AAN 2019—Soccer raises the risk of ALS


  • Daniel M. Keller, Ph.D
  • Conference Reports
L'accesso ai contenuti di questo sito è riservato agli operatori del settore sanitario italiano L'accesso ai contenuti di questo sito è riservato agli operatori del settore sanitario italiano

Takeaway

  • Italian soccer players are at higher risk of amyotrophic lateral sclerosis (ALS) compared with the general population, and their disease develops at a younger-than-expected age.

Why this matters

  • Playing soccer involves factors associated with ALS: physical contact, sustained exercise, and possible substance use/abuse, e.g., NSAID’s and dietary supplements. These factors extend to other sports.

Study design  

  • Exposed cohort was all-Italian professional soccer players active 1960-2000, identified through sports cards.

  • Incident cases identified for 1959-2016 using social media and verified by ≥2 independent sources.

  • Standardized incidence ratio (SIR) = observed over expected incidence.

Key results

  • With 1,012,337 person-years of follow-up, 33 players developed ALS vs 17.6 expected.

  • SIR 1.9 (95% CI, 1.3-2.6) for entire sample.

  • SIR 4.7 (95% CI, 2.74-7.53) for subjects with age of onset

  • Median age at diagnosis 43.3 years vs 62.5 years for controls.

  • Risk greatest for midfielder position (SIR 2.23; 95% CI, 1.22-3.73) and division 1 (SIR 6.23; 95% CI, 3.11-11.14).

Limitations

  • Social media identified cases, risking misclassification.

  • Possible cases missed by social media.

  • Regional reference population, Lombardy, Italy.