Male and female football players had similar rates of head collision events during recent international football tournaments but more medical assessments were carried out in the women's game, according to a new study published in JAMA.
The research, led by St. Michael's Hospital of Unity Health Toronto, found that half of the female players involved received medical assessments, compared with only one third of the impacted male players.
There was no significant difference in the number of female players removed from play compared with male players, while the median time that play was stopped for a medical assessment in women's tournaments was 70 seconds compared with about 50 seconds in men's matches.
A minimum of 10 minutes is required to perform a concussion assessment, the researchers pointed out.
"There is international consensus that athletes who sustain a potentially concussive head collision should be given a proper medical assessment and be removed from play until a qualified professional can determine that it is safe for them to return to play," said Dr Michael Cusimano, lead researcher and a neurosurgeon at St. Michael's Hospital.
"It is clear that this is not happening in elite women's or men's play at this time."
Researchers reviewed 52 matches of the 2019 FIFA Women's World Cup and monitored for the frequency and medical assessment of head collision events, time stopped for assessment, and visible concussion signs. The data was compared against the 2014 and 2018 FIFA Men's World Cup and UEFA Euro 2016. In the matches reviewed, 84% of female athletes and 88% of male athletes showed two or more visible signs of concussion after a head collision event, including clutching of the head or disequilibrium (feeling off-balance).
Stressing the importance of addressing this issue, Dr Cusimano suggested increasing the role of video assistant referees, employing independent medical assessors, or allowing temporary player substitutions to provide sufficient time for medical assessments.
"Hundreds of millions of people play soccer -- it is the world's largest and fastest growing sport," he added. "Tournaments like the FIFA World Cup attract millions of viewers, and the examples set by elite athletes and officials affect how players and officials globally, at any level, deal with concussions."