Concussion is an issue that affects all sports and it is important that everyone in rugby recognises the symptoms of concussion and removes from playing or training any player with clear or suspected symptoms.
Player welfare is the No1 priority for the IRB. This is not something we say lightly but rather a strategy that informs and guides every aspect of what we do. Without healthy players who are confident they are playing a safe sport, rugby would not experience the success and global growth that it currently enjoys.
As the governing body, the IRB applauds the significant role that the media is playing in raising awareness of concussion and the need for all involved in rugby to take this important area seriously. However, we also would like to provide reassurance that concussion is at the top of our player welfare agenda.
While there are risks associated with any sport - and rugby is no different - we want to reassure players, parents and fans that we are working hard with our national unions, including the New Zealand Rugby Union, to educate players at all levels of the game regarding the symptoms and dangers of concussion.
It is true that concussion is an emotive issue and that in very rare and sad cases it can be fatal, but it is important that Herald readers understand how, collectively, we are tackling the issue.
So, what are we doing about it? Well, the most important thing at all levels of the game is education and our message is simple - recognise and remove.
If any player demonstrates any signs or reports any symptoms of possible concussion, that player must be removed from the game and must not return to play. That is non-negotiable and we are making good progress in this from Eden Park right down to school playing fields.
There is no such state as "a little concussed" and rugby therefore exercises caution. Concussion is a complex injury and it is not always possible to diagnose it immediately. So we treat suspected concussion exactly the same as confirmed concussion. Get the player off the pitch, and don't let him or her back on. Before that player can play again, he or she must undergo a medically supervised graded return-to-play protocol to make sure the brain has fully recovered from the knock it received. If a player does not have access to medical supervision, a mandatory stand-down period applies.
At the elite level of the game we have introduced another protective measure, known as the Head Injury Assessment (formerly known as the Pitch-side Suspected Concussion Assessment). The HIA tool is often misreported as a means of diagnosis of concussion. It is impossible to make a clinical diagnosis of concussion in 10 minutes and therefore the HIA is designed to assess a player following a head knock when the diagnosis is not apparent.
Reports from medical staff and players confirms that the value of this intervention is the allowance of a temporary removal from play so that a head injury assessment can be undertaken. Prior to the introduction of this temporary substitution, the assessment of a player was completed within one minute, on the field of play.
This resulted in 56 per cent of players with confirmed concussion returning to play. Since the introduction of temporary substitution and standardised assessments, this figure has reduced to 13 per cent. This research has been independently reviewed and has been approved for publication by the British Journal of Sports Medicine.
The goal of the IRB is to drive this 13 per cent down to zero.
The HIA has reinforced the fact that education and cultural change are key to protecting our athletes. Players, coaches and parents at all levels must understand the dangers of concussion and the need to put the welfare of the player at the heart of all they do.
Concussion is a brain injury. It is not to be taken lightly. It is a complex subject and the IRB is engaged in research with Auckland University of Technology to learn more about the long-term effects of concussion.
The message from the IRB is simple - recognise and remove.
Brett Gosper is CEO of the IRB.