Rugby, concussion and illness

Sir, – Obviously most people are not elite rugby players. About 1 per cent of adults play it at any level. And many of the illnesses linked to it, such as motor neuron disease, are quite uncommon. So it will probably remain very difficult to convince people of a link between a rare risk factor and very rare consequence if they are sufficiently motivated not to see it.

Tim Lynch and Michael Farrell advise against over-interpretation of a recent Glasgow Study linking rugby to motor neuron disease (MND) and other neurological conditions (“Simplistic commentary on rugby concussion unfair”, Tim Lynch and Michael Farrell, Opinion & Analysis, December 5th). While this is probably a reasonable position to take, the suggestion that there might be a “specific genetic make-up that predisposes to high-level sport” and also to an “increased risk of motor neuron disease” has no evidential basis to support it.

They ask “is vigorous non-contact sport associated with MND?” as if it were an unfathomable conundrum. But studies from the US comparing Major League Baseball players with Gridiron football players (non-contact and contact respectively) show the latter to have three times the risk of neurodegenerative disease and significantly increased long-term overall mortality.

They propose a long-term study of brain structure and function “to track sports men and women through life to death”. One would presumably need to identify at the earliest ages those who are going to become elite performers, or at least stick with the sport studied. As around one in 50,000 people get MND per year the study would need to be enormous in its intake. There are less than 100,000 rugby players on the island, so almost all would need to be included. Obtaining consent from such a group – very many of whom are children – would be difficult in the extreme.

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Research on such a scale is not really feasible, hence the need to take seriously the recent study from Glasgow. Meanwhile the cases of neurological illness in elite players, such as Dodie Weir, Steve Thompson, and Joost van der Westhuizen, will continue to trouble the consciences of rugby fans, as we wonder what is the real cost of the sport and spectacle we follow. – Yours, etc,

BRIAN O’BRIEN,

Kinsale,

Co Cork.