CHICAGO –A study of 14 Swedish amateur
boxers suggests that they have higher levels of certain chemicals in
their cerebrospinal fluid in the days following a bout, indicating
injuries to neurons and other cells important to brain function,
according to a report in the September issue of Archives of
Neurology, one of the JAMA/Archives journals.
About 20 percent of professional boxers develop chronic traumatic
brain injury, according to background information in the article.
Some studies have suggested that amateur boxers also damage their
nervous systems, but because their shorter bouts allow fewer blows
to the head and because they must wear safety equipment, the effects
tend to be less severe. These studies have been based on assessment
of thinking, learning, memory and other brain functions long after
boxing, rather than an immediate test performed soon after a fight.
Henrik Zetterberg, M.D., Ph.D., The Sahlgrenska Academy at Göteborg
University, Göteborg, Sweden, and colleagues obtained spinal fluids
(via spinal tap) from 14 amateur boxers (11 men and three women,
average age 22 years) seven to 10 days after a bout and again three
months later, after a rest from boxing.
At the first assessment, the
boxers reported how many hits to the head they received during the
match and underwent physical and neurologic examinations; none
showed signs of brain injury. The researchers also tested the
cerebrospinal fluids of 10 healthy men who were not boxers as
controls. Levels of several chemicals that indicate damage to brain
cells (neurons) and their axons, the thread-like extensions of the
cell that reach toward other brain cells to transmit electrical
impulses, were measured.
Seven to 10 days after a boxing match, the group of boxers had
higher average levels of chemicals known as neurofilament light
protein and total tau than they did three months later. “The
cerebrospinal fluid levels of these proteins increase in disorders
with neuronal and axonal degeneration and damage, and the increase
is known to correlate with the size of the brain lesion,” the
authors write. “When applied to the results of this study, the
increases in neurofilament protein and total tau probably reflect
damage to neuronal axons from hits to the head during a bout.”
They
also had elevated levels of glial fibrillary acidic protein, which
indicates damage to the astroglia, specialized cells that surround
neurons to insulate and support them. An increase in this chemical
was also recently found in patients who experienced severe brain
injury, and the levels were linked to the patient’s clinical
outcome. Levels of all three chemicals were significantly higher in
the seven boxers who had sustained more than 15 hits to the head or
experienced grogginess during or after a bout, compared with those
who had 15 or fewer hits to the head and no grogginess.
Compared with the non-boxers, immediately after a bout the boxers
had higher levels of neurofilament light protein and glial
fibrillary acidic protein. Three months later, the boxers still had
higher levels of neurofilament light protein than the control
subjects.
“Amateur boxing is associated with acute neuronal and astroglial
injury,” the authors conclude. “If verified in longitudinal studies
with extensive follow-up regarding the clinical outcome, analyses of
cerebrospinal fluid may provide a scientific basis for medical
counseling of athletes after boxing or head injury.” (Arch
Neurol. 2006;63:1277-1280. Available pre-embargo to the media at
www.jamamedia.org.)
Editor’s Note: This study was supported by grants from the Swedish
Medical Research Council and the Swedish Council for Working Life
and Social Research. Please see the article for additional
information, including other authors, author contributions and
affiliations, financial disclosures, funding and support, etc.
# # #
Anti-boxing lobby
http://www.ozboxing.org/health/antibox.htm
The Australian Medical Association (AMA) policy
The Australian Medical Association has for the past ten years had a
policy position that professional boxing be banned and that amateur
boxing be "discouraged". However their stated strategy was to
destroy amateur boxing first as a means of achieving a professional
ban. Other
medical bodies
such as the National Health and Medical
Research Council and the Public Health Association had issued
policies that are basicly carbon copies of the AMA resolution.
In November 1997 a revised policy was announced in Australian
Medicine journal. The AMA now says it will lobby for changes in the
rules to protect contestants. President Dr Keith Woollard was quoted
as saying "we're keen to modify the sport until such time as it is
banned". However the actual lobbying activities by the AMA since
then have not changed - they are intent on destroying the sport.
The AMA policy begins with the sweeping statement that "all forms of
boxing are public demonstrations of interpersonal violence which is
unique among sporting activities". So, a rugby tackle isn't
interpersonal violence?
The AMA policy quotes another body of self-appointed boxing experts
(the National Health and Medical Research Council) in stating that
"victory is obtained by inflicting on the opponent such a measure of
physical injury that the opponent is unable to continue...". The silvertails who wrote that line have never been to any amateur
boxing bouts; most amateur bouts are won on points, not by
knockouts.
The anti-boxing lobby
The anti-boxing arguments are an example of a phenomenon which one
philosophy writer has called " the hypocrisy of selective concern".
The same commentator notes that one of the major causes of death in
the USA is un-necessary surgery by doctors (40,000-80,000 avoidable
deaths per annum!). That number of deaths would probably shock any Chicago work injury lawyer
or malpractice lawyer. The medical community should focus on its own
problems and stop complaining about the injuries boxers receive
while working.
In reality, amateur boxing is less dangerous than many other amateur
sports.
The AMA says boxing is dangerous. Whilst amateur boxing certainly
entails risks, definitive research (and common sense) shows that
amateur boxing is no riskier than many other popular sports
including football, horse racing and skydiving.
There are occasional deaths in boxing (though there have been no
deaths in Australia asscoiated with amateur boxing). But when a
death occurs in boxing, the anti-boxing lobbies talk it up with
phrases like "Yet another boxing death" and call for boxing to be
banned; but when a death occurs in football or racing, there is no
such talk of abolishing the sport. The reaction to sports deaths is
extremely selective and loaded; so dead motor racing drivers are
praised as fallen heroes, but dead boxers are called victims of a
violent, unsafe and barbaric practice "which shouldn't be called a
sport"!
Amateur boxing in Australia accounts for negligible injuries, and
very few of them are serious. Other amateur sports (especially
football) account for massive numbers of injuries (and the social
cost thereof). In the state of New South Wales during the
twelve-year period to 1996, 49 rugby players suffered permanent
paralysis below the neck. (Rotem, T.R., Lawson, J.S., et al Severe
Cervical Spinal Cord Injuries related to Rugby Union and League
Football in New South Wales, 1984-1996 Medical Journal of Australia,
1998; 168).
To put the risks in perspective, here are some pertinent US figures
on sports fatalities:
Fatality rate per 100,000 participants Horse-racing 128
Sky-diving 123
Hang gliding 55
Mountaineering 51
Scuba diving 11
Motorcycle racing 7
College football 3
Boxing 1. 3
Cited in Cantu, Robert (Editor) Boxing and Medicine. Human Kinetics,
Illinois, 1995 (pp xi-xiii)
The "intentional injury" argument
Faced with the fact that boxing is less dangerous than many other
sports, the traditional fall-back argument is that the sport
intentionally aims to cause concussion and brain injury by blows to
the head. Other anti-boxing lobbies repeat this same falsehood.
And it is a falsehood. The aim of amateur boxing is to win points by
more skillful punches; concussing your opponent is NOT the aim. You
don't need to injure your opponent to win an amateur boxing match,
and you don't get extra points for a knockout; read the scoring
rules and see for yourself. Most amateur bouts are won on points,
not by knockout.
The corollary claim is that most injuries in other sports
(especially football) are accidental. Consider rugby; sure some
rugby injuries are truly accidental (such as inadvertent
collisions), but many of the more serious injuries are a direct
outcome of the way the game is played. Tackles are deliberate and
injuries (including concussions) are an inevitable consequence. To
call the resulting injuries "accidental" whilst calling a boxing
injury "deliberate" is irrational and dishonest.
Treating head injuries consistently
In the USA, football leads to 250,000 concussions annually and
accounts for 95% of all catastrophic sports injuries*. You don't
need to be Einstein to predict that a similar scenario applies in
Australia; but has anybody heard the AMA calling for a ban on
football?
*Cited in Cantu, Robert (Editor) Boxing and Medicine Human Kinetics,
Illinois, 1995 (pp197-198)
Health is not the issue, it's the excuse
The so-called medical arguments against boxing are not based on
objective health and safety issues at all, since some other sports
are far more dangerous than boxing, yet attract no AMA criticism
whatsoever.
Can you imagine the AMA targeting the Australian Rugby League about
the safety risks in rugby? Not likely, since the good doctors know
they'd be pilloried. But they see boxing as a "soft target" because
it's a minority sport, without funding or significant sponsorship,
and therefore easy to beat up.
The opening words of the AMA policy ("All forms of boxing are public
demonstrations of interpersonal violence ...") expose the AMA's real
objection to the sport - they are ideologically opposed to the
sport.
The rhetoric about safety and injury is simply a smokescreen for an
ideological or personal bias against boxing. Pressure an anti-boxing
proponent about their lack of facts, and they'll soon descend to
perjorative words like "barbaric" and "violent". It's this emotional
reaction that drives their opposition, and their attempts to dress
up these emotional responses in pseudo-medical terminology are
dishonest and unethical.
It's a safe bet that most of those opposed to boxing have never been
to an amateur match. How much easier it is to demonise something
when you have never seen it, and never talked to the boxers or their
families.
This page was last updated on 02 January 2006
The American Association of
Professional Ringside Physician’s (AAPRP) Medical Conference was
held September 22-25, 2005 at
the Tropicana Casino Resort in Atlantic City, New Jersey. Over 150
doctors, commissioners, members and guests attended this year’s
conference on boxing safety. This year’s program took on a greater
meaning with the news of the Leavander Johnson tragedy and the
urgency to develop protocols with the goal of preventing further
boxing deaths. A moment of silence was observed during the program
in honor of Mr. Johnson and his dedication to the sport.
The program began with Bruce Spizler, Esq. (ABC Legal Counsel)
updating the AAPRP
AAPRP Presents Medical Recommendations
to Improve Boxing Safety
At the request of boxing commissions and in response to the recent
ringside tragedies, The American Association of Professional
Ringside Physicians (AAPRP) announced today recommendations to
improve safety in professional boxing. At the recent AAPRP Medical
Conference in Atlantic City, New Jersey, the AAPRP Board Members in
cooperation with the AAPRP membership discussed immediate changes in
boxing to decrease the likelihood of additional injuries or
catastrophes in boxing. Dr. Michael Schwartz, AAPRP Chairman stated,
“It is time that we urge all commissions across the world to develop
uniformed standards to protect these athletes. In an inherently
dangerous sport, it is imperative that these recommendations be
adopted immediately in the hope of saving a life. Obviously,
additional research is needed and we ask all of our ringside
physician experts to continue to investigate and develop ringside
protocols to improve the sport.”
Below are the AAPRP Recommendations:
1) All sparring should take place with oversized gloves to minimize
the cumulative forces of the punches during training. (i.e.
Heavyweights 20-22 oz gloves...Middleweights 16 oz gloves and
lightweights 12 oz gloves, etc.)
2)Minimize head shots during training to decrease the likelihood of
pre-existing damage prior to entering the ring for the competition.
3)All states immediately adopt the minimum medical requirements of
the ABC and AAPRP. If these requirements are not adopted, the AAPRP
asks promoters and sanctioning bodies to consider not holding boxing
matches in these venues until they comply with these
recommendations.
4)Boxers who have not fought for over 12 months should not fight
more than 10 rounds. The question of inactivity raises concerns
about the likelihood of increased risks of injuries based on
inactivity and conditioning.
5)Fighter's not be permitted to lose more than 3% body weight at the
weigh-in before a fight. Additionally, no fighter gaining more than
5% body weight should be permitted to compete after the weigh-in.
6)Medial data bank is implemented immediately to follow the medical
history during a boxer's career.
7)Promoters, managers, cornermen, commissioners are encouraged to
anonymously report boxer's whom they believe are showing early
changes consistent with brain damage. This information will then be
investigated and (if necessary) be utilized to require more tests or
to terminate a boxer's career.
8)The ringside physician should remain at the venue until all the
competitors have left the
arena.
9)The ringside physician should notify the local hospital and
on-call neurosurgeon that a
boxing match will be taking place.
10) No fighter who is Hepatitis C or HIV antibody positive should be
permitted to fight even
if the virus is undetectable in their blood.
11) Further research (i.e. the medical severity index, the Impact
concussion study, rapid
HIV/infectious disease testing, etc.) is encouraged and should be
utilized to determine
those at greater risk for injury.
12) A minimum of two ringside physicians should attend every boxing
match.