The FIELD study, which was published in October 2019, was a ground-breaking piece of work.
The independently led-research study, which was joint-funded by the FA and the PFA, made a significant step in our understanding of whether degenerative neurocognitive disease, such as dementia, is more common in ex-professional footballers and the findings have been talked about worldwide.
The findings helped us to answer the research question that accompanied our first Call For Research: "Is degenerative neurocognitive disease more common in former professional footballers than in the normal population?"
The database of 7,676 Scottish former professional footballers, born between 1900 and 1976, which was used by Dr William Stewart and colleagues at the University of Glasgow and the Hampden Sports Clinic for the study, also contained a large amount of other medical information which has been analysed.
Dr Stewart and his colleagues have now been able to use the data to look at other health outcomes in the same group of Scottish former professional footballers and the large ‘control’ group of men of the same age and social background.
The key findings from the new FIELD study demonstrate that, whilst the group of footballers included in the research did show a higher level of degenerative neurocognitive disease as a cause of death, compared to the controls, they were also approximately half as likely to suffer from a number of mental health conditions including anxiety, stress, drug and alcohol misuse and mood disorders, including depression.
This is important for two reasons; firstly, the research supports findings from a number of studies which have shown that mental health is improved in those who regularly exercise. Secondly, there had been studies suggesting that in former NFL players who were affected by Chronic Traumatic Encephalopathy [CTE], there was also a higher rate of depression and suicide. It is important therefore that given the initial findings of the FIELD study regarding dementia, there seem to be no corresponding mental health effects in this group. In fact, the contrary is true.
This is yet another important step in our understanding of the long-term health of former professional footballers.
LOUGHBOROUGH UNIVERSITY STUDY
In recent years, the FA has invested in and supported a number of studies into the long-term health of professional footballers and the impact of head injuries. To keep momentum on this, we recently commissioned the Sports Technology Institute at Loughborough University to undertake a new and distinct piece of research, which focuses on the impact of footballs.
The FA-funded study, which was overseen by Professor Andy Harland and Dr Sean Mitchell, into the impact characteristics of a range of current and historic footballs, has now been completed.
The study looked at the relationships between impact severity and the type and condition of various footballs used historically. These footballs were fired against a ‘proxy’ head, similar to those used when testing car collisions and other industrial impacts and impact forces derived. The test used the old leather balls from the last century, as well as more modern footballs. In addition, the balls were fired at the head when both wet and dry.
The key finding from the study is that when a leather ball is wet, it can weigh approximately 40% more than the dry ball, and the resultant impact force is significantly higher. The force of the dry leather ball and the modern ball, whether wet or dry, are all similar and very noticeably lower. It is not possible to draw any conclusions about the possible effects of this change in ball force from old to modern-day balls, but it does show that the point in time at which there was a change in ball type, which was a gradual change around the 1980’s, could be an important era to study in future research.
THE FA’S ONGOING COMMITMENT
Since the publication of the FIELD study in October 2019, we have made changes to the way the game is played in England, including updates to the way heading is coached, and support for the trial of concussion substitutes via world football’s governing body, the International Football Association Board [IFAB]. Even though we do not know what caused the increased dementia rates seen in the original FIELD study, we took these important steps in order to introduce possible preventive measures in our game.
Importantly, the FA has made an ongoing commitment to explore and invest in further research, in order to help build our understanding in this area. But as we have previously stated, collaboration is key, and we would like to work on this important research with stakeholders across the game, as we believe that all areas of football should come together for this meaningful cause.
In February this year, we announced our latest step in our ongoing progress. Following consultation and collaboration with our independently-chaired Research Taskforce, we agreed the principal research question for further independent research into neurodegenerative disorders in former professional footballers.
The new research question is: "What is the cause of the observed increased risk of death from neurodegenerative disorders in former professional footballers found in the FIELD study?"
We're working with our Research Taskforce and other football stakeholders to agree next steps, future funding and a potential timeline for our new Call For Research. The impact of Covid-19 has delayed our recent progress on the project, as capacity in the medical industry has quite rightly been focused on tackling the pandemic, but we plan to have a further update in the coming months.
In the meantime, the FA is continuing to support two separate research studies, with Nottingham University and the London School of Hygiene & Tropical Medicine, which are examining former professional footballers for early signs of neurocognitive degeneration. We hope that both studies will be concluded within the next two years.
I look forward to updating you further on our progress in due course.
– A full summary of the FIELD study findings can be found here
– FA Head of Medicine, Charlotte Cowie, December 2019 update can be found here
– FA Head of Medicine, Charlotte Cowie, February 2020 update can be found here