325 Concussion knowledge and experience amongst football referees in England

Objective Football players are at risk of sustaining sport-related concussions (SRC). In 2015 The Football Association (The FA) in England released guidelines promoting recognition of SRC and immediate removal from the sporting environment as an important strategy in reducing SRC associated morbidity. The responsibility to safeguard players with a suspected concussion includes all stakeholders in the game, and this extends to referees. To date, referees’ experience and knowledge of concussion with particular reference to The FA concussion guidelines is unknown. Design Cross-sectional study. Participants An online questionnaire based on the 5th Consensus Statement on Concussion in Sport (Berlin, 2016) and The FA concussion guidelines was distributed by The FA and the Professional Game Match Officials Limited (PGMOL) to their referee members (Queen Mary University of London Research Etics Committee QMREC2014/24/162) Main Results 208 questionnaires were completed of which 34 (16%) were from referees officiating in top two tiers of English football (Premier League and Championship). 48% felt confident recognising SRC on pitch, 62% confident in the immediate management of concussion, and 69% confident that their concussion knowledge was adequate to officiate games. Some concussion-related symptoms had high awareness, but seizure and aggression had lower recognition. 32% incorrectly believed only a direct blow to the head could cause a concussion. 30% felt the final say on player removal was not that of the medical team. Low rates of concussion specific education or training were found, but high interest in future education. Conclusions Improvement in concussion knowledge amongst football referees is required. An emphasis on educational initiatives aimed at these stakeholders could improve the health and welfare of those participating in football.