Major sporting codes, such as the NRL and AFL, should have mandatory return-to-play protocols in concussion, including 21 days out of competition to allow players to properly recover.
The recommendation is among a series from a six-month inquiry into concussions and repeated head trauma in contact sports which were tabled in the Senate on Tuesday night.
Greens senator Janet Rice, the chair of the committee, said it was “a landmark report” in understanding the effects of concussion on Australian sports players and recognising the actions needed to address the issue.
“It is time for the commonwealth to step up. Concussion is a serious issue affecting thousands of Australians,” Rice said. There is much more that the commonwealth could and should be doing.”
The report recommended that sporting organisations should consider rule modifications to minimise concussion risk, while the government should develop a national sports injury database, with which sporting bodies should share concussion-related data.
The committee supported the government following the UK’s approach to grassroots sport in developing universal protocols that recommended players take a minimum of 21 days out of competition after sustaining a concussion.
It agreed with inquiry participants who said the financial, medical and other supports offered to players affected by concussion and repeated head trauma were inadequate.
“Fundamentally, key national sporting organisations could further enhance their commitment and their duty of care to athletes across the country, providing athletes with more support or resources to respond more effectively to life-changing challenges,” the committee said.
“It was clear to the committee that significant reforms and improvements are needed to ensure that individuals from all levels of sport are adequately supported, remediated and compensated in the event that they suffer from the ongoing impacts of concussion and repeated head trauma as a result of their participation in sport.”
The federal government should also find ways to enable independent research funding into the issue to ensure the integrity of the work, the report said.
“Comprehensive and independent research is vital to ensure that future sports people and their families do not have to experience the anguish and suffering that current and former generations have faced,” the committee said.
The inquiry was established in December last year in the wake of increasing public concern, including reporting by Guardian Australia, about sporting organisations’ management of player head injuries and the large and growing body of scientific evidence showing links between repeated exposure to head injury in contact sports and neurodegenerative disease.
The inquiry heard from many people who experienced long-term and ongoing effects of traumatic brain injury, including harrowing testimony from people with family members who were found to have had chronic traumatic encephalopathy (CTE), the debilitating neurodegenerative disease caused by repeated head trauma.
There was clear evidence of a causal link between repeated head trauma and concussions and subsequent neurodegenerative diseases such as CTE, the committee said. While there remained some questions about the degree of exposure required to trigger such neurological decline, “these questions should not be used to undermine the fundamental nature of that link”, and it was imperative that governments and sporting bodies acted immediately with precautionary, preventative measures.
It was “unsatisfactory and inequitable” that professional players were excluded from workers’ compensation schemes, the committee said, and recommended that state and territory governments explore how to include sportspeople in their schemes.
No-fault insurance arrangements were not part of the recommendations, despite the report recognising the need for players to be insured for head injury, and considerable time during hearings spent discussing the necessity of it.
Rice said she was “personally disappointed” that the committee did not make this recommendation.
“The Greens would support the development of a no-fault insurance scheme for sports injuries. For many in our community, dealing with concussions is too late – we have work to do to protect future harm across the country.”
Rice said she hoped the federal government took the report seriously and would move quickly to implement the recommendations.
“Many of the recommendations are couched in terms of recommending that the government ‘consider’ taking action,” she said. “I urge the government to move beyond considering and to urgently take the concrete actions that we have raised.”
Concussion experts and scientists responded overwhelmingly positively to the committee’s findings on Wednesday.
Sarah Hellewell, senior research fellow in neurotrauma at Curtin University, said the recommendations were “important for the future of concussion research in Australia, and will go a long way to support our understanding of the long-term effects of traumatic brain injury.”
Prof Hendry Brodaty at UNSW Sydney’s Centre for Healthy Brain Ageing, said the recommendations in the report were “excellent”. “As a specialist who has run a memory clinic for almost 40 years, I am acutely aware of this issue and have seen many football players with dementia, other neurological conditions and psychiatric problems in late life which is tragic for them and their families,” he said.
La Trobe’s Prof Alan Pearce, research manager at the Australian Sports Brain Bank, who gave evidence to the committee, praised the report but echoed Rice’s concerns regarding the language the recommendations were couched in.
“The inquiry report is thorough and I commend the committee for synthesising so many points of view,” Pearce said. “The recommendations certainly acknowledge the science on the causal links between repetitive head trauma and CTE, but some lack the forcefulness needed to reduce the risk of long term brain disease.”
