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The final match of the FIFA Confederations Cup 2009 South Africa between the United States and Brazil was played on 28 June 2009 in Johannesburg in memory of Marc-Vivien Foé, who suffered sudden cardiac death as a result of hypertrophic cardiomyopathy. His 15-year-old son spoke to the 52 000 spectators in honour of his father, bringing back sad memories of the tragic event during the FIFA Confederations Cup 2003 in France. Even though CPR was correctly performed on the sideline followed by treatment within the emergency room, his life was tragically lost, to the shock and dismay of the international sporting community.
This tragic event, like many others before and after, not only indicates the high importance of preventive measures to stop these events from occurring but also emphasises the necessity for the availability of advanced life support and medical emergency care within and outside the stadium prior to and during major sports competitions such as the FIFA World Cups or Olympic Games. FIFA reacted in 2003, making it mandatory to equip all stadiums with automated external defibrillators (AEDs) as well as to make available medical and paramedical personnel who are able to manage emergencies such as cardiac arrest. In addition, the focus of the medical committee of FIFA has been the development of preventive measures such as implementation of the precompetition medical assessment (PCMA) or preparticipation medical examination (PPE). Such a PCMA (Dvorak et al. Clin J Sports Med 2009) was made mandatory for all 32 teams participating in the FIFA World Cup 2006 Germany and the FIFA Women’s World Cup 2007 in China. The team physicians performed the examination of athletes at their own institutions or took advantage of FIFA Medical Centres of Excellence established around the world to assist in screening. However, the sole responsibility for the eligibility of the footballer/athlete for participation in a competition remained with the team physician. A particular focus must be on youth competitors, who are often not sufficiently medically assessed prior to a major sporting event.
A recent medical examination of under-17 football players from eight participating teams who qualified for the CAF under-17 Cup in Algeria 2009 was completed in March in collaboration with the African Football Confederation (CAF) and the Algerian Football Association. One hundred and sixty players were medically assessed on arrival at the competition in Algiers by international experts in close collaboration with the Algerian sports physicians. The results of this examination are presented in this supplement. A surprise to all of us was the fact that almost 70% of the 160 players had never seen a doctor prior to the examination in Algiers. This fact reflects the reality in many countries, where the medical assessment prior to participation in training and competition, even at the national level, is far from optimal. Such an experience should stimulate us as sports physicians to discuss the necessity of medical examination, particularly of the cardiovascular system, with the respective national and international sports federations who are responsible for the sports and games.
In this respect the initiative of the IOC medical committee under the leadership of Professor Lars Engebretsen and Dr Peter Jenoure to call a consensus meeting on the current state of the PCMA, presented in this supplement, is an important statement and should serve as a foundation for discussion with the executives of the sports federations.
Our main objective is to promote sport as a health-enhancing activity, and in this respect the appropriate medical assessment should become an integrated part of the healthcare programme in all sports, and not only at the highest competitive level.
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