817 FO51 – Concussions over 12 seasons of English men’s community rugby union

Background Rugby union is a high-intensity sport with frequent collision events which can result in injury. This particular injury has received increasing attention in recent years. Objective Determine the incidence and propensity of concussions across different levels of English men's community rugby union match play over twelve seasons. Design Observational prospective study and video analysis of tackle events during match play. Setting English Men's Community rugby match play over twelve seasons, 2009/10–2021/22. Participants Male English community rugby players. Independent variables Match exposure and tackle events. Main Outcome Measurements Concussion incidence (per 1000 player match hours) and longitudinal trend (linear regression), number of tackle events per match and propensity of concussions in tackles (concussions per 1000 tackle events). Results Over 15,845 team games, 749 concussions were reported with an overall concussion incidence of 2.4/1000 match hours (95%CI: 2.2–2.5). Incidence increased over the twelve-season period from 1.1/1000 match hours in 2009/10 to 4.9/1000 match hours in 2021/22 (β: 0.33, 95%CI: 0.24–0.42; P<0.001). The tackle was the most common cause of concussion, accounting for 77% of all concussions. The mean number of tackles per match was 161 (95%CI: 156–166) in season 2009/10 and 201 per match (95%CI: 196–206) in 2019/20 and the propensity for concussion was 0.21 concussions per 1000 tackles (95%CI: 0.18–0.25) in 2009/10 and 0.47 concussions per 1000 tackles (95%CI: 0.38–0.57) in 2019/20. Conclusions Concussion incidence English men's community rugby union match play increased over twelve seasons. This may be partly explained by an increase in the number of tackles per match, but the risk of injury per tackle event also appears to have increased. Other factors could be an increasing level of concussion awareness and reporting of concussions by player and community medical staff over this period.