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Football Refereeing and Cardiovascular Health: A Scoping Review

A scoping review examining cardiovascular risk factors, psychological stress, physical demands, and cardiac events among football referees during matches.

GIST

by Toby M Plasto, Geoffrey H Tofler, Tom Buckley Background Physical and psychological stress can precipitate Acute Coronary Syndrome (ACS) events. Football (soccer) is a popular sport globally, with referees covering significant distances, often at high-intensity during a match, and facing potentially intense psychological stress from high-stakes decision-making and potential verbal abuse from players and spectators. The aim of this scoping review was to identify what is known about the cardiovascular health and risk of acute cardiac events in referees during football matches. Methods A librarian-assisted search of six databases was completed, with publications written in English or with English translation available included. The PRISMA checklist was utilised and data were extracted from publications to form both descriptive and thematic analyses.

Clinical Editorial

Referee Health Context and Scope: - This scoping review examines what is known about cardiovascular health and acute cardiac event risk for football referees during matches. - A librarian-assisted search across six databases was conducted, including English-language publications or those with English translations. The study followed PRISMA guidelines for data extraction and thematic analysis. Study Design and Methods in Brief: - Publications were analyzed to produce descriptive summaries and thematic syntheses of the literature related to referees’ cardiovascular risk, stress, physical demands, physiological aspects of refereeing, and cardiac events on the field. - The review aggregates evidence across studies rather than reporting primary trial outcomes or a meta-analysis. Key Thematic Insights: 1) Cardiovascular risk factors profile: - The literature documents prevalence of hypertension, dyslipidaemia, and diabetes among football referees. 2) Psychological stress and abuse: - Referees experience verbal and physical abuse at all competition levels. - Such experiences are associated with elevated psychological stress, anxiety, and anger. 3) Physical intensity and activity levels: - Referees cover substantial distances and engage in high-intensity activity during matches, illustrating notable physical demands. 4) Physiological aspects of refereeing: - The review notes various physiological considerations related to officiating, though specific mechanistic details are not individualized in the summary. 5) Cardiac events on the field: - Instances of cardiac events among referees are reported; however, referees infrequently participate in cardiopulmonary resuscitation (CPR) or on-field life-saving interventions. Contextual interpretation and gaps: - The synthesis indicates meaningful cardiovascular and psychological demands placed on referees, coupled with exposure to abuse. - There is a noted paucity of research evaluating educational or preventive interventions targeting referees’ cardiovascular health. - Referees may function as first responders during ACS events, underscoring a potential need for symptom awareness and first-aid preparedness among officials. - The review explicitly notes limitations in the available literature and calls for more targeted research on interventions and practical training.

Original source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0346360