FA told of de­men­tia link 22 years ago

Baroness Mur­phy wrote to foot­ball chiefs about study As­tle’s daugh­ter calls for a par­lia­men­tary in­quiry

The Sunday Telegraph - Sport - - Front Page - By Jeremy Wil­son DEPUTY FOOT­BALL COR­RE­SPON­DENT

The Jeff As­tle Foun­da­tion has called for a par­lia­men­tary in­quiry into past missed warn­ings over the po­ten­tial link be­tween foot­ball and brain dis­ease amid rev­e­la­tions to­day that the Foot­ball As­so­ci­a­tion was first in­formed of a pos­si­ble prob­lem at least 22 years ago.

Baroness Elaine Mur­phy, who be­came an in­de­pen­dent life peer in 2004, told The Sun­day Tele­graph that she wrote to the FA in 1995 fol­low­ing a study in the med­i­cal jour­nal she was then edit­ing but that the FA “were very short and re­futed any such as­so­ci­a­tion could ex­ist”.

The ar­ti­cle had been prompted by the death of Danny Blanch­flower from Alzheimer’s and the ex­pe­ri­ence of staff at Guy’s Hospi­tal in Lon­don who had treated sev­eral for­mer pro­fes­sional foot­ballers with de­men­tia. It was writ­ten by the se­nior reg­is­trar, Dr Jon Spear, and posed the ques­tion, “Are pro­fes­sional foot­ballers at risk of de­vel­op­ing de­men­tia?” It con­cluded that “fur­ther work should be un­der­taken to as­sess the rel­a­tive risk of Alzheimer’s Dis­ease in for­mer pro­fes­sion­als”, be­gin­ning with a ret­ro­spec­tive case-con­trol study in play­ers.

Yet, it is only now, al­most a quar­ter of a cen­tury on and af­ter the As­tle fam­ily has been con­tacted by the fam­i­lies of more than 300 ex-play­ers suf­fer­ing with de­men­tia symp­toms, that the FA has com­mis­sioned in­de­pen­dent re­search that is ex­pected to largely fol­low Spear’s rec­om­men­da­tion. “I re­mem­ber writ­ing to the FA and say­ing they might be in­ter­ested in this ar­ti­cle,” ex­plained Baroness Mur­phy. “I thought it was worth them be­ing con­cerned about it and be­ing aware. I got a let­ter back say­ing they were sure there was no con­nec­tion. In ret­ro­spect and look­ing at the ev­i­dence, it seems likely that the brain dam­age caused by head­ing the ball leads to early pre­sen­ta­tion of all types of neu­rode­gen­er­a­tive dis­eases. It is time the in­dus­try, with its fab­u­lous wealth, ac­knowl­edged the toll it has taken on its play­ers and their fam­i­lies.”

As­tle died seven years af­ter the pub­li­ca­tion of the ar­ti­cle from head in­juries sus­tained through play­ing foot­ball and, while re­search was then com­mis­sioned by the FA and Pro­fes­sional Foot­ballers’ As­so­ci­a­tion, it was con­sid­ered in­con­clu­sive.

Only this year, fol­low­ing the work of the As­tle fam­ily and a cam­paign by The Tele­graph, has a new more com­pre­hen­sive project been promised that will specif­i­cally an­swer whether foot­ballers are at a height­ened risk of de­gen­er­a­tive brain dis­ease. An an­nounce­ment is ex­pected im­mi­nently on who will lead a project that is be­ing jointly funded by the FA and PFA.

The FA’s con­cus­sion pro­to­col, which has a manda­tory six-day break from play fol­low­ing a sus­pected con­cus­sion, was also only in­tro­duced in 2015.

The As­tle fam­ily said that it was “not sur­prised in the slight­est” to hear that pre­vi­ous warn­ings were ig­nored. Dawn As­tle, Jeff ’s daugh­ter, has a foot­ball mag­a­zine from 1958 in which an ar­ti­cle is ti­tled “Foot­ball’s cor­ri­dors awash with punch-drunk for­mer play­ers”.

Bry­ony Hill, the wife of for­mer PFA chief ex­ec­u­tive Jimmy Hill, who him­self died of Alzheimer’s in 2015, also says that he was con­tacted in the 1970s by a med­i­cal ex­pert who was try­ing to es­tab­lish a link.

“The big ques­tion is what peo­ple knew,” said Dawn As­tle. “There should be a par­lia­men­tary in­quiry. They keep talk­ing about what they have done ‘since Jeff died’ but this has been swept un­der the car­pet for years. It would not hap­pen in any other in­dus­try. They don’t want peo­ple to think foot­ball could be a killer.”

An FA spokesman pointed out that new re­search would start im­mi­nently and said that there was no record of any cor­re­spon­dence with Baroness Mur­phy. “The FA is com­mit­ted to re­search­ing and ex­am­in­ing all ar­eas of head in­juries in foot­ball,” said the spokesman.

At one very ba­sic level, Roy Keane is, of course, right. Chess is, in­deed, rather safer than foot­ball. The very ob­vi­ous dif­fer­ence, how­ever, was that we pretty much know and un­der­stand the risks of chess. In foot­ball, the quite star­tling in­er­tia of the au­thor­i­ties leaves us all in var­i­ous states of ig­no­rance al­though, judg­ing by the rest of Keane’s com­ments, it seems that few con­trib­u­tors to this par­tic­u­lar de­bate are less ac­quainted with the facts.

Does it re­ally mat­ter? Should we just ac­cept, as Dawn As­tle said to me on Fri­day, that “Roy Keane is Roy Keane – we lis­ten to the ex­perts”, and all just move on? No. Quite apart from the un­nec­es­sary up­set Keane has caused some of the suf­fer­ing fam­i­lies with his ca­sual use of lan­guage, the over­all tone of his mes­sage was po­ten­tially dan­ger­ous.

On the first point, it was no great sur­prise to hear As­tle also de­scribe her­self as “an­gry and up­set” at his “in­sen­si­tive” com­ments. Not only was there the com­par­i­son to chess, but also a re­peated use of the phrase “it’s part of the game” and, per­haps worst of all, “knocks” to de­scribe th­ese sorts of in­juries. Knocks? It is not pleas­ant to out­line the re­al­ity that is fac­ing lit­er­ally hun­dreds of for­mer play­ers but, when one of foot­ball’s more in­flu­en­tial and usu­ally in­tel­li­gent fig­ures speaks out so con­tentiously, it surely be­comes nec­es­sary.

Th­ese are “knocks” that, if the sus­pected link be­tween foot­ball and de­men­tia is es­tab­lished, can man­i­fest them­selves sev­eral decades later into the pre­ma­ture dis­in­te­gra­tion of a per­son’s brain. We em­phat­i­cally are not talk­ing about the sort of “knocks” that you run off or even even­tu­ally get fixed on an op­er­at­ing ta­ble.

For Jeff As­tle, who was 54 when he first be­came se­ri­ously ill, it meant not know­ing that he scored the win­ning goal in the FA Cup fi­nal. It meant not know­ing the dif­fer­ence be­tween food and wash­ing pow­der. It meant ul­ti­mately dy­ing in front of his fam­ily while he choked be­cause his brain had for­got­ten how to eat.

For Frank Kopel, who was di­ag­nosed with de­men­tia at the age of 59, it meant be­ing un­able to walk, sit or feed him­self. It meant be­com­ing in­con­ti­nent, hav­ing hal­lu­ci­na­tions and tremors.

For Nobby Stiles, a leg­end like Keane in the Manch­ester United mid­field, it has meant a 16-year bat­tle with Alzheimer’s that has left him largely asleep and, at the age still of only 75, barely able to recog­nise his fam­ily.

Th­ese were cer­tainly all brave men who, as Keane pointed out in the case of Ire­land striker Kevin Doyle, who has just re­tired due to per­sis­tent headaches, could prob­a­bly dish it out as well as take it. But when Keane says “you know your­self there is a chance you might get hurt”, does he re­ally mean get­ting dam­aged like this? Is he se­ri­ously say­ing that th­ese men knew that their lives could ir­re­vo­ca­bly crum­ble be­fore they reached 60?

And when peo­ple tell you that even non-foot­ballers get de­men­tia, it is worth point­ing out that the odds of a di­ag­no­sis in the wider pop­u­la­tion be­tween the ages of 40 and 65 are one in 1,400. We do not yet know if it is higher in foot­ball be­cause no one has com­pleted the re­search even though, as re­vealed to­day by The Sun­day Tele­graph, clear anec­do­tal warn­ings were be­ing re­ceived at least 22 years ago.

“It does up­set me and make me an­gry to hear some­one triv­i­alise it,” said As­tle. “It was in­sen­si­tive. I am not fight­ing this cam­paign for me but be­cause other peo­ple who should have been lead­ing it – like the PFA – have not got it done. I would be ne­glect­ing what is right if I walked away from this. It is about pro­tect­ing play­ers and is not just about the past, but also the fu­ture.”

In fair­ness to Keane, he did also agree with the propo­si­tion that re­search was needed and Doyle was right to re­tire. Yet the ma­cho “take it or leave it” feel to his wider ob­ser­va­tions were badly mis­guided. As if it would be im­pos­si­ble to lessen risk at least in chil­dren’s foot­ball, where young brains are still de­vel­op­ing, if a prob­lem was found.

Or as if we could not still raise aware­ness and im­prove upon a con­cus­sion pro­to­col in se­nior foot­ball that de­pends not on in­de­pen­dent doc­tors to make a risk as­sess­ment, but of­ten just a few sec­onds with club doc­tors who them­selves ad­mit they of­ten feel un­der huge pres­sure to keep play­ers on the pitch.

There also seems to be a mis­un­der­stand­ing of what cam­paign­ers want and an al­most in­stinc­tive and ir­ra­tional de­sire to pre­serve foot­ball in its ex­act cur­rent form, even when quite sim­ple changes could mit­i­gate risk. Not one cam­paigner is call­ing for a ban on head­ing for adults who are old enough to make their own de­ci­sions. What they do want is some clo­sure, some an­swers, the abil­ity for peo­ple to make in­formed de­ci­sions and a ma­ture look at how foot­ball could be made safer, es­pe­cially for young chil­dren.

They are not even ask­ing for any com­pen­sa­tion, al­though they do won­der if foot­ball, with its fab­u­lous wealth, could do more to sup­port fam­i­lies of for­mer he­roes; some of whom are be­ing forced to sell their own homes to cover care costs.

As the neu­ropathol­o­gist Dr Michael Grey also stressed: “It is about risk man­age­ment, but you can’t un­der­stand risk if you don’t do the re­search. I was sur­prised to hear what Roy Keane said. It is sad. Re­ally, re­ally un­for­tu­nate. Most pro­fes­sion­als are not mak­ing those sorts of re­marks any more. I think we are see­ing a cul­tural change but when you hear some­thing like this, it makes you re­alise that we still have a long way to go.”

Early death: Jeff As­tle died in 2002 from head in­juries sus­tained play­ing foot­ball

Fam­ily’s an­guish: Dawn As­tle (left) and her mother Laraine re­mem­ber the foot­ball star

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