The Industrial Injuries Advisory Council was first urged to consider neurodegenerative disease in footballers almost two years ago after the University of Glasgow published landmark research which showed that former professionals were 3.5 times more likely to die of dementia.
The usual threshold for an illness to be deemed an industrial disease is if employees are at a doubled risk and, having begun studying the evidence among former footballers, the IIAC has decided to widen its inquiry to a range of contact sports. This will certainly include rugby, where former players in both the union and league codes with early onset dementia are currently taking legal action against governing bodies, and potentially also boxing.
Although families of former participants in rugby will welcome the decision to also consider their sport, there will be frustration within football at the ongoing wait for a decision on their application at a time when many families are in acute need.
The recognition of neurological disease in football as an industrial illness would mean that families could receive a statutory benefit that is available on a sliding scale of up to £180 a week.
The Glasgow study considered the medical records of almost 8,000 former professional footballers and has been extensively peer reviewed. No such extensive study has been conducted on former rugby players or boxers.
The football submission was made in January 2020 by Dr Judith Gates in collaboration with the charity Jeff Astle Foundation. Dr Gates has since founded the charity Head for Change. The application also has the backing of the Professional Footballers’ Association, whose new chief executive Maheta Molango, has won praise over the past week for his work in separately trying to create an industry-wide care fund for former players and their families who are being faced with huge care costs.
Dawn Astle, the daughter of former England striker Jeff, said that she was “beyond delighted” by the PFA draft plan for a football care fund. Penny Watson, the wife of former England captain Dave Watson, also praised the PFA’s work under Molanga, who replaced Gordon Taylor in July. “I know that he has taken the time to visit families of former players to hear what they have to say and more importantly what they need,” she said. “These visits have not been publicised as he is not interested in any glory, does not have an ego but just wants to do the right thing.”
A study last month of 146 former rugby players did suggest a link between multiple concussions and significantly worse brain function above the age of 75. This focussed on players from the old amateur era. A separate study, which was funded by The Drake Foundation, also found that 23% of current elite adult rugby players had abnormalities in brain structure.
A group of former players, including 2003 Rugby World Cup winner Steve Thompson, are taking legal action against rugby authorities over brain injuries they have suffered during their career.
Thompson, who is suffering from early-onset dementia, says he no longer remembers playing for England in the World Cup 18 years ago and there are fears that the game has become significantly less safe during the professional era.
Bobbie Goulding, Paul Highton and Jason Roach are part of a group of 10 ex-professional rugby league players who have been diagnosed with early-onset dementia and probable CTE and have launched their own legal action.
Q&A: What does treating dementia in rugby as an industrial problem entail?
What is the Industrial Injuries Advisory Council?
The Industrial Injuries Advisory Council (IIAC) is an independent scientific advisory body that advises the government on industrial injuries benefit. They consider published medical and scientific research, and make recommendations to update the list of diseases and occupations for which benefit can be paid.
What evidence is needed for a disease to be recognised as an industrial illness?
The IIAC looks for evidence that the risk of the disease is at least doubled for those working in that type of job.
The council usually requires at least two studies as well as wider evidence before ruling that a particular disease should be classified as an industrial injury. A large study of almost 8,000 former players by the University of Glasgow found that former footballers are 3.5 times more likely to die of dementia. The disease chronic traumatic encephalopathy – a type of dementia associated with head impacts – has separately also been found at post-mortem in a disproportionately high number of former footballers. A study in Italy found that former footballers were five times more likely to suffer motor neurone disease before the age of 45. This was broadly consistent with the Glasgow research which found a four fold increased risk of death by the disease among former professionals.
How would it help former players and their families?
Having neurodegenerative disease formally recognised would allow players to make a claim for Industrial Injuries Disablement Benefit, as is the case with more than 70 other diseases which are included in the scheme.
This is a capped weekly benefit paid to people who become disabled because of an accident at work or due to certain prescribed diseases caused by their job. The current government guidance suggests that people with industrial illnesses are assessed and, depending on the severity, are entitled to benefit on a sliding scale up to around £180-a-week.
Why don’t the sports themselves support their former players?
Some industries with serious industrial injuries have also launched their own compensation schemes, such as the Coal Workers’ Pneumoconiosis Scheme. The National Football League in America has set up a ‘Concussion Settlement Fund’ to help families of former players with neurodegenerative disease and has so far paid out almost £730 million.
The Professional Footballers’ Association announced last week that it had agreed a draft plan with the Premier League, the Football Association and the English Football League for a care fund for former players.