died of exertional sickling due to prolonged physical activity complicating sickle cell trait
A condition said to be among the top non-traumatic killers of high school and college athletes is blamed in the death of a Pine Tree High School football player who died less than 24 hours after a training session earlier this year.
According to a cause of death report obtained Wednesday, Pine Tree defensive back Joshua ‘Josh’ Warren of Longview died of exertional sickling due to prolonged physical activity complicating sickle cell trait.
Sickle cell trait is a hereditary condition that causes some red blood cells, which normally are round or oval, to change into a crescent shape, or to “sickle,” according to information from the Korey Stringer Institute, a nonprofit organization dedicated to the prevention of sudden death in sports.
During intense exertion, sickling causes a logjam of red blood cells in the blood vessels, leading to decreased blood flow and explosive muscle breakdown.
The National Athletic Trainers Association says the condition is the third leading cause of non-traumatic death among high school and college athletes.
Neither Pine Tree High School football coach David Collins nor Josh’s father, Larry Warren, could be reached for comment Wednesday evening. It was unknown whether anyone was aware Warren had a sickle cell trait.
The 16-year-old athlete died July 1 at Good Shepherd Medical Center, less than 24 hours after participating in a strength and conditioning workout at Pine Tree High School.
Emergency medical personnel were called to the home to check his condition June 30, when he had become ill after a morning workout.
Later in the evening, his condition worsened and he was taken to Good Shepherd. He was checked in for overnight observation and died the next morning.
The National Athletic Trainers Association, the professional membership organization for certified athletic trainers, has said all pre-participation physical examinations should confirm sickle cell trait status.
“As all 50 states screen at birth, this marker is a base element of personal health information that should be made readily available to the athlete, the athlete’s parents, and the athlete’s health care provider, including those providers responsible for determination of medical eligibility for participation in sports,” the association said in a policy statement.
But that may not be enough to catch the condition. While screenings are done at birth, athletes may not know their sickle-trait status, the association said, rendering self-reporting in a questionnaire unreliable. It said many institutions have employed screening strategies to rectify this. Sixty-four percent of NCAA Division I-A schools screen for it, a survey found, and the NFL Scouting Combine does.
It was unclear late Wednesday whether Pine Tree screens for the condition among its athletes.
In 2012, the trainers association reported exertional sickling had killed nine athletes ages 12 through 19 in the preceding seven years.
The cause of death report in Warren’s case was prepared by Dr. Chester Gwin of the Southwestern Institute of Forensic Sciences of Dallas.