Players' health the number one priority

The medical report from the 2006 FIFA World Cup Germany™ is about to be published in the British Journal of Sports Medicine, mere days after the tragic deaths of three young players. The report shows that far from merely reacting to these terrible events, FIFA has long been active in taking preventative measures to safeguard players' health.

Indeed, FIFA's Sports Medical Committee gave directives that every squad member from the 32 countries which took part was to undergo not only a detailed interview and general medical examination but also a full heart and blood pressure check including an electrocardiogram and echocardiogram before the 2006 FIFA World Cup. The questionnaire and study developed by the FIFA Medical Assessment and Research Centre (F-MARC) was primarily designed to detect previously unrecognised heart ailments. Timely diagnosis of malformations such as these can reduce the occurrence of sudden death due to heart conditions seen among young athletes - a rare, and yet still too common, occurrence. The anonymised data from all of the players collected during these examinations are currently being examined in great detail in order to continue the improvements which the prevention programme is making.

As at every major FIFA tournament, the team doctors were asked to provide an injury report at the end of each FIFA World Cup match. The various injuries were systematically entered into a standard database developed through studies carried out by F-MARC and then meticulously analysed. During Germany 2006, there was an average of 2.3 injuries per match - a slight reduction compared with 2002, when there were 2.7 injuries per match. In practical terms, however, the main fact was that there were fewer head injuries than in 2002. Before the 2006 tournament, the International Football Association Board instructed referees to sanction any obviously deliberate elbows with a red card. This change in the Laws of the Game was the result of an F-MARC study which showed that players who are elbowed while jumping can suffer serious head injuries. This led to a downward trend in injuries, although here again more data will have to be collected for definitive conclusions to be drawn.

The results of the drugs tests at Germany 2006 were similarly pleasing. None of the 256 urine samples taken during the tournament or the 224 taken during qualifiers, warm-up matches and at the training camps proved to be positive. The results confirm FIFA's policies, with doping statistics from 1994 up until Germany 2006 showing only four positive drugs tests at FIFA events - three at actual tournaments and one in a qualifier. The figures translate into a mere 0.1% of positive tests at FIFA tournaments over the past 12 years. Laboratory experts advised against taking blood tests, since given current levels of medical advancement, they would not be able to provide any further information. The blood tests taken at the 2002 FIFA World Cup did not throw up any abnormal results.

The scientific comment on the report provided by the publisher of the journal underlines these three points, in an attempt to stress the importance - still often underestimated - of a medical presence at major sporting events: the importance of preventative measures regarding sudden heart failure, the modifications in the laws of the game to prevent serious injuries and the permanent fight against doping.

Medical report from the 2006 FIFA World CupGermany.Jiri Dvorak, Astrid Junge, Katharina Grimm, Donald Kirkendall.Br J Sports Med 2007; 41: 578-581