Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players
Abstract
The cause of amyotrophic lateral sclerosis (ALS) is still unknown. A possible relationship between ALS and sport participation has been supposed, but never definitely demonstrated. We studied a cohort of 7325 male professional football players engaged by a football team from the Italian First or Second Division in the period 1970-2001. ALS cases were identified using different concurrent sources. Standardized morbidity ratios (SMRs) were calculated. During the 137,078 person-years of follow-up, five ALS cases were identified (mean age of onset, 43.4 years). Three cases had a bulbar onset, significantly more than expected (P = 0.003). Since the number of expected cases was 0.77, the overall SMR was 6.5 [95% confidence interval (CI), 2.1-15.1]. The SMR was significantly increased for an ALS onset before 49 years, but not for older subjects. A significant increase of the SMR was found in the periods 1980-1989 and 1990-2001, whereas no ALS case was found in the 1970-1979 period. A dose-response relationship between the duration of professional football activity and the risk of ALS was found (>5 years, 15.2, 95% CI, 3.1-44.4; < or =5 years, 3.5, 95% CI, 0.4-12.7). Our findings seem to indicate that playing professional football is a strong risk factor for ALS.
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This finding is similar to a previous report of increased frequency of bulbar onset ALS and a younger age of onset in a group of soccer players.
“This is similar to a previous report of increased frequency of bulbar onset ALS and a younger age of onset in a group of soccer players (43).”
From Chronic Traumatic Encephalopathy Within an Amyotrophic Lateral Sclerosis Brain Bank Cohort (2018) · cites this paper as [43]
Some data suggests that trauma and athletic exposure are risk factors for developing ALS, although there are conflicting reports regarding single versus repetitive head injury.
“Some data suggests that trauma and athletic exposure are risk factors for developing ALS [30, 31, 166], although there are conflicting reports regarding single versus repetitive head injury [24].”
From The neuropathology of sport (2014) · cites this paper as [30]
ALS incidence and mortality are reported to be unusually high among professional soccer players in Italy.
“ALS incidence and mortality are also reported to be unusually high among professional soccer players in Italy [30, 31].”
From The neuropathology of sport (2014) · cites this paper as [30]
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- Authors
- Chio, A.
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-01-05
- Volume
- 128
- Issue
- 3
- Pages
- 472-476
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- OpenAlex
- W2099565072
- Cited by
- 484
- References
- 24
- Citations by year
- 2026: 5 · 2025: 14 · 2024: 15 · 2023: 20 · 2022: 24 · 2021: 20 · 2020: 24 · 2019: 28 · 2018: 23 · 2017: 34 · 2016: 35 · 2015: 36 · 2014: 20 · 2013: 25 · 2012: 26
- FWCI
- 11.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Brain (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
- Keywords
- amyotrophic lateral sclerosis, professional football players, sports participation, ALS risk factors, bulbar onset, standardized morbidity ratio, dose-response relationship
- MeSH terms
- Adolescent, Adult, Aged, Amyotrophic Lateral Sclerosis, Humans, Italy, Male, Middle Aged, Occupational Diseases, Retrospective Studies, Risk Factors, Soccer, Time Factors, Incidence, Age of Onset
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