Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players
Резко повышенный риск бокового амиотрофического склероза среди итальянских профессиональных футболистов
2005-01-05
SCID: 54.1/h62xnu2z
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amyotrophic lateral sclerosisbulbar onsetdose-response relationshipprofessional football playersstandardized morbidity ratio
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Abstract (AI)
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.
Key Findings
1
ALS incidence was markedly elevated, with an overall standardized morbidity ratio of 6.5 (95% CI, 2.1–15.1) versus 0.77 expected cases.
2
ALS onset before age 49 showed a significantly increased standardized morbidity ratio, whereas older-onset ALS did not.
3
ALS risk increased with longer professional football exposure: SMR 15.2 after more than five years versus 3.5 after five years or less.
4
Among 7,325 Italian male professional football players, five ALS cases occurred during 137,078 person-years of follow-up.
5
Bulbar-onset ALS occurred significantly more often than expected, affecting three of the five identified cases (P = 0.003).
6
The authors conclude that professional football participation may be a strong risk factor for ALS, although no cases occurred during 1970–1979 and excess risk was observed in later periods.
Research Object
Italian male professional football players from First- or Second-Division teams (1970–2001)
Research Subject
The incidence and risk of amyotrophic lateral sclerosis, including age at onset, bulbar onset, temporal trends, and dose–response with duration of professional football activity
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2005-01-05
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