Increased risk and early onset of ALS in professional players from Italian Soccer Teams.
Level 3 - non-randomized controlled study
Retrospective cohort study comparing incident ALS cases to expected population rates
PubMed 32321311 · doi:10.1080/21678421.2020.1752250
What was done
Researchers conducted a retrospective cohort study of Italian professional soccer players active between 1959 and 2000, identified via archives from an Italian soccer cards publisher. Players were followed from age 15 through 2018 for incident ALS diagnoses. The expected incidence rate was calculated as ALS cases per 100,000 person-years based on general population data, and standardized incidence ratios (SIR) with 95% confidence intervals were determined.
What was found
Across the cohort, 34 ALS cases were observed compared to 17.8 expected, yielding an overall SIR of 1.91 (95% CI 1.32–2.67). Among players aged under 45 years, the SIR was 4.66 (95% CI 2.66–7.57). The mean age at diagnosis was 45.0 years, occurring 20.2 years earlier than the general population mean age of onset of 65.2 years.
Why it matters
This study provides longitudinal evidence that professional soccer participation is associated with an elevated risk of ALS and markedly earlier clinical presentation.
Limits
The total number of players and person-years in the cohort are not reported in the abstract. Identification depended on commercial trading card archives, which might lead to selection or tracking bias, and the abstract does not report specific environmental, physical, or pharmacological risk factors.
Cited by
- supports Three epidemiological studies (in Italy, Spain, and Scotland) have linked professional soccer playing to an increased risk of ALS.