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The American Society of Hematology (ASH) is challenging the major college sports organization over its policy on sickle cell trait testing for athletes.

In a new position statement, ASH declared that athletes need not be tested for or disclose sickle cell trait status before participating in sporting events -- directly contradicting current National Collegiate Athletic Association (NCAA) rules that require sickle cell testing and disclosure.

Instead, the society recommended preventive interventions, similar to those used by the U.S. Army since 1996, that would protect all student-athletes.

These interventions include:

• Environment-based work-rest cycles
• Heat acclimation monitoring
• Guidelines for hydration
• Rapid detection of and treatment for heat illness

The NCAA adopted a policy of mandatory screening for sickle cell carrier status for Division I athletes in 2010. The association and Rice University had been sued after a 19-year-old died of acute exertional rhabdomyolysis -- which has been linked to sickle cell trait -- after football practice.

Sickle cell trait is an inherited blood disorder that affects 8% of African Americans and differs from sickle cell disease. Patients affected with sickle cell trait only carry one gene that causes abnormal hemoglobin, as opposed to sickle cell disease patients' two genes. Trait carriers are unaffected by the condition under normal conditions, but can experience serious adverse events -- including sudden death -- when severely dehydrated or during intense physical activity.

ASH argued that current NCAA policy, as written, may harm student athletes and their communities, as well as stigmatizing students that have sickle cell trait.

They also noted that, since implementing the preventive interventions, the U.S. Army has significantly reduced the death rate during training, including in recruits with sickle cell trait.

"Until the NCAA requires universal interventions, student athletes remain at risk for suffering from significant heat stress/exertion-related injury or death," the ASH statement said.

"Participation in athletics can be made safer with these measures, thereby rendering screening for and disclosure of sickle cell trait status unnecessary."

A study published in the New England Journal of Medicine found testing would do more harm than good because it would require students to understand results while also necessitating multiple tests to prevent false-positives. In addition, the privacy of students that did test positive would be affected, and they could potentially be stigmatized as a result.

ASH concluded its statement by noting it would like to see more biomedical and population-based research on exertion-related illness in sickle cell trait patients, in hopes that such research would inform public policy.

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