WHY NOT BAN HEADING? MARTIN SAMUEL
DOCTOR Hubert Montague Murray was the first significant medical professional to identify a link between asbestos and death.
Before the Departmental Committee on Compensation for Industrial Diseases in 1906, Murray, senior physician at Charing Cross Hospital, related the story of a patient who presented in 1899, dying a year later.
The man was 33 and employed for 14 years in an asbestos textile factory, 10 of them inside the very dusty carding room. The patient claimed to have worked beside 10 others, and was the last survivor. He said all his colleagues had died in their thirties.
In 1924, a British pathologist, Dr W E Cooke used the phrase ‘pulmonary asbestosis’ to explain the death of a mill worker, Nellie Kershaw, and by 1928 there were sufficient concerns for the Government to commission a report from E.R.A. Merewether, its chief inspector of factories.
Published in 1930, Merewether concluded a high mortality rate among those undertaking dusty work was common in a number of industries and the role of asbestos had been overlooked. The result was the 1931 Asbestos Industry Regulations.
By then, it was already too late. Asbestos was in everything. It was a miracle substance. Heat resistant, acid resistant, strong, durable, long lasting, kept buildings warm, kept buildings cool. In 2011, it was estimated half the houses in Britain still contained asbestos. There was reluctance to ban it.
Despite Merewether’s conclusion of an irrefutable link between the substance and types of respiratory illness, despite the term mesothelioma — the type of cancer that affects the lining of the chest and lungs, and is triggered by asbestos fibres in more than 80 per cent of cases — being first used in 1931, asbestos continued to be at the heart of manufacturing.
As recently as 1967, the year United Kingdom asbestos imports peaked, the esteemed medical journal, The Lancet, wrote: ‘It would be ludicrous to outlaw this valuable and often irreplaceable material in all circumstances, as asbestos can save more lives than it can possibly endanger.’
Yet as evidence, and deaths, increased, that course of action became inevitable. Asbestos was banned in all forms in the UK in 1999. As a result of this delay, mesothelioma still kills approximately 2,500 each year, and that is expected to remain constant this decade at least.
As of last year, there were 67 countries in which asbestos was banned, but that is less than half the planet and contains some significant omissions. Russia, China, India and Kazakhstan are all huge producers of asbestos, and China are its biggest consumers, too.
The country does not have the level of fatality associated with asbestos in the west yet, but its use was at a low level before 1970, so it is expected to rise. It is very common for there to be 40 years, sometimes more, between exposure and effect. China will be the next mesothelioma wave. It is a hard addiction to shake, being such a helpful substance.
Like heading in football really. Another little miracle worker. Turns a corner, or even a throwin, into a goalscoring opportunity. Elevates those lacking technique into potential match-winners. Entire careers and reputations are built on it. Andy Carroll has generated more than £50million in transfer fees based largely on heading the ball.
Yet what we know now, beyond reasonable doubt, is that heading
kills. Not all the time, but some of it. The link between repeated heading of a football and degenerative brain disorders is proven, and every bit as much an industrial disease as asbestosis. Professional footballers are three and a half times more likely to succumb to dementia as those from outside the game.
Yet what are we going to do with this information? Continue demanding that something must be done, or do something?
The news that Sir Bobby Charlton is now the fifth member of England’s World Cup winning team to succumb to Alzheimer’s disease, brought the inevitable outpourings of emotion and opinion. Yet what was equally noticeable was how many of those commenting, no matter how deeply they felt, stopped short of drawing the obvious conclusion.
Dawn Astle (right) is in the vanguard of action for football’s victims of dementia, having lost her father Jeff, a brave, bold goalscorer for West Bromwich Albion, to chronic traumatic encephalopathy at the age of 59. She wrote of football’s ‘criminal negligence’ on the issue, spoke of the need for concussion substitutes, for limits on heading drills in training and comprehensive care plans for those already affected.
But she concluded: ‘I love football. I do not want it to change massively. You cannot eliminate risk. I do not want to see heading completely banned.’
ChrIS SuTToN set down in harrowing detail the condition of his footballer father Mike, now 76, whose symptoms developed much earlier. he, too, spoke of protocols in training, but still decided: ‘I’m not saying heading needs to be banned altogether. None of us want that.’
And he’s right. We don’t. Yet it is also frustrating every time a former player retreats into personal oblivion, to listen to what could or should be done, while not even contemplating root cause. Just as the Victorians and those who built 20th century Britain could not see the future without asbestos, football cannot see beyond harry Maguire.
For construction and other industries with asbestos in 1930, read football now in relation to heading. The early cases have been recorded, the warnings made, the suspicions confirmed. There is now an irrefutable link, with further studies yielding increasing information and understanding.
And, like the laws passed in the wake of the Merewether report, so football has passed protocols of its own, linked to heading in youth matches and training sessions. Indeed, going by the timescale of asbestos legislation, by 2089 we might be ready to face the truth. That is a lot of tragedy to endure, all because we cannot find another way to goal.
Precisely what part football played in Sir Bobby Charlton’s illness we may never know. That is the game’s escape clause right now. Some contemporaries, known for their aerial ability, have never developed dementia. And it strikes indiscriminately. Charlton is 83. There are plenty his age who suffer as he does having never headed a ball in their lives, 850,000 presently existing with the condition. As for Charlton, heading was not even a particularly noteworthy facet of his game. he had a good leap, and could certainly play as a target-man when required — Manchester united’s first goal of the 1968 European Cup final was a Charlton header — but he was no Astle, famed for his prowess in the air above all. Bobby’s brother, centre half Jack, also suffered dementia, but was a dogged, combative defender in the days of physical battles and aerial bombardments. Jack fits the profile of a player who might be vulnerable in later life. Bobby may simply have a genetic predisposition. What sets him apart from the other victims in England’s most celebrated XI is that he is the only one called Bobby Charlton. Bobby Charlton is a national treasure. Bobby Charlton with Alzheimer’s will be noticed in a way his contemporaries are not, even if the evidence is inconclusive.
Yet the wider discussion remains mired in recrimination, compensation and care, more than prevention. This is dangerous given that Dawn Astle says the foundation in her father’s name is beginning to hear from the families of those who played in the era after heavy, leather balls.
If this is the case, the hope the problem goes away with the passing of a generation appears remote. It may be the heading, not the ball that does the damage. And if that is the case it really does become an asbestos issue.
So WhErE could football go? hockey has rules governing an aerial pass, in which there must be an obvious receiver, given five metres space to control the ball. Defenders drop off, to then make a legitimate challenge. This also avoids a crowd of players chasing and waving their sticks in the air.
‘Play likely to lead to dangerous play,’ is the rather vague definition of an offence. A player can control the ball above shoulder height, but only if it is safe. It is an offence if two players have sticks raised, and the free hit goes to the team that did not chose to raise the ball.
Meaning it can be done. We presume that the only solution is to allow people to make choices, as boxers do, and pump Professional Footballers’ Association funds into Alzheimer’s charities to give victims a nicer window to stare out of, trapped in their strange world until death.
If we permit boxing and rugby and mixed martial arts, why interfere with football? And it is a valid argument. People have the freedom for all kinds of harmful acts. Why should cognitive russian roulette not be an option?
Yet there is, possibly, another way. The aerial pass in hockey is not as significant as in football — mainly because it is not a common form of assist in goalscoring — but hockey as a sport has adapted to take into account player safety, albeit it from accidental dangerous contact, rather than long-term, unseen health issues.
If football trod the same path — if a high ball had to be brought under control rather than contested, if corners and free-kicks had to be played along the ground — would the sport be ruined? Different, certainly.
More skilled, perhaps more predictable. And utterly alien at first. But ruined? Not necessarily. There are versions of the game that do not encourage heading already: five-a-side, some seven-aside, futsal.
And yet no one dare even contemplate it. The very idea that football may have an industrial injury issue on its hands, that it might have to change, is not considered, even by those who have lost most grievously. Like good insulation, the miracle of the near post inswinging corner is too precious to part with.
Maybe in another 70 years. Not in my lifetime, or yours probably. It’s a man’s game, apparently. So why the tears?