Tackle and scrum should be banned in school rugby, argue experts
Allyson Pollock and Graham Kirkwood at Newcastle University, say the evidence shows that collision sports, such as youth rugby, carry high rates of injury - and they call on the government to "put the interests of the child before the interests of corporate professional rugby unions" and remove the tackle and other forms of harmful contact from the school game.
Rugby union and rugby league are the most commonly played collision sports in the physical education curriculum of schools in England.
A recent evidence review of youth sports found that rugby, ice-hockey and American football had the highest concussion rates in children. Other studies show that rugby related injury emergency department attendances in the US are on the rise, in particular head and face injuries, which make up more than a third of injuries.
Head injury is associated with an increased risk of dementia and Alzheimer's disease, say the authors, adding to existing evidence that head injury may lead to neurodegenerative diseases, for example Parkinson's disease.
Furthermore, a history of concussion is associated with a lowering of a person's life chances across a range of social and educational measures, as well as an increase in violent behaviour and violent injury in adolescents.
Rule changes in collision sports can make a difference, they write. For example, Canada's ban on 'body-checking' (intentional body contact) in under 13s ice-hockey led to a reduction in concussion risk.
However, they point out that evidence for other strategies to reduce concussion risk in sport including the wearing of protective equipment such as mouthguards is weak. And in the UK, teacher training in the skills of rugby are lacking as is concussion awareness training.
In July 2016 the four UK chief medical officers (CMOs) rejected the call for a ban on tackling in youth rugby, citing a report which claimed rugby was no more injury prone than other sports.
But Pollock and Kirkwood argue that, under the United Nations Convention on the Rights of the Child (Article 19), "governments have a duty to protect children from risks of injury and to ensure the safety of children, which is why we are calling on CMOs to act now."