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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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