FIFA and Saarland University team up
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The FIFA Medical Assessment and Research Centre (F-MARC) and Saarland University are working together on the establishment of an international registry of cases of sudden death among footballers. Professor Tim Meyer and his team from the Institute of Sports and Preventive Medicine, together with F-MARC, want to systematically find out the most common causes of such tragic incidents in football.

This will lead to the further development and improvement of preventive measures, such as early identification of undetected heart conditions. The new registry should also reveal regional variations in causes of sudden death. Cases in which players experience cardiac arrest and survive will also be recorded, as in such cases it is often easier to determine the underlying causes.

FIFA’s Chief Medical Officer Professor Jiri Dvorak explains: “The FIFA Medical Office is continually receiving new reports of tragic incidents, which led us to develop the FIFA Medical Emergency Bag. This collaboration with Professor Meyer and his team will provide the scientific data necessary to enable us to develop better preventive measures worldwide.” The portability of the FIFA Medical Emergency Bag means it can be used on the pitch, anywhere in the stadium and even outside the stadium whenever an emergency situation arises. The rucksack contains all the equipment necessary for the immediate treatment of patients in the first hour following a serious medical emergency.

“When professional footballers collapse in the middle of a match or during training, the media interest is huge and it is obviously very distressing. However, the tragic fate of such players should not obscure the fact that in Germany every year more than 100,000 people die of sudden cardiac death, but very few of those deaths occur while playing sport,” comments Tim Meyer, director of the Institute of Sports and Preventive Medicine at Saarland University and team doctor of the German national football team. For the last two years, Meyer’s institute has already operated a Germany-wide registry to record cases of sudden death in athletes under the umbrella of the German Cardiology Association and with funding from the German Heart Institute (www.scd-deutschland.de).

According to sports medical specialist Jürgen Scharhag, who will lead the project’s implementation, “the risk of sudden cardiac death is much greater for men than women, with around 90% of all cases affecting men. Particularly affected are men in the 40 to 50 age group, who no longer play sport professionally but who are especially at risk when playing amateur sport.” Men in this age group are more likely to have some calcification of the coronary arteries. “Football continues to be played primarily by men and even the so-called veterans’ teams have regular training sessions and competitions. A registry of cases of sudden death amongst this group would help us to learn more about the frequency and age distribution of such incidents among players,” says Scharhag. The findings of an investigation into veterans’ football in Saarland carried out by sports medical specialists from Saarbrücken, have also contributed to this research. Their findings indicated that the metabolism and cardiovascular systems of older players had to work surprisingly hard, and there was no significant difference between training and competitions.

“As in many other types of ball sports, the high intensity of football means a lot of adrenaline is created and as a rule the intensity cannot be controlled. If players have existing heart conditions, this presents a certain degree of risk – the high demands placed on the system can cause problems such as constrictions in the coronary arteries or arrhythmia,” warns Scharhag.

The causes of sudden death occurring during or up to an hour after sporting activity are many and various. This information will now be recorded in the data-protected online registry in Saarbrücken, to the benefit of the international football community. Tim Meyer further explains, “in this project, which is financed by FIFA, we do not wish to restrict ourselves only to heart-related incidents, but to look at all cases of sudden death in footballers”. Other causes of death (for example from traumatic injuries) are of course also possible in a contact sport like football. “What we want to find out is whether there is a football-specific ‘pattern’ for dangerous incidents, from which specific preventive measures can be developed,” says Meyer. A further aim of the registry is to discover whether there are any regional differences beyond the known distribution pattern of diseases according to location.

Information about various symptoms will be given on the website of the registry, which will initially be in English and German, so that it can be ready as soon as possible, with translation into other major languages coming later. Alongside the website, via which individual cases of death can be registered, representative partners in various countries worldwide will be appointed. The researchers hope that, with the help of specialist contact people and media monitoring, they will be able to investigate the causes of death in more detail than would be possible with just the online notifications. They will also look at how commonly football is played and how often competitions take place in those countries. “This information will enable us to compare different types of sports or different regions of the world in a scientific and accurate manner,” explains Scharhag.