Temporal Patterns and Association Between FIFA World Cup Tournament Periods and Emergency Department-Treated Injuries

Background: Major soccer tournaments may temporarily change recreational soccer activity, community gatherings, and injury-prevention needs, but evidence for population-level emergency department (ED) injury patterns during these events is limited. Understanding whether ED-treated soccer injury burden changes during Men's FIFA World Cup periods may help inform surveillance readiness and prevention planning for future tournaments. Objective: To evaluate whether Men's FIFA World Cup tournament periods temporally coincided with changes in ED-treated soccer-coded injury burden in the United States and to assess the implications for public health surveillance and injury-prevention preparedness. Methods: We conducted a retrospective, repeated cross-sectional calendar-period analysis of publicly available national ED injury surveillance records from 1999 through 2025. Soccer-coded injuries were identified using product code 1267 in any available product field. The primary exposure was the set of official Men's FIFA World Cup tournament dates from 2002, 2006, 2010, 2014, 2018, and 2022. Tournament dates were compared with matched same-calendar dates in adjacent years, excluding dates that overlapped other FIFA World Cup tournament windows. The primary estimands were the mean daily difference and ratio in weighted national ED-treated soccer-coded injury estimates between tournament and matched-control periods. Results: The analytic cohort included 170,679 soccer-coded ED cases, corresponding to an estimated 5,366,681 ED-treated soccer-coded injuries nationally. Mean daily weighted estimates were 453.1 during Men's World Cup tournament dates and 384.1 during matched control dates. The absolute mean daily difference was 68.9 injuries per day (95% CI, -0.5 to 138.3), and the mean daily ratio was 1.18 (95% CI, 1.00 to 1.39). Tournament-specific estimates were heterogeneous, with a near-null estimate for the 2022 winter tournament and higher estimates for prior summer tournaments. Conclusions: Men's FIFA World Cup periods were associated with a modest, imprecise increase in mean daily ED-treated soccer-coded injury estimates, but the findings were heterogeneous and compatible with no difference to a moderate increase. These results should be interpreted as ecological and hypothesis-generating rather than causal. The primary implication is not that World Cup tournaments directly cause injuries, but that major soccer events provide a practical opportunity for real-time ED injury surveillance, targeted recreational soccer injury-prevention messaging, concussion awareness, and coordinated preparedness for community and fan-event injury patterns during future tournaments.