Re:Neurodegenerative causes of death among retired National Football League players
Everett JLehman, Deputy Director, Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational[email protected]
Misty J Hein, Cincinnati, Ohio; Sherry L Baron, Cincinnati, Ohio; Christine M Gersic, Cincinnati, Ohio
Submitted October 04, 2012
We thank Dr. Vanacore for commenting on our manuscript.[1] We were well aware of the important research that Vanacore and others conducted during the mid-2000's that found increased risk of ALS among professional Italian soccer players.[2] We note that there were position-specific and duration- specific elevations reported in one study.[3] As another author notes, further follow-up of the soccer cohort will be important due to the young age of the players in the cohort.[4] We feel the same is true for our football cohort. We acknowledge that what we found among long-term professional players may not be applicable to high school, college or shorter-term professional players. However, we do not feel that there is enough current evidence to relate type of helmet to either concussion or neurodegeneration. That is fertile area for future study. We did not report mean age of death for the players since we adjusted for race, age, and calendar year in our analysis. We noted in our discussion of study limitations that we did not have information on other possible etiologic factors, including genetic factors.
1. Lehman EJ, Hein MJ, Baron SL, Gersic CM. Neurodegenerative causes of death among retired National Football League players. Neurology. 2012 Sep 5.
2. Belli S, Vanacore N. Proportionate mortality of Italian soccer players: is amyotrophic lateral sclerosis an occupational disease? Eur J Epidemiol 2005;20:237-242.
3. Chio A, Calvo A, Dossena M, Ghiglione P, Mutani R, Mora G. ALS in Italian professional soccer players: the risk is still present and could be soccer-specific. Amyotroph Lateral Scler 2009;10:205-209.
4. Taioli E. All causes mortality in male professional soccer players. Eur J Public Health 2007; 17:600-604.
We thank Dr. Vanacore for commenting on our manuscript.[1] We were well aware of the important research that Vanacore and others conducted during the mid-2000's that found increased risk of ALS among professional Italian soccer players.[2] We note that there were position-specific and duration- specific elevations reported in one study.[3] As another author notes, further follow-up of the soccer cohort will be important due to the young age of the players in the cohort.[4] We feel the same is true for our football cohort. We acknowledge that what we found among long-term professional players may not be applicable to high school, college or shorter-term professional players. However, we do not feel that there is enough current evidence to relate type of helmet to either concussion or neurodegeneration. That is fertile area for future study. We did not report mean age of death for the players since we adjusted for race, age, and calendar year in our analysis. We noted in our discussion of study limitations that we did not have information on other possible etiologic factors, including genetic factors.
1. Lehman EJ, Hein MJ, Baron SL, Gersic CM. Neurodegenerative causes of death among retired National Football League players. Neurology. 2012 Sep 5.
2. Belli S, Vanacore N. Proportionate mortality of Italian soccer players: is amyotrophic lateral sclerosis an occupational disease? Eur J Epidemiol 2005;20:237-242.
3. Chio A, Calvo A, Dossena M, Ghiglione P, Mutani R, Mora G. ALS in Italian professional soccer players: the risk is still present and could be soccer-specific. Amyotroph Lateral Scler 2009;10:205-209.
4. Taioli E. All causes mortality in male professional soccer players. Eur J Public Health 2007; 17:600-604.
For disclosures, contact the editorial office at [email protected].