Keoghs Insight


Mandy Chahal

Pitch side saliva testing: A game changer?


Saliva testing for Covid-19 is already due for roll out, a medical development turbo-charged by the pandemic. However, this type of testing is now creating waves that could wash up on the shores of traumatic brain injury in the future too.

A study carried out by the University of Birmingham in association with the Rugby Players Association and Rugby Football Union has found that using pitch side saliva tests on male rugby players can diagnose a concussion. Researchers took saliva samples during matches from 2017 to 2019 from 156 male elite Rugby Union players with either a confirmed or suspected concussion immediately following the injury. Samples were taken of microscopic DNA markers and the test was found to be 94% accurate, with the results received within minutes.

Professor Antonia Belli, the study’s Chief Investigator, has stated: “Crucially, the differences in the salivary concentration of these biomarkers are measurable within minutes of injury which means we can make rapid diagnoses. We now have a laboratory based non-invasive and accurate diagnostic test using saliva, which is a real game changer.”

Those who have suffered a head injury have had samples taken both during and after a game. Taking a saliva test is less invasive than taking a blood sample, which means it is easier and less expensive to roll out. 

This is seen as a breakthrough as it could potentially be used in not just sport, but also in the military and in healthcare. The study will now expand into further areas including checking the biomarkers in women, youth and community sports players.

Practical Implications

It is still very early days and more in depth investigations will be required, but there is the potential for these tests to be rolled out in emergency departments when head injuries are suspected in the future. It may be particularly useful for assisting in the diagnosis of mild traumatic brain injuries including post-concussion syndrome, where symptoms can be vague making it difficult to diagnose.  Very often diagnosis is based on reported symptoms. This new testing would provide an objective test for diagnosing such injuries. 

In the context of subsequent personal injury claims an objective test for concussion and early diagnosis could potentially lead to an earlier resolution of some cases, thus cutting case cycle times and importantly making a costs saving for insurers. 

There is also scope for the tests to expand beyond concussion to possible heart attacks, cancer biopsies and other conditions which would ordinarily require a blood test so this could pave the way for a new approach for dealing with claims in the future. 

Although laboratory results could be used within a few months for elite players, we are a long way off pitch side testing that delivers instant results and it could yet be several years away. It does however, bring an exciting prospect but as with many medical developments, only time will tell.