Concussions

In the upcoming days of the annual NFL spring meetings this week, there was a lot of discussion going on about the NFL and the obvious problems of negative long-term health effects of the game on players. In the wake of Junior Seau's tragic death, the question of the NFL's responsibility for retired players is more prominent than ever.

One phenomenon that was often downplayed or even ignored is the number of concussions professional football players suffer from during their careers. The league is facing an avalanche of lawsuits from former players who argue that they suffer from neglected long-term effects from ignored head injuries and concussions. While the NFL was quick to release a study which should prove that retired NFL players actually live longer than other people. The study, carried out by the National Institute for Occupational Safety and Health (NIOSH), is focusing on all retirees who played in the NFL for at least five seasons from 1959 through 1988. It argues that playing in the NFL actually offered health benefits. While I do not know the exact details of the study (some results are presented here), I am sure that most of the problems you will face when evaluating the healt effects of a certain activity, were not dealt with adequately. Of course, the group of NFL player is highly selected and in order to make it to the NFL, you have to be in above-average health conditions already. So there is a lot of potential for sample selection bias and there is definitely not the full information on injuries like concussions. Moreover, the study has no power to prove any form of causality between playing in the NFL and long-term health effects.

What should be evaluated is the effect of playing in the NFL compared to other sports. We, and definitely the NFL, should be interested in the influence of the number of concussions on long-term health and brain conditions in retirement age. The NIOSH study concludes that former NFL players had a much lower rate of death overall compared to men in the general population. This does by no means surprise me. And it has no power as evidence that former NFL players do not suffer from negative effects when they have retired.

It will be interesting to see how Commissioner Goodell will address this issue in the future and at the spring meetings. The current stance of the commissioner on the Saints "bountygate scandal" indicates that the problem of (head) injuries and possible consequences has already been addressed. My intuition is that the danger of losing a huge amount of money in upcoming lawsuits is the main reason for this. The long-term health of players, however, should be the only reason. The NIOSH study does not tell us anything (new). While the neurologists are already working on the issues, a lot of further research in this area is needed.