Educate students and staff about the dangers of substance abuse, misconduct during physical activity, excessive weight control (rapid weight gain or loss), and the importance of using safety gear as well as other aspects of safe participation in physical activities. Safety education must be a major component of the physical education program.

Substance abuse and misconduct adversely affect safety during physical activity. Alcohol, other psychoactive drugs, and excessive weight control are examples of student practices that can have long term adverse consequences on the body.

Use of alcohol and other drugs increases chances of injury through impaired judgment and delayed reaction time. Many performance enhancing products, such as creatine and substances related to anabolic steroids, are readily available and often legally purchased. Most of these substances have never been tested for safety for use in the long-term or for use by children and adolescents. Many of these substances may pose numerous or significant health hazards.

Bullying, harassment, unsportsmanlike behavior, and violent behavior are hazardous to student and staff safety and discourage many students from wanting to participate in physical activities. Educate students about behavior in play areas. Inform them of rules and the consequences for breaking them. Coaches, physical education teachers, and those supervising other physical activities must be trained to recognize and educate students on signs and symptoms of injuries, including muscle, bone, head and abdominal injuries, and actions to be taken when they occur. Teach students the rationale for removing a student from a physical activity after an injury and for seeking medical assessment and assistance.

Young athletes must be discouraged from trying to gain weight for sports such as football and body building, and from trying to lose weight for sports such as wrestling or dance/ballet. Excessive weight control may impair athletic performance and safety in the short term (e.g., dehydration). Water-loading to increase short term weight before measurement also poses danger to health. Surveys of youth find that youth practice weight control through self-induced vomiting, binge eating, use of diuretics, diet pills, and laxatives. These practices and disordered eating may lead to suboptimal calcium deposition into bones, menstrual disorders, anorexia nervosa and bulimia. The consequences of the latter two can be fatal.

Dietary supplements, such as protein powders and amino acids, are commonly perceived by athletes as healthier than ordinary foods. To correct erroneous associations between nutritional supplements and athletic accomplishment, teachers and coaches should emphasize that a nutritious diet of healthy foods also promotes muscle growth and optimal performance. Encourage students to keep records of their own practice, training, and improvement in performance so that accomplishments in athletic endeavors are easily seen to be more closely associated with effort and practice.

Adirim TA, Cheng TL. Overview of injuries in the young athlete. Sports Med 2003;33(1):75-81.

Centers for Disease Control and Prevention. School health guidelines to prevent unintentional injuries and violence. MMWR Recomm Rep. 2001;50(RR-22):1-73.

Centers for Disease Control and Prevention. Guidelines for school health programs to promote lifelong healthy eating. MMWR Morb Mortal Wkly Rep. 1996;45(RR-9):1-41.

Congeni J, Miller S. Supplements and drugs used to enhance athletic performance. Pediatr Clin North Am 2002; 49(2):435-61.

Griesemer BA: Performance Enhancing Substances. In: Sullivan JA, Anderson SJ, eds. Care of the Young Athlete. Rosemont, IL: American Academy of Orthopaedic Surgeons/American Academy of Pediatrics; 2000:95-104.

Ross JG, Eihaus KE, Hohenemser LK, Green B. School health policy prohibiting tobacco use, alcohol and other drug use, and violence. J Sch Health. 1995;65:333-338.

Stainback RD: Alcohol and sport. Champaign, Il: Human Kinetics, 1997. xi, 219 p.

Steen SN, Bernhardt DT: Nutrition and Weight Control. In: Sullivan JA, Anderson SJ, eds. Care of the Young Athlete. Rosemont, IL: American Academy of Orthopaedic Surgeons/American Academy of Pediatrics; 2000:81-94.