Talk of concussions in the NFL has been all the rage in last couple of years, and rightfully so. There is a lot that science is learning about the long term effects of repetitive head injuries on someones long term health, both physical and mental, but there is still a lot we don't know or understand. However, that lack of scientific insight hasn't stopped people from taking strong stances on the issue. The most common “knee-jerk” reaction are comments like “Come on, man! What is there to study? All that banging heads together, of course it's not good for you! Of course it's gonna mess guys up in the head.”
The most recent link between Mild Traumatic Brain Injury (mTBI) and off the field mental health has been the issue of suicide amongst former NFL athletes. In just over the past year-and-a-half, four former NFL players (Ray Easterling, Dave Duerson, Junior Seau and O.J. Murdock) have committed suicide, adding more fuel to the already heated debate over the long term effects of brain injuries and the game of football. One recent headline even read “Junior Seau and the disturbing NFL suicide trend”. Scary stuff, but “trend”? Is there even any hard evidence to back up these sorts of claims?
The NFL has taken a lot flack for what many consider their “nonchalant” response to the concerns surrounding mTBI and their game, so much so that the United States Congress got involved and have grilled NFL officials and doctors on the matter. Specifically, Dr. Ira Ca**on the former NFL doctor, told Congress that there was no proven link between football head injuries and brain disorders. Evidence since that statement has all suggested otherwise. But, the idea of “brain disorders” is a pretty broad one. In there are included everything from Alzheimer's disease to dementia and Parkinson's and even depression. Teasing these out and searching for an indisputable link between each disease and mTBI will take some time, mainly because the only way to truly see, on a microscopic level, what is going on in the brains of the men in question is to examine their brain tissues after they have pa**ed away. Here's Where It Gets Interesting: A recent study done by a group of researchers at the National Institute for Occupational Safety and Health (NIOSH) looked at the mortality (a measure of the number of d**hs) among 3,439 retired football players who had played at least five years in the NFL between 1959 and 1988. Their report appeared in Volume 109, Issue 6 of the American Journal of Cardiology and what they found, well, may surprise you.
“Overall,” the study concluded, “retired NFL players from the 1959 through the 1988 seasons showed decreased all-cause and (cardiovascular disease) mortalities compared to a referent United States population of men.”
In other words NFL players, in general, live longer. Wrap your head around that for a second. If you're anything like most people, you're probably asking yourself “How is that possible? You mean to tell me these guys lived longer lives than guys in the general population?” Yes. That is exactly what this study found.
Researchers point out that these players for the most part lived “healthier” lives. For example, they are less likely to smoke and were in good overall health- all of which would contribute to their lower than expected likelihood of dying compared to the general United States population.
Even more interesting were the results when it came to d**hs due to suicide. Researchers found that 9 former players died through suicide. Based on the numbers seen in the general population in men of the same race, age etc., the number was expected to be closer to 22. In short, the actual percentage of d**hs due to suicide was 59% less than what they expected to find.
Now, although the NIOSH study indicated that NFL alumni are less likely to commit suicide than others, this shouldn't be interpreted as “the NFL is off the hook”. This same study found that 12 of 3,439 players died of “diseases of the nervous system and sense organs”. Only 9.7 men in the general population would have died of these causes. So, there's still work to be done and the NIOSH plans on a more complete study examining this small group of former NFL players.
This study likely raises more questions than answers, but it's a step in the right direction. One thing is clear however, these issues aren't going to be solved with a few changes in the rules on the field or a better built helmet. The best thing we, as both physicians and consumers of the game, can do is ask questions and demand answers. It's going to take time, but slow motion is better than no motion.