This FastFact highlights an American Medical Society for Sports Medicine (AMSSM) position statement on blood-borne pathogens in sport.^1. In football, the Laws of the Game require any player who is bleeding (or has contaminated clothing or equipment) to be removed from the field of play. While this is clearly a sensible rule, and this practice should be encouraged, the overall risk of disease transmission during sport appears extremely low.

This position statement provides clear, practical and evidence-based advice about blood-borne pathogens (BBPs) including HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis D virus (HDV as they relate to sports participation.

In general, the available evidence suggests that the prevalence of BBPs among athletes is similar to that of the general population, suggesting that participating in sport does not increase the risk of contracting this type of condition. One study estimated the risk of HIV transmission in American Football, which involves a much higher risk of bleeding than football, at 1 per 85 million game contacts. High-risk behaviours outside of sport, such as unprotected sex and the sharing of injection-related equipment, is likely to be the most common route of transmission among players.

The authors of this position statement highlight the potential to further reduce the risk of disease transmission by implementing simple preventative measures, like FIFA’s blood rule outlined above. Adopting basic hygiene and standard precautions, including the use of personal protective equipment, adequate decontamination of soiled equipment and the removal of bleeding players, should be mandatory.

Reference
1.McGrew C, MacCallum D-S, Narducci D et al. AMSSM Position Statement Update: Blood-Borne Pathogens in the Context of Sports Participation. Clinical Journal of Sport Medicine: July 2020 30 (4) pgs 283-290 doi: 10.1097/JSM.0000000000000738