by BY STU DURANDO sdurando@post-dispatch.com 314-340-8232 , St. Louis Post-Dispatch

The recommendation released Monday was the result of a lawsuit resolved between the NCAA and the family of Dale Lloyd II, a former Rice football player who died in 2006 following a practice. Lloyd carried the sickle cell trait, which was ruled to have contributed to his death.

Missouri announced this month a plan to test its athletes. In 2005, Mizzou football player Aaron O'Neal died of viral meningitis, according to the Boone County medical examiner. However, other experts said sickle cell trait played a role.

Approximately two-thirds of NCAA Division I schools already conduct the test. An estimated one in 12 African-Americans carry the trait, according to the American Sickle Cell Anemia Association.

"This is something that has to be not only on the athletic trainer's radar, but on the administration's and coach's radar,'' said Tony Breitbach, director of the athletic training education program at St. Louis University.

"We need to educate coaches on the symptoms and that they can kill. We have to allow athletes, without repercussion, to step out of an activity instead of feeling like they have to finish. When someone has been identified and becomes symptomatic, what looks like a lack of conditioning could be the beginning of a process that could cause their death.''

SLU does not routinely test, although an official said athletes are handled on a case-by-case basis. Illinois athletes have been tested for many years.

Missouri agreed in March to pay O'Neal's parents $2 million. The family's lawsuit included claims that medical personnel were not familiar with symptoms related to exercise and the sickle cell trait.

The Associated Press reported recently that court depositions revealed medical officials at the voluntary workout where O'Neal died had little knowledge of warnings that signal a problem.

Missouri announced its plan to conduct tests before the NCAA made its recommendation. Tests in Columbia will be done even if someone claims to know of the trait's existence, according to athletic department spokesman Chad Moller.

"It was decided collectively by our physicians and head trainer that as part of our annual physicals - they're going to make this part of it automatically,'' he said. "Previously, our kids were given an option of being tested. Now it is going to be part of our regular process.''

Breitbach said it is likely that all NCAA schools will follow the recommendation because any further deaths related to sickle cell trait "will show negligence on your school's part.''

The National Athletic Trainers Association released a consensus statement regarding sickle cell trait in 2007, noting its role as the third-leading, non-traumatic cause of sports deaths in high school and college athletes.

The organization recommended at the time that colleges test athletes. The statement said that of 13 college football deaths related to the condition, nearly all occurred at schools "that did not screen for sickle cell trait or had a lapse in precautions for it.''

NATA referred to the condition as the least understood of the four most common non-traumatic causes of death.

"It's treated differently than heat stroke,'' Breitbach said. "Sometimes when someone has a sickle cell episode, all they're thinking of is cooling the person. The best treatment is to keep the person hydrated and really watch their symptoms and get them out of activity.''

As part of its resolution with Lloyd's family, the NCAA agreed to donate $50,000 to the Sickle Cell Disease Association of America and produce an educational video that will be available on the NCAA website and to all schools.

The family of Ereck Plancher has a lawsuit pending against the University of Central Florida following his sickle cell-related death after a football practice in March 2008.

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