NCAA Sickle Cell Trait Fact Sheet
NCAA Sickle Cell Educational Column

How do I meet new NCAA requirements for sickle cell trait status confirmation?
Effective August 1 of 2022 per the recommendation of the NCAA, student-athletes in their initial season of eligibility and currently enrolled students no longer have the option to sign a waiver declining confirmation of sickle cell trait status. This proposal is not retroactive. Specifically, an individual who previously signed a waiver declining confirmation of sickle cell trait status before August 1, 2022, is not required to provide documented sickle cell solubility test results prior to participation.

Sickle Cell Trait status requirements can be met in the following ways:

Newborn Screening Test Results: Contact your hospital of birth/pediatrician’s office and request a copy of your sickle cell trait status from your birth. Most states required newborn SCT testing beginning in 1990.

Please refer to the link below for state-specific contact information:
https://www.cdc.gov/genomics/resources/h.htm

Get tested: Provide a copy of a recent Sickle Cell Solubility Test indicating your Sickle Cell Trait status. This requires a written request from a physician, a blood draw from a physician’s office or lab, and a lab test with results indicated.
What is sickle cell trait?

Sickle Cell Trait is not a disease. It is the inheritance of one gene for normal hemoglobin and one gene for sickle hemoglobin. Red blood cells with normal hemoglobin are smooth, disk-shaped, and flexible. They can move through the blood vessels easily. Cells with sickle cell hemoglobin are stiff and sticky. When they lose their oxygen, under conditions of intense or extensive exertion, they form into the shape of a sickle or crescent moon. These cells stick together and begin to accumulation, eventually blocking the movement of healthy, normal oxygen-carrying blood. This can lead to physical distress, tissue damage and eventual collapse/death.

Who gets sickle cell trait and how common is it?

Anyone can have sickle cell trait, but it is a condition of inheritance. The sickle cell gene is more common in those of African, Mediterranean, Middle Eastern, Indian, Saudi Arabian, Caribbean, and South and Central American ancestry. Approximately 8% of the African Americans population, and 1 in 2,000-10,000 of the U.S. Caucasian population have sickle cell trait. In the state of California, from 1990 through 2003, 1 of every 122 newborns tested (all combined ethnicities) had sickle cell trait. Most athletes with sickle cell trait do NOT know they have it.

Will a positive SCT test impact my sports participation?

Athletes with sickle cell trait will not be excluded from participation as precautions will be put in place. Education helps increase awareness of potential complications and what can be done to avoid them.

What can I do to prevent problems associated with sickle cell trait?

Know your status, set your own pace, and hydrate!!

Avoid using high caffeine energy drinks or stimulants that contribute to dehydration.
Avoid pushing with all-out exertion longer than two to three minutes without a rest interval.
Avoid extreme exercise during acute illness, if feeling ill, or while experiencing a fever.
Modify training when adjusting to a change in altitude (as little as 2,000 feet).
If you have asthma, be sure to always have your medications with you, and practice proper asthma management.
The key to avoiding problems related to sickle cell trait is IMMEDIATELY stopping activity and alerting appropriate medical personnel when experiencing unusual physical distress (muscle weakness, cramping, shortness of breath, pain, and fatigue).

Athletes that run into problems often fully recover, especially if identified and treated as early as possible. Basic treatment includes rest, oxygen, and hydration.

What are sickle cell trait symptoms and how quickly can I develop symptoms?

Typical symptoms of sickle cell trait include, but are not limited to, muscle weakness, cramping, shortness of breath, pain, and fatigue. Additional signs and symptoms of sickle cell trait can be visible blood in the urine, chest of abdominal pain, nausea, and vomiting. A characteristic of collapse related to sickle cell is that the athlete can still talk, as opposed to athletes that collapse from heat stroke or cardiac causes.

Sickling of blood cells and onset of symptoms can occur very quickly in the first 2-3 minutes of any all-out exertion. Heat, dehydration, altitude, illness, and asthma can increase the risk for and worsen sickling, even when exercise is not all-out. It is important to note that complications from sickling are related to the intensity of the exercise and it is not purely related to overheating in hot climates.

Does having a positive SCT test have any long-term consequences?

Sickle cell trait is generally benign and consistent with a long, healthy life. Most athletes complete their careers without complications. In fact, most people with sickle cell trait cannot tell that they have it. The most important implication that may arise in the future is that you can have a baby with sickle cell trait or even sickle cell disease (a serious condition). If a test is positive, the student-athlete will be offered counseling on the implications of sickle cell trait.