Mark Bullingham: 'FA would take no chances with concussion'

The FA and the Premier League, as well seemingly as FIFA, favour a continuation of the three-minute assessment period for concussion but with an additional permanent substitute made available. Other organisations, such as world players' union FIFPRO and brain injury charity Headway, say a 10-minute period provides greater protection.

Bullingham insists no chances would be taken with any player in the FA's favoured model.

"The permanent substitute works best provided that there is an assumption that the player goes off," he said.

"You're working on the assumption that the player almost has an option, we're working on the assumption that if you go down the permanent substitution route, if there's a clash of heads and there's any suspicion of concussion there, they're off.

"Where you may end up in that situation is with what the medical people call false positives.

"You may end up pulling some people off who actually are then determined not to have had concussion. We would rather be on that side of the argument. But fundamentally we're not saying it means less likelihood of players coming off."

Last Monday the FA, along with its Northern Irish and Scottish counterparts, announced new coaching guidelines which specified that heading should not be part of training at all for children of primary school age, with a gradual introduction after that.

It was a decision which was welcomed by campaigners such as Dawn Astle, whose father Jeff's death was ruled by a coroner to have been caused by repetitive heading, but she suggested restrictions should be in place in senior football too.

The conclusions of the FIELD study, co-funded by the FA and the Professional Footballers' Association, were published in October last year and found that professional footballers were three and a half times more likely to die of neurodegenerative disease than age-matched members of the general population.

The study did not identify a cause of that increased risk, but repetitive heading, as well as poor concussion management, could be possible factors.

On the subject of extending the heading guidance to adults, Bullingham said: "There'll be continued discussions around that as we continue to get more medical evidence.

"But in the beginning we were very much focused on youth football, and having something which applied to all levels of youth football.

"It's focused on training, not the matches, because if it's ever found in the future that repetitive heading is the issue, repetitive heading takes place in training.

"The guidelines that we have distributed are all about youth football and very specifically limiting repetitive heading in training.

"We've also been clear that adults should be careful, you should only really head the ball commensurate with the need. So we think there are sensible guidelines, but adults are more well positioned to control their own exposure.

"(The FIELD study) showed a correlation (in terms of increased risk of dementia), it in no way showed what caused it.

"It might be heading, it might not be heading. There is nothing to show that heading is the link. However when you isolate what the potential risk factors are, it makes perfect sense to try to reduce potential risk factors.

"That's what we're doing with concussion. Concussion is proven to lead to neurological issues if there is insufficient concussion management.

"So we've been addressing that one today. Heading was another potential risk factor that was not proved, but it made sense to look at it.

"We accept that our guidelines may come over as over-cautious, and the reality is we'd like in 10 years' time for them to be proved to be over-cautious, , there's nothing we'd like more than that, but it felt sensible."