The DOI matches its Crossref record; 24 of the 24 references it cites were found in a registry or an index; none of the 24 sources its claims cite is checked for support yet.
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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Written from the paper’s full text.
TL;DR
In a cohort of 7325 Italian male professional football players followed for 137,078 person-years, five ALS cases occurred versus 0.77 expected, yielding an overall SMR of 6.5 (95% CI 2.1–15.1). The authors conclude that professional football playing is a strong risk factor for ALS, though the causal exposure remains unknown.
Key findings
- Overall ALS SMR was 6.5 (95% CI 2.1–15.1) based on 5 observed cases and 0.77 expected during 1970–2001.
- Risk was significantly increased for ALS onset before age 49 (SMR 7.5, 95% CI 2.0–19.2) but not for ages 50–69 (SMR 4.2, 95% CI 0.1–23.4).
- A dose-response relationship was found by duration of professional football activity: >5 years SMR 15.2 (95% CI 3.1–44.4); <5 years SMR 3.5 (95% CI 0.4–12.7).
- Three of five cases had bulbar onset, significantly more than expected (P = 0.003); mean age of onset was 43.4 years (SD 9.1).
Methods
- Retrospective incidence cohort of all male professional football players engaged by Italian First or Second Division teams from September 1, 1970 to June 30, 2002, who played at least one official match; foreign-born players were excluded, leaving 7325 players.
- ALS cases were identified from death certificates, major Italian ALS centre archives, the Italian ALS Association, media/websites, and self-reports; only definite or probable ALS by El Escorial revised criteria were included.
- Standardized morbidity ratios were calculated using age- and gender-specific incidence rates averaged from the Piemonte and Valle d’Aosta Register for ALS and the Puglia ALS register, with 95% CIs assuming a Poisson distribution; a two-tailed chi-square test compared observed and expected site of onset.
Limitations
- The authors state that underestimation of cases in the first decade cannot be ruled out, possibly explaining the absence of ALS cases in 1970–1979; they also note foreign-born players were excluded because complete follow-up was not possible, and the causal exposure remains unknown.
- The authors consider and correct for a possible “false cluster” using implicit multiple comparisons, and state that all other requirements for evaluating an identified cluster were met with a conservative design.
- Evident from the text: the analysis rests on only five ALS cases, producing wide confidence intervals; case finding combined active ascertainment with passive “spider” methodology, which could be influenced by media publicity and self-reporting; and no individual-level data identified specific toxic, drug, trauma, or environmental exposures.
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Claims the paper makes
16 Own result · 14 No full text of the sources · 4 Sources not found · 4 Own method · 4 Own interpretation · 1 Not checked yet · 1 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Three cases had a bulbar onset, significantly more than expected (P = 0.003).”
- Also stated in: § ALS cases · plain
“with a significant excess of bulbar onset compared with the expected distribution calculated using the age-specific data of the two Italian ALS registers (0.7 bulbar and 4.3 spinal onset cases) (P = 0.003).”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Abstract
plaincorrelationaln = 5 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § ALS cases · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“mean age of onset, 43.4 years”
- Also stated in: § ALS cases · plain
“The mean age of onset was 43.4 years (SD 9.1; range 33-56).”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Abstract
plainn = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § ALS cases · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During the 137 078 person-years of followup, five ALS cases were identified (mean age of onset, 43.4 years).”
- Also stated in: § ALS cases · plain
“During the 137 078 person-years of follow-up, five cases were identified.”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Abstract
plainn = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § ALS cases · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Since the number of expected cases was 0.77, the overall SMR was 6.5 [95% confidence interval (CI), 2.1-15.1].”
- Also stated in: § SMRs calculation · plain
“Using the incidence rates of the two Italian ALS registers as a reference, the number of expected cases during the period 1970-2001 was 0.77.”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Abstract
plainn = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § SMRs calculation · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
- Also stated in: § Study cohort · plain
“After excluding those players who were not born in Italy, the study cohort consisted of 7325 professional football players, whose age, at the last day of the follow-up, ranged from 18 to 69 years.”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Study cohort · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“None had a positive family history for ALS or other neuromuscular disorders.”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > ALS cases
plainn = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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;<5 years, 3.5, 95% CI, 0.4-12.7).”
- Also stated in: § SMRs calculation · plain
“A significant relationship between the risk of ALS and a longer duration of professional football activity was found (Table 4).”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Abstract
plaincorrelationaln = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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- Also stated in: § SMRs calculation · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When considering the playing position, a significant increase of risk was found only for midfielders (Table 3).”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > SMRs calculation
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Since the number of expected cases was 0.77, the overall SMR was 6.5 [95% confidence interval (CI), 2.1-15.1].”
- Also stated in: § SMRs calculation · plain
“Therefore, the overall SMR was 6.5 (95% CI, 2.1-15.1).”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Abstract
plaincorrelationaln = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § SMRs calculation · plain
In the paper
“To reduce the risk of misdiagnoses, only cases with definite or probable ALS (Brooks et al., 2000) were included in the study.”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > ALS cases ascertainment
What the sources say
- Not checked — no full text of the sourcecites Brooks et al., 2000 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 11
- Probably not a substantial claim. 12
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Three cases had a bulbar onset, significantly more than expected (P = 0.003).”
- Also stated in: § ALS cases · plain
“Three cases had a bulbar onset, two a spinal onset (one each in lower and upper limbs)”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Abstract
plainn = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § ALS cases · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“One of the five subjects was still playing professional football when ALS symptoms first occurred.For the other four cases, the time-period between the end of professional football activity and the onset of ALS ranged between 4 and 19 years.”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > ALS cases
plainn = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
- Also stated in: § SMRs calculation · plain
“The SMR was significantly increased in the period 1980-1989 and, to a lesser extent, in 1990-2001, whereas no ALS case was found in the first decade of the study (Table 2).”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Abstract
plaincorrelationaln = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § SMRs calculation · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The SMR was significantly increased for an ALS onset before 49 years, but not for older subjects.”
- Also stated in: § SMRs calculation · plain
“There was a significant increase of SMR for ALS onset before 49 years, whereas the risk for older subjects was not increased.”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Abstract
plainn = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § SMRs calculation · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The mean duration of ALS was 32.8 months (SD 8.1) in the four deceased cases; the duration of ALS in the only living case was 42 months.”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > ALS cases
plainn = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Interestingly, none had major traumas requiring admission to hospital or had had professional or accidental contact with substances such as metals or solvents, which are generally suspected to be related to ALS.”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > ALS cases
plainn = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Interestingly, when considering the whole series of 18 professional players who developed ALS during the study period, the mean age of onset was 51.2 years (SD 12.4, range 33-74), >10 years lower than expected.”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“The effect of football-specific traumas/microtraumas cannot be ruled out since trauma is an alleged risk factor for ALS (Strickland et al., 1996).”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Discussion
What the sources say
- Not checked — no full text of the sourcecites Strickland et al., 1996 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“which has been related to poorer results in cognitive tests in football players (Matser et al., 2001).”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Discussion
What the sources say
- Not checked — no full text of the sourcecites Matser et al., 2001 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although this preliminary study had some biases (mainly related to the structure of the football cohort), its results prompted us to perform a retrospective incidence study on ALS in a rigorously defined cohort of Italian professional football players.”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Introduction
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Several case control studies have analysed risk factors for ALS, but with inconsistent results (Armon, 2003).”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Introduction
What the sources say
- Not checked — no full text of the sourcecites Armon, 2003 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Although sport participation has been supposed a risk factor for ALS since at least the 1970s (Kurtzke and Beebe, 1980)”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Introduction
What the sources say
- Not checked — no full text of the sourcecites Kurtzke and Beebe, 1980 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“since trauma is an alleged risk factor for ALS (Strickland et al., 1996).”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Discussion
What the sources say
- Not checked — no full text of the sourcecites Strickland et al., 1996 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The mean duration of ALS was lower than expected for young onset cases, but within the range of classical ALS (Chio `et al., 2002).”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Discussion
What the sources say
- Not matchedcites Chio `et al., 2002
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainn = 5- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Two concurrent sources were used to determine the study cohort; (i) the archives of the football players pension plan (ENPALS), to which all professional football players have been obligatorily enlisted since June 1983; and (ii) the archives of the Panini Company, the major Italian football cards publisher, which has been in operation since 1961.”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Study subjects
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
In the paper
“a type of trauma relatively football-specific (Piazza et al., 2004)”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Discussion
What the sources say
- Not checked — no full text of the sourcecites Piazza et al., 2004 source
plainn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“However, currently there are few, if any, data supporting the relationship between mechanical traumas and ALS (Kurland et al., 1992;Armon, 2003).”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Discussion
What the sources say
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the possibility of an underestimation of cases in the first decade of the study cannot be ruled out; this could partly explain the absence of ALS cases in the period 1970-1979.”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Considering the professional sports in Italy, the total number of possible comparisons does not exceed 30; therefore, even after the proposed correction, the lower limit of SMR confidence interval would largely exceed 1.”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Discussion
What the sources say
- Not checked — no full text of the sourcecites Armon et al. (1991) source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The total number of possible comparisons among professional sports in Italy does not exceed 30.
In the paper
“The suggestion that one or more toxic substances may act as triggers for ALS is not new”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Discussion
What the sources say
- Not checked — no full text of the sourcecites Mitchell, 2000 source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“although no specific substance has yet been identified, even in the ALS high incidence foci of the western Pacific (Mitchell, 2000).”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > Discussion
What the sources say
- Not checked — no full text of the sourcecites Mitchell, 2000 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
The total number of possible comparisons among professional sports in Italy does not exceed 30.
“Considering the professional sports in Italy, the total number of possible comparisons does not exceed 30; therefore, even after the proposed correction, the lower limit of SMR confidence interval would largely exceed 1.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“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]
The cited source says what the claim attributes to it.
In the citing paper
“The latter category includes professional or intense recreational soccer playing, which has been associated with ALS in some reports (17;50).”
From Association of ALS with head injury, cigarette smoking and APOE genotypes (2010) · cites this paper as [17]
In the citing paper
“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]
In the citing paper
“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]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > ALS cases ascertainment
“death certificates obtained from the Italian Statistics Bureau (ISTAT) for the period 1970-2000”
§ Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players > ALS cases ascertainment
“1980-2001, ICD-9 code 335.2”
Citations
Cites
El Escorial revisited: revised criteria for the diagnosis of amyotrophic lateral sclerosis
Brooks, B. R., Miller, R. G., Swash, M., & Munsat, T. L. (2000) · Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders · doi:10.1080/146608200300079536 · Cited by 5,433
Rowland, L. P., & Shneider, N. A. (2001) · New England Journal of Medicine · doi:10.1056/nejm200105313442207 · Cited by 1,913
Incidence and prevalence of ALS in Ireland, 1995–1997: A population-based study
Traynor, B. J., Codd, M. B., Corr, B., Forde, C., Frost, E., & Hardiman, O. (1999) · Neurology · doi:10.1212/wnl.52.3.504 · Cited by 292
Bach, J. R. (2002) · Chest · doi:10.1378/chest.122.1.92 · Cited by 272
Early symptom progression rate is related to ALS outcome: A prospective population-based study
Chiò, A., Mora, G., Leone, M., Mazzini, L., Cocito, D., Giordana, M. T., Bottacchi, E., & Mutani, R. (2002) · Neurology · doi:10.1212/wnl.59.1.99 · Cited by 266
Sexual differences in onset of disease and response to exercise in a transgenic model of ALS
Veldink, J. H., Bär, P. R., Joosten, E. A. J., Otten, M., Wokke, J. H. J., & van den Berg, L. H. (2003) · Neuromuscular Disorders · doi:10.1016/s0960-8966(03)00104-4 · Cited by 252
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Focus on the heterogeneity of amyotrophic lateral sclerosis
Bendotti, C., Bonetto, V., Pupillo, E., Logroscino, G., Al‐Chalabi, A., Lunetta, C., Riva, N., Mora, G., Lauria, G., Weishaupt, J. H., et al. (2020) · Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration · doi:10.1080/21678421.2020.1779298 · Cited by 67
Pagani, M. R., Reisin, R. C., & Uchitel, O. D. (2006) · Journal of Neuroscience · doi:10.1523/jneurosci.4394-05.2006 · Cited by 67
Metadata
- 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 › Clinical 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-11-07, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-11-07 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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