Nearly six years ago, in a nationally televised boxing match aboard the former aircraft carrier U.S.S. Intrepid, 26-year-old Beethavean Scottland was knocked out by opponent George Jones's right-left combination to his chin after 10 rounds of fighting. One week later, he died as a result of the blow to his head.
Though fatal fights don't occur often in boxing, physicians and officials need better, more objective methods for judging when a fight could become deadly, neurosurgeon Vincent Miele of West Virginia University said. To arrive at such a method, Miele made a statistical comparison of the number of punches thrown in fatal and non-fatal professional fights.
He found that fatal fights had far more punches thrown than "average" matches, but not as many as "classic," more competitive non-fatal matches.
"This approach could provide sufficient data to stop matches that might result in fatalities," Miele said.
A dangerous sport
Boxing has some of the same injury risks as other sports, but because the main target areas of punches are the chest and head, boxers are at high risk for brain injuries.
"Any time you get hit in the head, there's brain damage," Miele told LiveScience.
In terms of acute injury, or damage sustained by one punch or in one match, boxing is actually one of the safer sports, Miele said. But it is one of most dangerous in terms of chronic injury, or injuries accumulated over the boxer's career, he added.
"You're not supposed to get punched in the head every day for five years," Miele said.
He knows of boxers who are only 30 years old, but are unable to speak because "they've taken too many punches," he said.
The two main causes of death from boxing injuries are the subdural hematoma, a rupturing of the veins between the brain and the skull, and cerebral edema, a buildup of water in the brain. A subdural hematoma that put Scottland in a coma ultimately led to his death.
Applying a model
In a boxing match, such as the one set between Shane Mosley and Luis Collazo in Las Vegas for Saturday, each fighter has a dedicated official observer and ringside physician who watches for signs that the fighter has reached his punishment limit, but these judgments are subjective and can be hard to spot in the heat of the match, Miele said.
Miele, who also works as a ringside physician, said that when he reviewed tapes of fatal matches, he saw several warning signs that physicians and officials should have caught.
In the Scottland-Jones match, Scottland took a flurry of punches in the seventh round, prompting a physician to warn the official to call the match off if Scottland sustained many more hits. But because Scottland won the next two rounds, the match continued until Scottland was knocked out in the 10th round.
To see if fatalities could be linked to the number of punches thrown in a match, Miele and his colleagues had expert observers review tapes for fatal and "average" boxing matches and count the number of punches thrown and landed with a computerized system called Punchstat.
They found that the number of punches thrown was significantly higher for fatal matches, with 26.6 punches landed per round (a professional match lasts no more than 12 rounds) for the survivor, 22.9 for the fighter who died and only 9.4 in an average match.
"There was a huge difference," Miele said.
But when they compared fatal matches to "classic," or well-known, highly competitive matches, the classic bouts had 10 more punches landed per round on average, indicating that the number of punches isn't the only factor involved in fatalities.
The study "objectifies some of the things we already knew," Miele said. The results of the study were published in the February issue of Neurosurgery.
Understanding how the force of blows thrown in a match relates to the chance of fatality is the next key step in developing a method to prevent boxing fatalaties, Miele said. To test this, he plans to put tiny accelerometers in boxers' mouthpieces to judge just how hard a boxer has been hit.
Eventually Miele wants accelerometers to be used in all boxing matches, allowing physicians to monitor them from ringside and stop a match when the force of a blow becomes too great. Amateur and Olympic boxing matches are more likely to use methods to cut matches short because they place more emphasis on safety than professional matches, which have fewer standard rules, Miele said.
Some boxing fans would not support cutting matches short, he added, believing that fighters tough enough to continue after repeated blows should be allowed to make the decision themselves.
"The diehards, the purists would not like it," Miele said.
Calls for a ban
Some groups, like the Journal of the American Medical Association, the American Neurological Association, and the Canadian and Australian Medical Associations have called for a complete ban on boxing.
"It would be healthier for everybody if it were banned," Miele said. "But I don't think it's going to happen."
Even if there were a ban, Miele argued, many fighters would still box illegally. Instead of trying to ban the sport, he said, physicians should devise ways to stop fights before they get out of hand and thereby reduce the injuries--and sometimes the deaths--that are visited upon boxers.