Dr Willie Stewart, the specialist brain doctor whose landmark research has proven the link between professional football and dementia, has outlined his frustration at the ongoing failure of the game’s leading governing bodies to mitigate risks for current and future generations.
It is now five weeks since the Glasgow neuropathologist, Dr Stewart, presented unequivocal evidence that former professional footballers were significantly more likely to die from neurodegenerative disease.
At the time, the Football Association said their medical and advisory group had concluded that there was insufficient evidence to make changes to how football is played.
Dr Stewart, who sits on the medical and advisory group, said that “we have a long way to go before we have a consensus view - a credible view - on what happens next” and that “not enough evidence is not the same as nothing is happening and nothing needs to be done”.
Dr Stewart is advocating a review of heading in children’s football, including its removal at youngest ages, unified concussion protocols that would include temporary substitutions, restrictions in heading practice and, likening the situation to the shipbuilders and asbestos, a properly funded care scheme for the many former footballers living with dementia.
His team found that there was a five-fold increased risk of dying from Alzheimer’s Disease. To put that in context, research for the British Medical Journal in 2015 found that heavy smoking was the previously highest known risk factor for Alzheimer’s. This showed a doubled increase compared to professional footballer’s 500 per cent rise. The Glasgow study also found a four-fold increase in dying from Motor Neurone Disease, a doubled risk of Parkinson’s and an overall 3.5 increased risk of dying from dementia or other neurological diseases. Improvements in heart and lung health were also found among professional footballers and they had lower death rates due to other major diseases.
The findings on neurological disease were almost identical (though marginally higher) to a comparable study of NFL players in 2012. The NFL have so far approved more than $700 million in claims to families and made rule changes to minimise head impacts alongside improvements to their head injury management. Dr Stewart has so far heard nothing from Fifa, Uefa, the Premier League or the Football League about his team’s research.
Telegraph Sport also contacted every Premier League and Championship club to canvass their reaction and ask whether, like AFC Bournemouth, they would introduce a heading ban on their Under-12 players. Less than half answered and no club indicated any willingness to introduce similar precautions as Bournemouth or outline support for concussion substitutes.
The FA and the Professional Footballers’ Association funded Dr Stewart’s research and a taskforce will now discuss future research to focus on narrowing down the precise dementia cause.
The Glasgow study looked at 7,676 footballers born between 1900 and 1976, meaning that the youngest are in their early forties. “This is not a bygone era and there are no data to suggest that the older leather balls were more or less of a risk,” said Dr Stewart.
“I would not be confident if I were managing or playing the game of football, that there is anything in the modern game that has mitigated against this dementia risk. The only way that we could know that is to develop a time machine, zip forward 40 years, and do the study again. I don’t think it is worth risking that 40 year wait to find out we should have been changing things now.
“We know the only common risk factor for degenerative brain disease in these individuals is head injuries and head impacts. Now is the time to act.”
Although heading is exceptionally rare in the lower age groups of youth football, the wider concern is the associated risk of repeated exposure in training. The Scottish Youth Football Association (SYFA) has already proactivity advised a ban on heading for children. The International Football Association Board has convened a taskforce to consider how concussion substitutes might work.
“I am encouraged by groups like the SYFA but disappointed and a little frustrated to say the least to see the response from the professional game,” said Dr Stewart. “I certainly don’t think that the management of head injuries in football in 2019 is in any way acceptable.”
Of the care crisis among former players, Dr Stewart added: “I equate it to asbestos and the shipbuilding industry. A lot of time was spent working out how you might compensate families for what was an industrial disease.
“There was a very strong union for the shipbuilders. I think the players’ union needs to step in and say, on behalf of our current players, there will be no more 100 headers a week in training, players will go off for 10 minutes to be assessed if they get a head injury and those players living with dementia now will be getting care packages and support. When Jeff Astle passed away, football said that it needs evidence and research. Are they now saying that despite the evidence we are not going to do anything anyway?”