The issue of concussion in football has been broadly discussed following recent high profile cases at the 2014 FIFA World Cup in Brazil™, particularly the incident which involved the German player Christoph Kramer during the final match. FIFA has been active in this field for many years, carrying out a number of scientific studies and hosting several conferences with international sports federations which led to clear recommendations on the subject. However, the incidents at the World Cup have shown that the role of team doctors needs to be reinforced in order to ensure the correct management of potential cases of concussion in the heat of the competition.

Following recent discussion with team doctors and Confederations, the FIFA Medical Committee agreed at a meeting held yesterday in Zurich to submit a proposal to the FIFA Executive Committee in order to improve the protocol. Under the proposal, whenever a suspected incident of concussion occurs, the referee will have the ability to stop the game for three minutes, allowing the relevant team doctor to complete an on-pitch assessment and decide if the player has suspected concussion. The referee will only allow the injured party to continue playing with the authorisation of the team doctor, who will have the final decision.

The Medical Committee, under the chairmanship of Dr. Michel D’Hooghe, also stressed that an education programme for team doctors, coaches, referees, officials and players should be undertaken.

The meeting of the Medical Committee was also the occasion to report on the 2014 FIFA World Cup Brazil, which was a clear success from a medical perspective with a decrease in injuries and no positive doping cases reported. The number of injuries went down from 2.7 per match at the 2002 World Cup to 1.7 per match at Brazil 2014. Compared to previous editions, less injuries were caused by fouls, which shows the improvements in refereeing.

For the first time at a FIFA World Cup all participating players underwent out-of-competition anti-doping tests in addition to routine in-competition tests. 256 samples were taken in-competition and 777 out-of-competition, with no positive results. Despite early concerns concerning the shipment of samples to Switzerland due to the lack of an accredited laboratory in Brazil, all samples were delivered on time, with analyses from the lab in Lausanne completed two days before the following match of the respective teams.

The Brazil World Cup also marked another key step in the implementation of the biological profile of athletes, with 1300 players from 55 different countries now included in FIFA’s database – 470 of which have already been tested at least twice, and in some cases as often as seven times.

Finally, the Medical Committee discussed the pressing issue of Ebola and how it has been affecting football in several African countries. Based on recommendations by the World Health Organisation (WHO), it was agreed that FIFA would not impose travel bans on the affected countries, but the Committee advised the postponement of any non-essential and non-urgent FIFA courses there. On the other hand the Medical Committee will urgently explore ways to support the fight against Ebola in the affected countries by using the power of football to help convey important messages for the prevention of the disease. “We will contact and collaborate with WHO to explore possible effective actions to tackle the Ebola prevention”, said FIFA Chief Medical Officer, Prof. Jiri Dvorak.