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.
12 times higher = 18 total, easily small enough of a number for it to be a coincidence.
How the heck do you play soccer without using your head or chest? That's like trying to play baseball without a glove!
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.
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.
"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.
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.
BTTT
"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.
It is better to go fishing than play soccer.
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.
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.
Understood. But around 5% of the time, it is actually just coincidence.
I remember the concern about playing fields, too.
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.)
Drugs are used by another group that performs strenuous physical activity -- Rock musicians. I wonder what the rate of ALS is among them.
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.
ping...sorry if you've already seen this one. :)
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.
Ummm....24,000 players studied, 12 times higher?
Any statisticians out there?
Supposedly, ALS affects 1 in 100,000.
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