We aimed to analyze the number and type of contacts involving the risk of respiratory disease transmission during football match play. We analysed videos of 50 matches from different levels of play (professional, amateur, youth). Two reviewers evaluated the contacts of all players in the field of view in each match. We focused on between-player contacts (duels), crowding, actions with potentially increased aerosol and droplet production (speaking, shouting, spitting) and within-player hand-to-head contacts. We categorized the duels with direct contact into frontal (face-to-face) and other ones and measured contact duration. The number of between-player contacts were similar between playing levels (median 28.3 [IQR 22.6,33] contacts per player-hour). Frontal contacts summed up to 8% of all contacts. Contacts involving the head occurred on average less than once per player during a 90-min match with none in frontal positioning and none lasting longer than 3 s. Crowding included on average between two and six players and the duration was mostly less than 10 s. Only goal celebrations lasted more than twice as long in professionals (median 21.4 s [IQR 13.8,24.8]) and amateurs (median 18.6 s [IQR 16.3,22]) compared to youth players (median 8.9 s [IQR 0,14.8]). Aerosol and droplet producing activities were three to four times more frequent in adult compared to youth players. Our results suggest that the risk of respiratory pathogen transmission is low during football matches. This conclusion is based on the finding that most close contact situations are of short duration and on the fact that it is mainly an outdoor sport.
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