ALS in Italian professional soccer players: The risk is still present and could be soccer-specific

We previously found an increased risk for ALS in Italian professional soccer players actively engaged between 1970 and 2001 (n =7325). The present study extends previous work with a prospective follow-up of the original cohort to 2006 and investigates the risk of ALS in two other cohorts of professional athletes, basketball players (n =1973) and road cyclists (n =1701). Standardized morbidity ratios (SMRs) were calculated. Among soccer players three new cases of ALS were identified, reaching a total of eight ALS cases (mean age of onset, 41.6 years). The number of expected cases was 1.24, with an SMR of 6.45 (95% CI 2.78–12.70; p<0.00001). The risk of ALS was higher for careers lasting >5 years, for midfielders, and for players engaged after 1980. No basketball player and no cyclist developed ALS. This prospective extension of the Italian soccer players cohort survey confirms the highly significant risk of developing ALS, the young age of onset, the dose-effect risk and a predilection for midfielders. The absence of ALS cases in professional road cyclists and basketball players indicates that ALS is not related to physical activity per se.

[1]  R. Trent,et al.  A gene-environment study of the paraoxonase 1 gene and pesticides in amyotrophic lateral sclerosis. , 2007, Neurotoxicology.

[2]  Sonja W. Scholz,et al.  Genome-wide genotyping in amyotrophic lateral sclerosis and neurologically normal controls: first stage analysis and public release of data , 2007, The Lancet Neurology.

[3]  E. Taioli.  Use of permitted drugs in Italian professional soccer players , 2007, British Journal of Sports Medicine.

[4]  F. Hug,et al.  Recovery kinetics throughout successive bouts of various exercises in elite cyclists. , 2006, Medicine and science in sports and exercise.

[5]  P. Cox,et al.  Commentary on: return of the cycad hypothesis – does the amyotrophic lateral sclerosis/Parkinsonism dementia complex (ALS/PDC) of Guam have new implications for global health? , 2006, Neuropathology and applied neurobiology.

[6]  T. McGuine.  Sports Injuries in High School Athletes: A Review of Injury-Risk and Injury-Prevention Research , 2006, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[7]  S. Ostojić,et al.  PROFILING IN BASKETBALL: PHYSICAL AND PHYSIOLOGICAL CHARACTERISTICS OF ELITE PLAYERS , 2006, Journal of strength and conditioning research.

[8]  R. Pamphlett,et al.  Amyotrophic Lateral Sclerosis and Exposure to Environmental Toxins: An Australian Case-Control Study , 2006, Neuroepidemiology.

[9]  M. Małecki,et al.  Paraoxonase gene polymorphisms and sporadic ALS , 2006, Neurology.

[10]  J. Haines,et al.  Paraoxonase cluster polymorphisms are associated with sporadic ALS , 2006, Neurology.

[11]  G. Baverel,et al.  Physiological differences in professional basketball players as a function of playing position and level of play. , 2005, The Journal of sports medicine and physical fitness.

[12]  P. Ince,et al.  Return of the cycad hypothesis – does the amyotrophic lateral sclerosis/parkinsonism dementia complex (ALS/PDC) of Guam have new implications for global health? , 2005, Neuropathology and applied neurobiology.

[13]  E. Beghi,et al.  Incidence of amyotrophic lateral sclerosis in southern Italy: a population based study , 2005, Journal of Neurology, Neurosurgery & Psychiatry.

[14]  M. Roderick,et al.  Drug use in English professional football , 2005, British Journal of Sports Medicine.

[15]  A. Chiò,et al.  Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players. , 2005, Brain : a journal of neurology.

[16]  L. H. van den Berg,et al.  Physical activity and the association with sporadic ALS , 2005, Neurology.

[17]  M. Thun,et al.  Prospective study of military service and mortality from ALS , 2005, Neurology.

[18]  L. Wilkins,et al.  Occurrence of amyotrophic lateral sclerosis among Gulf War veterans , 2003, Neurology.

[19]  S. Grambow,et al.  Helicobacter pylori eradication and l-dopa absorption in patients with PD and motor fluctuations , 2003, Neurology.

[20]  C. Bouchard,et al.  The human gene map for performance and health-related fitness phenotypes: the 2005 update. , 2003 .

[21]  H. Al-Hazzaa,et al.  Aerobic and anaerobic power characteristics of Saudi elite soccer players. , 2001, The Journal of sports medicine and physical fitness.

[22]  C. Burns,et al.  Mortality in chemical workers potentially exposed to 2,4-dichlorophenoxyacetic acid (2,4-D) 1945–94: an update , 2001, Occupational and environmental medicine.

[23]  A. Williams,et al.  Talent identification and development in soccer , 2000, Journal of sports sciences.

[24]  O. Hardiman,et al.  Incidence and prevalence of ALS in Ireland, 1995–1997 , 1999, Neurology.

[25]  U. Wisløff,et al.  Strength and endurance of elite soccer players. , 1998, Medicine and science in sports and exercise.

[26]  G. Belle,et al.  Risk of amyotrophic lateral sclerosis and history of physical activity: a population-based case-control study. , 1998, Archives of neurology.

[27]  A. Al-Chalabi,et al.  Amyotrophic lateral sclerosis in an urban setting: a population based study of inner city London. , 2006, Journal of neurology.

[28]  C. Bouchard,et al.  The human gene map for performance and health-related fitness phenotypes: the 2005 update. , 2006, Medicine and science in sports and exercise.

[29]  Iñigo Mujika,et al.  Physiological and Performance Characteristics of Male Professional Road Cyclists , 2001, Sports medicine.

[30]  B. Schoenberg.  Calculating Confidence Intervals for Rates and Ratios , 1983 .