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An A.L.S. Puzzle on the Soccer Field
NY Times ^ | March 1, 2005 | NICHOLAS BAKALAR

Posted on 03/01/2005 3:54:30 PM PST by neverdem

Why soccer would be a risk for amyotrophic lateral sclerosis is a mystery.

But a new study has found that Italian professional soccer players get the disease at a rate nearly six times as great as the general population.

The study, led by Dr. Adriano Chiò, a professor in the department of neuroscience at the University of Turin, was inspired by the work of an Italian prosecutor, Raffaele Guariniello, who was investigating soccer players' use of illegal drugs.

As part of his inquiry, he ordered a report on the causes of death among 24,000 men who played professional or semiprofessional soccer in Italy from 1960 to 1996.

His finding - that Italian players died of A.L.S. at a rate almost 12 times as great as normal - puzzled researchers, who decided to undertake a much more rigorous study.

A.L.S., often called Lou Gehrig's disease, is an incurable and invariably fatal degenerative disease of the nervous system.

Although there have been many suggestions about the possible risks for the illness, including participation in sports, no clear-cut evidence has been found for any risk factors except age and sex. (A.L.S. tends to strike around age 60, and a vast majority of patients are men.)

The new study, however, found not only an increased risk among these Italian athletes, but also that the risk was dose-related: the longer an athlete played, the greater his risk of contracting A.L.S.

Moreover, the researchers found, the mean age at which the athletes developed the disease was 51, 10 years younger than the general population. The report appears in the March issue of the journal Brain.

Dr. Chiò said he was surprised by the results.

"I can tell you that when I was asked to perform this study, I thought it would be a waste of time," he said. "I didn't believe I would find any significant result. Now I know I was wrong."

He said the study's methodology was sound.

"We are very confident that these results are real and are not due to a statistical effect," Dr. Chiò said.

But he cautioned that the meaning of the findings was not clear, that A.L.S. is a very rare disease and that the study's results in no way suggested that anyone should stop playing soccer.

"I think this is a very good study," said Dr. Ruth Ottman, a professor of epidemiology at Columbia University. "The methodology seems quite rigorous, and the dose-response relationship supports the validity of the results."

The study's subjects included all native Italian male professional soccer players who were on a team roster from 1970 to 2002 and who had played in at least one official match. The total came to more than 7,000 men.

Eighteen cases of amyotrophic lateral sclerosis were identified. The researchers interviewed all living players who had A.L.S., as well as the doctors and relatives of players who had died from the disease, and compiled detailed medical and personal histories of the patients' activities and health before, during and after their time as active athletes.

The researchers also gathered family histories, paying particular attention to neuromuscular disorders. One form of A.L.S. is inherited, but no affected player had the disease in his family.

Dr. Chiò and his colleagues suggest several explanations, none of them with certainty. Perhaps, they say, A.L.S. is related to heavy physical exercise, and therefore not related particularly to soccer.

Or maybe trauma, particularly the head trauma involved in heading the ball or repeated traumas involving the legs, is a factor. Illegal or legal therapeutic drugs may also be involved, and it is possible that environmental toxins like fertilizers or herbicides used on soccer fields play a role.

The authors concede, however, that each of these hypotheses has weaknesses, and the puzzle endures.


TOPICS: Culture/Society; News/Current Events
KEYWORDS: als; health; italy; lougehrigsdisease; medicine; soccer; sports
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1 posted on 03/01/2005 3:54:31 PM PST by neverdem
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To: El Gato; JudyB1938; Ernest_at_the_Beach; Robert A. Cook, PE; lepton; LadyDoc; jb6; tiamat; PGalt; ..

FReepmail me if you want on or off my health and science ping list.


2 posted on 03/01/2005 3:55:40 PM PST by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: neverdem

Very interesting.


3 posted on 03/01/2005 3:56:17 PM PST by Tax-chick (Donate to FRIENDS OF SCOUTING and ruin a liberal's day!)
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To: neverdem

Maybe something to do with headbutting the ball half a million times. Nah!


4 posted on 03/01/2005 4:00:56 PM PST by Fog Nozzle
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To: neverdem

i had a cousin die of this disease a few years back. it is the absolute worse disease you can possible get. the pain and suffering i saw him go through was something i wont forget. i pray that any research may help lead to a cure someday.


5 posted on 03/01/2005 4:01:24 PM PST by philsfan24
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To: neverdem

Unless they find similar results among other nations' soccer players, this looks like a simple coincidence.


6 posted on 03/01/2005 4:01:36 PM PST by thoughtomator (Unafraid to be unpopular)
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To: sweet_diane

Thought you'd want to see this.


7 posted on 03/01/2005 4:05:22 PM PST by miele man
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To: neverdem

Interesting. Thankfully I'm not an Italian playing at the pro level :).


8 posted on 03/01/2005 4:06:34 PM PST by cruiserman
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To: thoughtomator

Ummm....24,000 players studied, 12 times higher?

Any statisticians out there?


9 posted on 03/01/2005 4:07:29 PM PST by proxy_user
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To: Fog Nozzle

Until a few years ago Americans were smarter than europeons, perhaps because the young boys brains weren't bruised from soccer and ritalin.


10 posted on 03/01/2005 4:11:38 PM PST by hoosierham
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To: neverdem
A.L.S., often called Lou Gehrig's disease, is an incurable and invariably fatal degenerative disease of the nervous system.

My understanding (which could certainly be wrong) is that ALS isn’t so much a disease as it is a category of diseases.

That’s pretty much what the doctors that treated my dad said. They were in Houston and claimed to be pretty close to the bleeding-edge when it came to diagnosing/treating such things.

They (~1996) performed various muscle biopsies and other tests and systematically ruled out A, ruled out B, ruled out C – finally at the end, having ruled out everything else, you are diagnosed with ALS. If you come in with certain complaints/symptoms and they cannot definitively diagnose you with something else, you will be diagnosed with ALS by default, IOW. That’s how I understand it.

I think that’s true because while he had symptoms associated with “typical” ALS, he also had several other “weird things” going on that I noticed that were *not* typical regarding what you’re told to expect regarding ALS. Then again, at various times they had him on medicine (experimental and otherwise) that could have contributed to the “weirdness.”

11 posted on 03/01/2005 4:14:47 PM PST by Who dat?
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To: philsfan24

I agree.

Soms strides have been made in recent years in the treatment of neuro-muscular diseases...but ALS is really eluding researchers.


12 posted on 03/01/2005 4:17:04 PM PST by MplsSteve
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To: neverdem
Thanks for this post.

No one in our family ever had A.L.S. I have played and coached for 50 years. Now 65, I am getting a touch of it. Leads me to believe the headers did have something to do with it.

13 posted on 03/01/2005 4:19:46 PM PST by AGreatPer
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To: proxy_user
Ummm....24,000 players studied, 12 times higher? Any statisticians out there?

Statistically significant, to say the least. Assuming, of course, that the methodology is as sound as claimed.... I was rather surprised to see Dr. Chiò actually defending the methodology, as if he expected to be attacked on that front.

14 posted on 03/01/2005 4:19:56 PM PST by r9etb
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To: thoughtomator
Unless they find similar results among other nations' soccer players, this looks like a simple coincidence.

You can bet money that someone will be trying to replicate the results in other counties and in other contact sports.

15 posted on 03/01/2005 4:32:43 PM PST by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: Who dat?; AGreatPer; All
Amyotrophic Lateral Sclerosis

I'm sorry to read about your dad. My friend was recently diagnosed with it.

16 posted on 03/01/2005 4:41:43 PM PST by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: hoosierham
I love soccer, and enjoy playing it, but never use my head to stop a ball, never. Never use my chest either. Just my foot. If people play soccer without the aggression of say the British players, soccer would be a lot of fun.
17 posted on 03/01/2005 4:46:04 PM PST by conservlib
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To: conservlib
"but never use my head to stop a ball, never. Never use my chest either."

Nothing personal, but I can tell you right now in front of the world, YOU STINK as a soccer player. Your not even playing soccer. It is something in your mind.

You have no clue what soccer is.

18 posted on 03/01/2005 4:51:41 PM PST by AGreatPer
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To: neverdem
very interesting thanks for posting this.

mom, died from this catastrophic disease.

actually wondered about the causes...she grew up on farms back in the late 1930's and 1940's.

i don't think it has to do with head butting the ball etc., more like playing on specially maintained grass would sound more like it. I'd love to see similar studies done on football players and baseball players.

Looking for the common thread...
19 posted on 03/01/2005 5:03:45 PM PST by EBH (And the Wall came tumblin' down...)
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To: proxy_user
Ummm....24,000 players studied, 12 times higher?

It says 7000 players, with 18 cases of the disease.

I played soccer all my life, including as an adult for over 10 years at a high competitive level, approximately 30 matches a year, practices, etc.

I always felt, the day after a match, like I had been beaten with a stick over every square inch of my body.

There are special muscles used in soccer (interior of thighs, adductors/abductors) that aren't used to any similar degree in other sports, at least sports I've played.

Anyone who'se played knows the physical difference between endurance training by running, versus a real soccer workout. The former can never fully prepare you for the latter -- only by playing soccer can you build up those muscles.

Just some thoughts....

20 posted on 03/01/2005 5:09:00 PM PST by WL-law
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To: proxy_user

12 times higher = 18 total, easily small enough of a number for it to be a coincidence.


21 posted on 03/01/2005 5:11:37 PM PST by thoughtomator (Unafraid to be unpopular)
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To: conservlib

How the heck do you play soccer without using your head or chest? That's like trying to play baseball without a glove!


22 posted on 03/01/2005 5:13:08 PM PST by thoughtomator (Unafraid to be unpopular)
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To: WL-law
Some further thoughts...

Football players receive plenty of head trauma -- do they get ALS?

We've all seen what happened to Muhammed Ali -- Parkinson's disease. Do boxers have higher incidences of ALS?

Soccer players recieve their headers on the hairline, which is a very specific impact point. Boxers take hits in may places, but typically NOT where a soccer ball is headed.

23 posted on 03/01/2005 5:16:04 PM PST by WL-law
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To: WL-law
Some further thoughts...

Football players receive plenty of head trauma -- do they get ALS?

We've all seen what happened to Muhammed Ali -- Parkinson's disease. Do boxers have higher incidences of ALS?

Soccer players recieve their headers on the hairline, which is a very specific impact point. Boxers take hits in may places, but typically NOT where a soccer ball is headed.

24 posted on 03/01/2005 5:16:32 PM PST by WL-law
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To: WL-law; neverdem

"I played soccer all my life, including as an adult for over 10 years at a high competitive level, approximately 30 matches a year, practices, etc."

"I always felt, the day after a match, like I had been beaten with a stick over every square inch of my body.'

Soccer, marathons and competitive bicycle riding may push the envelope a little too much for those who are really into it and are conditioned to perform at peak level several times a week.

Our youngest son is addicted to bicycle riding. He does over 10,000 miles per year while working 40 to 60 hours per week. He has basically zero body fat and his resting and active pulse rates are amazing low.

However, we have seen him several times reach what he calls his peak condition and get whacked a little later somehow by his immune system. It takes him a couple of months to recover. Then about a year later there is another attack by his body on him.

The last one scared him with a GI bleed, some anemia and feeling miserable for about two months.

There is a fine balance with some of these athletes and some severe problems where their bodies seem to attack them.


25 posted on 03/01/2005 5:44:09 PM PST by Grampa Dave (The MSM has been a WMD, Weapon of Mass Disinformation for the Rats for at least 4 decades.)
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To: Grampa Dave
From a web site on ALS:

Leading theories concern neurotoxicity relating to abnormalities of calcium and amino acids (especially glutamate) essential to neurotransmission. Excessive entry of these compounds into the neurons damages cell metabolism, resulting in pathologic changes. Neuronal damage could similarly result from oxidative processes that produce hydroxyl radicals. Clinical trials of medications that attempt to reverse these processes are under way. Other hypothetic causes of ALS include neurotoxicity from various metals, chemicals or foods,12 and, conversely, deficiency of neurotrophic agents (poorly understood proteins that enhance neuronal maintenance and growth).4,

An intriguing theory that brings together several factors holds that ALS develops when vulnerable persons are exposed to a neurotoxin at times of strenuous physical activity.14 For example, bursts of maximal muscle strength in athletes could create conditions that would deliver such a toxin to the anterior horn cells.

26 posted on 03/01/2005 6:03:21 PM PST by WL-law
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To: neverdem

BTTT


27 posted on 03/01/2005 6:52:03 PM PST by Sweet_Sunflower29 (No Christian child should be left behind in government schools.)
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To: thoughtomator
From Dr. Adriano Chiò:

"I didn't believe I would find any significant result. Now I know I was wrong."

If he's using the word "significant" the way it's used in medical journals when discussing statistical results, then he means that he would have expected to find those results by chance less than once out of twenty random sample populations.

28 posted on 03/01/2005 7:35:40 PM PST by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: neverdem
I am a big golf fan, and I remember a couple of years ago there were two semi- famous golfers, Jeff Julian and Tom Watsons' caddie Bruce Edwards, that both died from ALS within the same year. When they were diagnosed there was a scare that the chemicals used on courses might be the cause. I have not heard of anything coming of this, but it is interesting.
29 posted on 03/01/2005 7:45:19 PM PST by mgobluegop (Just DO it!)
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To: neverdem

It is better to go fishing than play soccer.


30 posted on 03/01/2005 8:51:37 PM PST by Chewbacca (When it comes to Social Security, I'm Pro-Choice. I would choose to opt-out.)
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To: Who dat?

There was a group of doctors out on Long Island several years back who were trying to get funding for a study on potential links btwn. lyme disease and ALS. Why? Bcse of 18 ALS patients they treated, exactly half also tested positive for lyme by PCR and titer. I don't know if they ever got funding, but I know that there have been many anecdotal cases of ALS patients testing positive for lyme. Whether that means untreated lyme can eventually lead to ALS, or if it means some tertiary lyme patients have been misdiagnosed with ALS, I couldn't say. It's intriguing in the context of this article, though, since soccer players spend lots of time out in parks, fields, etc.


31 posted on 03/01/2005 9:40:24 PM PST by MonaMars
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To: WL-law
Thanks. This is intriguing and scary at the same time:

An intriguing theory that brings together several factors holds that ALS develops when vulnerable persons are exposed to a neurotoxin at times of strenuous physical activity.14 For example, bursts of maximal muscle strength in athletes could create conditions that would deliver such a toxin to the anterior horn cells.

32 posted on 03/01/2005 10:18:01 PM PST by Grampa Dave (The MSM has been a WMD, Weapon of Mass Disinformation for the Rats for at least 4 decades.)
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To: neverdem

Understood. But around 5% of the time, it is actually just coincidence.


33 posted on 03/02/2005 12:40:01 AM PST by thoughtomator (Unafraid to be unpopular)
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To: mgobluegop
When they were diagnosed there was a scare that the chemicals used on courses might be the cause. I have not heard of anything coming of this, but it is interesting.

I remember the concern about playing fields, too.

34 posted on 03/02/2005 4:38:26 AM PST by syriacus (Was Margaret Hassan kidnapped because she knew the Oil for Food program failed to aid Iraqis?)
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To: syriacus
From another forum in 2002:
Italy: ALS rates up in soccer players
My husband has been diagnosed with ALS and was a juvenile soccer/rugby player. Personally, we believe that people may be off the mark to believe that "doping" or even excessive muscle use are responsible for a connection of soccer with ALS. We believe the culprit is much more likely to be the chemical--pesticides, herbicides, greening agents, etc.--with which the playing fields are treated. My husband has tested positive for a high lindane level, which is a potent neurotoxic pesticide. I seriously doubt whether Lou Gehrig's was a "doper"; but he certainly was exposed to chemicals on the field. (Lindane, I believe, was patented in 1938.)

35 posted on 03/02/2005 4:43:40 AM PST by syriacus (Was Margaret Hassan kidnapped because she knew the Oil for Food program failed to aid Iraqis?)
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To: WL-law
An intriguing theory that brings together several factors holds that ALS develops when vulnerable persons are exposed to a neurotoxin at times of strenuous physical activity.

Drugs are used by another group that performs strenuous physical activity -- Rock musicians. I wonder what the rate of ALS is among them.

36 posted on 03/02/2005 5:02:19 AM PST by syriacus (Was Margaret Hassan kidnapped because she knew the Oil for Food program failed to aid Iraqis?)
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To: miele man
thanks miele man.

Seems this 'rare' disease is getting all sorts of attention lately.

I heard from that fella in my area who has lived with ALS for 21 years that was in the article we discussed yesterday. What an awesome guy! I wish my MIL had had the opportunity to meet him.

37 posted on 03/02/2005 5:17:45 AM PST by sweet_diane ("Will I dance for you Jesus? Or in awe of You be still? I can only imagine..I can only imagine.")
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To: the lone haranguer

ping...sorry if you've already seen this one. :)


38 posted on 03/02/2005 5:19:43 AM PST by sweet_diane ("Will I dance for you Jesus? Or in awe of You be still? I can only imagine..I can only imagine.")
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To: neverdem
possible that environmental toxins like fertilizers or herbicides used on soccer fields play a role.

THIS would be the reason why...I like how they buried it as the last thing. There is a US Football team, who has something like 7 past players who got ALS. Because of the particular chemicals used on their field, drs are linking (non-scientifically, of course ;) the disease to the fertilizers.

Our salesman at our dealership just died of this in December. It is a HORRIBLE thing.

39 posted on 03/02/2005 5:23:51 AM PST by Dasaji (Are the voices in my head bothering you?)
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To: proxy_user

Ummm....24,000 players studied, 12 times higher?

Any statisticians out there?

Supposedly, ALS affects 1 in 100,000.


40 posted on 03/02/2005 5:24:42 AM PST by Dasaji (Are the voices in my head bothering you?)
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To: AGreatPer

My first inclination is to look at the pesticides and herbicides used on the fields.


41 posted on 03/02/2005 5:26:14 AM PST by AppyPappy (If You're Not A Part Of The Solution, There's Good Money To Be Made In Prolonging The Problem.)
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To: neverdem
I had an uncle succumb to this, 4 months after diagnosis, and wham! gone.

For anecdotal reasons, he was a fireman.

42 posted on 03/02/2005 5:26:47 AM PST by Maigrey ("... I will stand in front of the box to put my heart in it." - Mohammed from Iraq the Blog)
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To: MonaMars
"potential links btwn. lyme disease and ALS."

Even tho it was ruled out by the doctors, my mother in law always felt like Lyme disease was somehow related to her ALS. In the reading I've done, the docs seem to pooh pooh the idea of there being a connection.

43 posted on 03/02/2005 5:27:02 AM PST by sweet_diane ("Will I dance for you Jesus? Or in awe of You be still? I can only imagine..I can only imagine.")
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To: Maigrey
sorry about your uncle, sure was quick for him.

My MIL had about 2.5 years from diagnosis to death. She didn't play soccer but she was one heck of a bowler! Very involved in leagues and competitions, spent several years working the snack bar at the bowling alley. It was while bowling that she noticed her strenght going and began having muscle twitching.

44 posted on 03/02/2005 5:31:16 AM PST by sweet_diane ("Will I dance for you Jesus? Or in awe of You be still? I can only imagine..I can only imagine.")
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To: sweet_diane

Thanks; I had not. Interesting to see if other sports played on natural turf have similar instances of ALS, taking into account US or EU locales.


45 posted on 03/02/2005 6:23:48 AM PST by the lone haranguer (Sola Scriptura, Sola Fide, Sola Gratia)
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To: AGreatPer
No, I enjoy the game, and play routinely. I don't compete, and enjoy running, and kicking around without the killer instinct of MUST WIN IF IT KILLS YOU! That can be saved to the young, the fools, and the professionals. Soccer is a hobby to me.

AS a matter of fact, I play a lot of sports; non with the drive to win if it kills me. For example, I play volley ball, and would never attempt to save a powerful spike. I play basket ball, with no wish to defend the basket against a 250 lbs 6 feet five guy running at & trough me. There is a difference between playing for enjoyment of the game or playing for money. I like the challenge, and the competition, but to a point that is not to risky for my well being. You may call that I stink at these games, I would rather call it a middle age wisdom.

46 posted on 03/02/2005 7:32:10 AM PST by conservlib
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To: thoughtomator

read post 46


47 posted on 03/02/2005 7:33:19 AM PST by conservlib
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To: Maigrey
For anecdotal reasons, he was a fireman.

FWIW, so is my friend.

48 posted on 03/02/2005 8:04:09 AM PST by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: conservlib
"I don't compete"

Everyone to their own feelings.

No matter what game, I personally try to win them all. If I do, great. If I don't, I know I tried.

49 posted on 03/02/2005 8:32:27 AM PST by AGreatPer
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To: AppyPappy
"My first inclination is to look at the pesticides and herbicides used on the fields."

That could well be true over the years. I used to smell some strange stuff over the years. However, modern methods have eleminated or greatly reduced that possibility.

50 posted on 03/02/2005 8:36:59 AM PST by AGreatPer
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