Head injuries in sport should be treated as public health issue, leading doctor says

Research from Trinity College Dublin and St James’s Hospital identified a significant proportion of retired athletes show persistent disruption of the blood-brain barrier, a critical protective system. File picture

Experts will on Wednesday demand head injuries in sport to be treated as a public health issue, warning even routine collisions on the pitch may be driving long-term brain injuries.

Professor Colin Doherty, head of the School of Medicine at Trinity College Dublin, will call for a move from self-regulation by sporting bodies, and for the establishment of a publicly funded national concussion centre.

He will say alongside sport's benefits, “there is now a body of scientific and clinical evidence that we can no longer ignore”.

Recurrent head injury in sport, including both concussion and the much more frequent sub-concussive impacts that do not cause immediate symptoms, is associated with long-term risks to brain health.

Research from Trinity College Dublin and St James’s Hospital identified a significant proportion of retired athletes show persistent disruption of the blood-brain barrier, a critical protective system.

“In some individuals, this barrier remains compromised years, and in some cases decades, after they have stopped playing sport.” 

These long-term changes do not appear to be explained simply by the number of diagnosed concussions an athlete has sustained, according to Professor Doherty.

“Rather, they are more closely associated with the cumulative exposure to repetitive head impacts over time. In other words, the everyday collisions that are often considered routine in many sports may, in aggregate, be driving long-term brain injury.

“Some former athletes present with symptoms consistent with what is termed traumatic encephalopathy syndrome, including cognitive impairment, mood disturbance, and behavioural changes. 

There have also been well-documented cases, some involving Irish athletes, who have died with full-blown dementia, also known as chronic traumatic encephalopathy, or CTE.

However, Ireland currently does not have a comprehensive national system to track head injuries or cumulative exposure across different sports and levels of participation.

“Concussion protocols vary between sporting bodies, and sub-concussive impacts are largely unmeasured and unregulated.”

This issue should no longer be viewed solely as a matter for individual sporting organisations, Professor Doherty will say. 

"In fact, it is unfair to put this burden on these organisations to deal with alone. It should be recognised as a public health issue requiring coordinated national leadership."