Jonathan P. Baird

Football is returning and like many, I am glad to have it back. As a life-long Philadelphia Eagles fan, I am looking forward to the NFL season and wondering how my team will fare without AJ Brown, the Patriots’ outstanding new acquisition at wide receiver.

For a few years, football has preceded without discussion of chronic traumatic encephalopathy or CTE, the neurodegenerative disease affecting football players. That hiatus is over. A new published study found that one quarter of NFL players who died over a recent six year period suffered from CTE. That is a staggering statistic. It likely means that CTE is much more common among NFL players than had previously been thought.

The study conducted by Mass General Brigham, Boston University and the Concussion and CTE Foundation found that the rate of brain disease represented an occupational hazard way beyond that found in other American workplaces. In response to the study, David Michaels, who led the Occupational Safety and Health Administration under President Obama said:

“There are workers who’ve been exposed to high levels of asbestos exposure, which leads to very high rates of lung disease. And, certainly, you know, a lifetime working in coal mines leads to very high risk of black lung disease. But a degenerative neurological disease – I’Ve never seen anything comparable.

The experts say that CTE risk comes from the cumulative effect of hundreds (if not thousands) of hits football players experience over their lifetime of playing the sport. This must be a concern at all levels of football including youth leagues, high school, college and the NFL.

CTE has also been associated with hockey, rugby, and soccer. It was first recognized in the boxing world almost a century ago. Symptoms include cognitive impairment and dementia, depression, headaches, confusion, memory loss, erratic behavior, mood swings, loss of impulse control and uncharacteristic violence. One complication is that CTE can only be diagnosed after death.

While the NFL always says it is committed to maintaining the physical and mental health of players, it has a long history of downplaying the risks associated with repeated head trauma. It is not unlike tobacco or firearms companies where big business generates and manufactures doubt to sidetrack reform efforts. The NFL denied liability when it settled the class action about CTE in 2013. Their acknowledgements have been marginal at best.

The NFL doesn’t want the CTE publicity. Very few CTE cases actually break through and achieve public notice and comment. Junior Seau, Kenny Stabler, Vincent Jackson and Frank Gifford did because they were superstars. There are many players who are relative unknowns in the NFL trenches who have died with CTE complications. These players suffer in obscurity later in their life when they are unknown and completely removed from the public spotlight.

Most active NFL players worry that disclosing concussions will put them out of the game and possibly end their career. There is a disincentive to disclose. Also, and this is very human, players don’t want to think about it because they worry they probably have or will have the disease.

The NFL has taken some positive steps like improving football helmets. Players, with a few exceptions, are now mandated to wear padded covers over their helmets known as Guardian caps during contact practices unless they have specific helmet models deemed high performance, Limiting full-contact practices is another important protocol all football teams could do. Reducing the number of head impacts could definitely help reduce CTE. Shortening the season deserves consideration as well although the league has been moving in the opposite direction.

It remains unknown why some players get the condition and others don’t. Researchers hope to do a follow-up study to the one just released that will estimate the overall rate of CTE in all NFL players at the time of their death.

The 2001 New England Patriots, a team that won the Super Bowl, has had seven former players die who were between the ages of 35 and 50 according to the Boston Globe. At least three were diagnosed with CTE.

The reality of the harm of football has not sunk in with the American public and I say that as a fan. The toll the sport is taking on players is devastating. If you think of any other workplace, would people put up with a quarter of workers dying from their job? And it is possible the numbers might be much higher. We have only learned about CTE because some players have donated their brains to be studied after their death. Much more scientific information needs to be gathered, Hopefully scientists will be able to figure out a way to diagnose CTE before death.

I think the question needs to be raised: should football continue as it is currently played? Is the cost too high? Should football be reimagined in a flag football version or some other safer incarnation?

No doubt this idea would absolutely be met with howls of protest. So many love the sport but parents particularly need to think hard about whether they want their kid taking this risk. Injuries go along with the game but brain injuries place football in a different and more dangerous category, You can replace other body parts, the brain not so much.

It is not that people want injuries but Americans seem more than willing to accept the injuries for the sake of distraction and entertainment. It is someone else’s son being harmed and the harm is not a certainty. I am not seeing a reckoning about CTE any time soon. It might take some more horrific shocks to awaken our collective conscience.