6 August 2026
A first-ever Australian study on emotional stressors faced by football (soccer) referees suggests they undergo a significant amount of stress and abuse that could contribute to cardiac risk.
A new study published today in the Internal Medicine Journal, published by the Royal Australasian College of Physicians, evaluated surveys of 134 football referees in Australia ranging from amateur to professional levels.
A staggering 93.6 per cent of referees had experienced verbal abuse in their careers, and of those, 73.5 per cent had experienced verbal abuse in the past year. One in seven (15.2 per cent), reported experiencing physical abuse while refereeing. Younger referees were more likely to report abuse than their older colleagues.
In the survey, referees were asked to identify the level, frequency and type of emotional stressors they faced in the last 12 months and throughout their careers. Emotional stressors included psychological stress, anxiety, frustration, anger, and verbal and physical abuse.
More than two-thirds of participants (69.8 per cent) had experienced stress and more than half (58.9 per cent) experienced anxiety during at least one match in the previous year. Player and team official (coach/manager) conduct were identified as key reasons for these stressors.
Dr Toby Plasto, lead author of the study, says acute emotional stressors are known triggers for heart attacks, and referees should be treated as a population with heightened risk.
“In Australia, there are more than 13,500 registered referees, who each make between 150 to 250 decisions a match while exerting the cardiovascular fitness that keeping up with the game requires.
“In addition to the physical demand of the game, the prevalence of emotional stress each match adds a potential trigger for heart attacks.
“This study revealed just how frequent and intense emotional stressors are for referees, and from a health perspective, the results are concerning.
“Existing studies on professional-level referees suggest the more experienced the referee, the less stress they report. Our study, however, found no association between years of experience and their reporting of emotional stressors.
“Young referees, who often have fewer coping strategies and less mental resilience, were most at risk to be victims of psychological stressors and verbal abuse during matches.
“Our survey found stress is so common among referees that one in five had considered quitting due to the stress they experienced.
“Anyone who has ever watched a football match knows the physical and emotional stress referees are exposed to, and it truly takes a toll on their health. The recent FIFA World Cup demonstrated that this abuse is prevalent, even at the pinnacle of the sport.
“Referee participation is vital for football to continue, therefore supporting referees to feel safe is a responsibility both spectators and clubs should share.
“While some football governing bodies have implemented programs in an attempt to quell the level of abuse directed at referees, we are yet to see tangible outcomes from them. The support and protection for referees needs to include every referee, from our juniors through to the elite level.
“This study is a yellow card for the sport. It’s a warning that unless there are stronger support systems to help referees manage their stress, and a whole-of-game approach to reduce abuse, our referees will quit, or potentially suffer a heart attack,” says Dr Plasto.