of transmission, and HIV is practically impossible . . . but nobody ever says never.

About specifics of the Blood Rule?

\o7 Those giving the answers:

--Larry Rice, state representative to the National Federation Football Rules Committee and the football rules interpreter for the California Interscholastic Federation.

--Barbara Hively, volleyball rules interpreter for CIF and a collegiate and high school official.

--Bob Davis, wrestling rules interpreter for CIF and principal of Hanford High West Campus.

--Dr. Robert Loveland, medical consultant for the CIF.\f7

Where did the idea for the Blood Rules come from?

It began in the fall of 1992 in response to the NCAA's plan for dealing with the subject during the 1992-93 basketball season.

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What kinds of problems have there been with these guidelines in the past?

Wisconsin has had these rules in place for all sports for the past two years and has reported no significant problems with the administration of the rule.

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A softball player must change uniforms because of the rule. There is no place to change in private. How does the player accomplish this?

Athletes don't always have to change uniforms. Schools should have with them a bleach-based disinfecting solution recommended by the Center for Disease Control. The jersey merely needs to be washed off.

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What if it's not your blood on the uniform?

It doesn't matter.

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What if there is no replacement jersey for an athlete to wear?

In football, an athlete can wear the jersey of a non-playing substitute and it won't be construed as an attempt to deceive the opponent; there would be no penalty. In volleyball, an athlete can wear a junior varsity uniform and the only penalty would be a sideout or a point. In wrestling, an athlete can change into a teammate's uniform--probably the next higher or lower weight--without regard to time limit.

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Most officials are lay people when it comes to making medical determinations. Why put such a rule in their hands?

A determination of whether there is a significant amount of blood and whether it is transferable can be made by any reasonable observer.

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In a volleyball match, if a team is out of eligible substitutes and a player must be replaced, what is the penalty?

The team could go with five players or could make an abnormal substitution until the bleeding player is able to return, provided it wouldn't be the bleeding player's fourth appearance in the game.

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A pitcher must cover his/her arm because of injury, but rules prohibit anything white on the pitching arm. What's the answer?

Flesh-colored bandages, tape and wrappings.

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A wrestler bleeds excessively on the uniform of his opponent. The bleeding wrestler is administered to, but the opponent has no spare uniform. What now?

Wise wrestling coaches will carry extra uniforms. There are no maximum timeouts or no maximum amount of time available to clear the situation. It is at the referee's discretion. Officials are on notice to catch the bleeding early.

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A defensive tackle bleeds all over a quarterback with only a few seconds left in the game. Does the coach have to remove his quarterback?

Yes. From Larry Rice: "That pales in comparison to the issue of the safety of the players involved. Though there may be some unfairness, (officials) are still going to have the player removed. The primary concern is with the health and safety of the players. Fairness is not in issue in the application of this rule."

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