A landmark study has proven beyond doubt that heading in football causes increased risk of dementia, scientists say.
Its author and a leading global expert on the issue insists we should now consider taking heading out of the sport at lower levels.
Research found that footballers who play in defence - who usually head the ball more - were most likely to develop the devastating condition.
Health records data for 8,000 professional footballers were compared to those of 23,000 similar individuals from the general public.
Lead author Prof Willie Stewart, of Glasgow University, said the findings establish that head contacts involved in attempts to head the ball is causing the increased risk.
He said footballs should now be sold with health warnings on them.
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“We know what the risk factor is here and it’s entirely preventable,” Prof Stewart told a media briefing to unveil the findings.
“We can stop this now, potentially. To do that we need to reduce, if not eliminate unnecessary heading practice in the sport.
“Is heading absolutely necessary for football to continue? Or to put it another way, is exposure to dementia risk absolutely required with the game of football?
“I think we have enough evidence to suggest to football manufacturers that they should be displaying a warning with sales of their products that repeatedly heading the ball may lead to increased risk of dementia.
“A quarter of a billion people participate in football globally. Now with this data the global game of football has to change.”
The latest part of the FIELD study adds to its earlier findings from 2019 showing footballers were three and a half times more likely to go on to develop dementia.
The new findings found dementia risk in footballers was higher depending on player position and career length.
They suggest 30% of professional footballers will eventually develop dementia compared to 10% in the general population.
Goalkeepers - who generally do not head the ball - were at the lowest risk and were no more likely to develop the brain condition than the general population.
Outfield players were generally almost four times more likely to develop dementia.
Defenders were at five times greater risk while attacking players were at three times higher risk.
Image:Getty Images/Image Source)
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Central defenders are typically called upon to make headed clearances during a game. Head contacts could also include clashes of heads when competing for the ball.
To put the increased risk in context, smokers are two times more likely to go on to develop dementia.
Prof Stewart is one of the world’s leading experts on head injuries and dementia in sport and advises both the FA, FIFA and sporting authorities in the US.
He said: “Part of what we do is work with the families and players affected by this. I tell you that none of them see this as ‘political correctness gone mad’.
“If you’ve ever had to live with dementia or seen someone dying from dementia, if you could figure out a way of preventing that you’d do everything you could to achieve that.
“I know people will say ‘football isn’t the same without heading’ and heading is integral to football.
“But rules in sports have changed continuously. In rugby the rules change every season. If we change the rules a year or two later no-one will bat an eyelid.
“This is what’s known as good public health [policy] and trying to keep us health and living as long as possible.”
Prof Stewart is a consultant neuropathologist and it was his re-examination of the brain of West Brom and England legend Jeff Astle that confirmed the link between football and dementia.
He found that Astle, who died aged 59 in 2002, was killed by a form called chronic traumatic encephalopathy (CTE) that has been found in boxers.His latest study analysed health records from players from the 1930s to the late 1990s. It found the dementia risk was similar throughout the time period covered.
It suggests modern players may still be just as at risk despite no longer using heavier leather footballs.
The longer career a player had was linked to a greater chance they would develop dementia.
The risk was three times greater than the general population in professionals who played for less than five years.
The risk was five times greater in players whose careers lasted for more than 15 years.
Prof Stewart said measures taken by the FA to limit top footballers to 10 “higher force” headers a week in training “have no basis in science”.
Prof Stewart said: “They based their recommendation on analysis of matches, so they recorded videos of matches and estimated what the forces might be, and then used that to extrapolate some kind of guidance for training.
“That would be equivalent to standing on the edge of a motorway and getting car speeds, and then heading into town and talking about good traffic measures in a city centre.”
He added: “What football should perhaps be doing rather than thinking about limitations on heading in training, which have no basis in science, they should be thinking about what would football look like without heading.
“Let’s let’s try that.”
Prof Stewart insisted children should not be put off playing football because the lifetime of activity it encourages provides many more health benefits.
Charlotte Cowie, FA Chief Medical Officer, said: “The FIELD study team, funded by ourselves and the PFA, have continued to produce insightful data that has enabled us to make changes in the game.
“We welcome these new findings.”
PFA Chief Executive, Maheta Molango, said: “The PFA would like to thank the FIELD study team.“The welfare of our players, past, present, and future is at the forefront of everything we do and this data will inform us how best to protect them and improve our services.”
Dr Susan Kohlhaas, research director at Alzheimer’s Research UK, said: “This is another piece of a large and largely unfinished jigsaw when it comes to understanding dementia risk.
“Dementia risk is complex, caused by an interweaving mixture of age, genetics and lifestyle.
“There is still more to do in order to fully understand what is causing increased dementia risk in outfield players. “This study did not look at all aspect of players’ lives on or off the pitch to determine what may be behind the increased risk.
“Football is close to the hearts of so many of us, and it’s right that authorities and footballing bodies take sensible steps to mitigate the risk of injury to ensure players can enjoy the game safely at all levels.”
Dr Christopher Morris, neurotoxicology lecturer at Newcastle University, said: “This link to heading a ball although plausible, isn’t proven and more research will be needed.”