When 16-year-old Tom Cutinella died after collapsing on the field following a collision during a football game at his Long Island high school, questions arose about concussions in sports and the safety of the children playing them.
While what happened to the Shoreham-Wading River High School student is extremely rare, research shows concussions in school sports are not uncommon.
A survey of high school sports-related injuries compiled by researchers at the Colorado School of Public Health shows that football-related concussions are on the rise. In 2005, there were 55,007 reported concussions from football games and practice. By 2012, that number had more than tripled to 167,604.
"We tell our guys, we get anyone with a head injury, they are immediately out of it," said Mike Carter, who oversees Bloomfield High school's football program in New Jersey.
Carter says his students wear some of the newest helmets available on the market. But the I-Team discovered that not all students at area schools have access to such equipment.
Over a period of two months, the I-Team asked about 200 schools in the tri-state area what kind of helmets they use and found many use helmets that received low marks in a Virginia Tech study that evaluates the likeliness of football helmets to reduce concussion risk.
To determine how well certain helmets absorb impact, Virginia Tech researchers placed them on a device and slammed them onto a steel block. Helmets were given one to five stars based on how well they absorbed impact -- or how likely they would be to prevent concussions.
"The better the helmet, the better it cushions the impact and the more it lowers acceleration," said Virginia Tech professor Stefan Duma, who helped author the study.
The VSR-4 helmet, for example, received only one star in the Virginia Tech study and was labeled as "marginal" in terms of its ability to reduce concussion risk. Riddell discontinued the helmet in May 2011.
"The game has since evolved significantly making room for major advancements in helmet technology," Riddell said in a statement. "Riddell has programs in place to encourage those playing football to transition to new helmets that incorporate more advanced technology."
Though Riddell's VSR-4 was discontinued more than three years ago, Clifton High School in Clifton, New Jersey, lists mostly that helmet in its inventory, the I-Team found.
Clifton High School's athletic director, Tom Mullahey, thanked the I-team for bringing the outdated helmet's safety ranking to his attention and said the school purchased 26 new helmets for the team.
In a statement, Mullahey said, "This is the first we've heard of this study," and that he ordered new helmets so that "every football player in our program is wearing a Revolution ( four stars) or Revolution Speed (five stars)."
Brentwood High School on Long Island, Ridgewood High School in Ridgewood, New Jersey, and Yonkers Public Schools in Westchester County also use one and two star helmets, the I-Team found. Among the Yonkers Public Schools, Yonkers Montessori Academy had the most low-star helmets.
Some of those schools stood by their helmet choices.
At Brentwood High School, athletic director Kevin O'Reilly, who is also president of the Suffolk County Athletic Directors, said, "We believe our helmets meet the safety standards set by the National National Operating Committee on Standards for Athletic Equipment (NOCSAE). Any helmet that cannot be completely reconditioned and recertified is taken out of service."
O'Reilly also pointed out that the Virginia Tech study analyzed impact and injury risk at the collegiate level, not the high school level. Still, O'Reilly said, "We are currently reviewing the study and its findings including what application, if any, the study has on the Brentwood football program."
Ridgewood Public Schools told the I-team it sends football helmets out for "reconditioning and recertification" and that only certified helmets are used. A spokesman for Yonkers Public Schools said the VSR-4 helmets the district uses also meet the qualifications for certification.
Though research shows some helmets are more likely than others to reduce concussion risk, the risk cannot be eliminated completely.
A disclaimer that accompanies Virginia Tech's study reads: "Any player in any sport can sustain a head injury with even the very best head protection. This analysis is based on data trends and probabilities, and therefore a specific person’s risk may vary. This variation is likely dominated by genetic differences, health history, and impact factors such as muscle activation."
Gad Klein, a neuropsychologist with the Long Island Concussion Center in Lake Success, New York, says it's dangerous for players to believe they are completely protected by a helmet, even one that received high safety marks.
"There’s really no clear evidence that one helmet is any better than any one helmet," Klein said. "However, helmets do absorb and redirect impact and therefore energy and force that comes from a collision and thereby minimizes the acceleration deceleration forces to the brain, theoretically therefore reducing the injury."
There are no state mandates in New York, New Jersey or Connecticut concerning helmet choice or maintenance but most schools follow recommendations put forth by the National Operating Committee on Standards for Athletic Equipment (NOCSAE). The group recommends reconditioning helmets every year and replacing them every 10 years or sooner based on the condition of the helmet.
Scott Gunter, an athletic trainer with SportsCare in Whippany, New Jersey, has worked with hundreds of high school football players. He says how a helmet fits on a player's head is more important than the quality of the helmet.
"If you have a helmet that does not fit properly, you are at risk for that helmet to pop off and to expose your face," Gunter said.
The I-Team created a map (above) listing all the schools that reported their helmet inventories. You can look up your school in the search field or click on the red pins. Not every tri-state school responded to the I-Team's request, but the I-Team will continue to accept information and update the map from time to time as new information flows in.