DANIEL:

So Wendy, how did you come across Doctor Rudy Castellani’s involvement in the research for the NRL?

WENDY:

Well, Doctor Castellani has been one of the many American scientists who've been involved in research programs with the US National Football League.

Audio Excerpt - Doctor Rudy Castellani:

“I'm delighted to be here. I think it's a tribute to the organisers that they'd be open minded enough to have me come and talk about some of these, some of these issues. I'm a neuropathologist, and I've studied neurodegenerative diseases quite a lot over the years.”

WENDY:

Castellani had been on my radar for a very long time as one of those sort of, if you like, contrarian scientists disputing the link between repetitive head injury and CTE.

He gave a keynote speech at the World Rugby Concussion Conference in Amsterdam in 2022, and that's where he made his remarks that, you know, CTE was a hypothesis and that he was a denier of certain aspects of the research and that this was a, you know, hypothesis that they were investigating.

DANIEL:

But just to be, just to be clear, the science is in on CTE.

WENDY:

Yeah, I think there's no doubt about that. The US National Institute of Health issued a statement a couple of years back saying that CTE was caused by repetitive head injury. This is the finding of the world's top scientists.

The view of scientists associated with the NRL and the AFL around whether or not CTE is caused by repetitive head injury, these are outlier views. These are fringe views, if you like. And that's what's been, you know, we're witnessing in this space.

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DANIEL:

From Schwartz Media, I’m Daniel James, This is 7am.

At a Senate committee last year, the NRL acknowledged the link between head injuries in contact sports and the neurodegenerative disease, CTE.

But a core member of the NRL’s concussion research group is also one of the most outspoken critics of the link between repeated head injury and CTE, calling it an “invented disease conjured out of thin air”.

So how does the NRL justify advancing a position that most scientists don’t agree with? And what are other major codes like the AFL doing about the issue?

Today, journalist and contributor to The Saturday Paper Wendy Carlisle, on the brain epidemic killing ex-athletes, and why the science is still being contested.

It’s Thursday, September 5.

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DANIEL:

Wendy, can you sketch out for us what CTE is and how our understanding of it has evolved over time?

WENDY:

Yeah, CTE stands for chronic traumatic encephalopathy. It is a form of a neurodegenerative disease. So that puts it in the same category as other kinds of dementia such as Alzheimer's, Parkinson's disease, ALS, and so on. So those are all dementias, and under that sort of umbrella of neurodegenerative diseases, those dementias, sits CTE.

What's different about CTE from the other dementias is what causes it. And, of the cases that have been identified around the world, the only known environmental cause of it is repetitive head injury. When scientists, sort of, dissect the brain, what they discover is that this disease appears in unique parts of the brain and it occurs, you know the lumpy bits of your brain on the outside? The disease tends to cluster at the base of those lumps in the sulci, and it really reflects the physics of the hit. The force of the hit just shakes at the bottom of those bits of the ripply curly bits of the brain. And so that's what they're starting to identify. Now you're hearing all about it in former footballers.

But what scientists, and particularly these are scientists who are leading this research in the United States, are finding is that CTE is not necessarily correlated with the number of concussions somebody's had. What it's correlated with is years of exposure to repetitive head injury. So these are the hits and the bumps that are routinely part of contact and collision sports.

Audio Excerpt - Football commentator 1:

“But even wider and longer is Brown.”

Audio Excerpt - Football crowd:

[Crowd noises of shock]

Audio Excerpt - Football commentator 1:

“Crunching Mark over the top of Phillips.”

Audio Excerpt - Football commentator 2:

“Ohhhh, oh he’s tapped Luke”.

Audio Excerpt - Football co-commentator 2:

“Oh my god.”

Audio Excerpt - Football commentator 3:

“Sky high Murphy, and they’re coming for him and he’s down and might be out.”

Audio Excerpt - Football crowd:

[Booing]

WENDY:

What they're discovering is that thousands of these hits over time is what causes, for some people, this brain disease.

DANIEL:

So Wendy, you've taken a closer look at the NRL. Can you tell us about the first NRL player to be diagnosed?

WENDY:

Yeah. So that, that was Steve Folkes.

Audio Excerpt - News Reporter 1:

“Tragic news. The rugby league community left in shock, after former high profiled NRL player and coach Steve Folkes passed away. The Canterbury Bulldogs…”

WENDY:

And he died in his late 50s by heart attack. He was exercising on his exercise bike at home. They could not get a proper diagnosis of why he died. They thought it was heart failure, but they couldn't really tell.

Audio Excerpt - News Reporter 2:

“The club has paid tribute to Folkes, saying his legacy as a bulldog and what he did for the club will never be forgotten and our hearts go out to his family and friends at this difficult time. Coming up shortly…”

WENDY:

And his family had been talking about Steve having, you know, memory problems. He kept reintroducing family friends to each other and it started to become a little bit of a talking point in the family. So his brain was sent to Michael Buckland at the Australian Sports Brain Bank, because Michael Buckland is the Chief Neuropathologist for the coroner, and Buckland examined his brain and he made the CTE diagnosis.

DANIEL:

Okay, so tell me about the NRL's own research, what does their research say?

WENDY:

Well, there was a couple of studies on depression and cognition and concussion, and they found that the two were not correlated. And note also that they're only looking at concussion, they're not looking at years of exposure to football, so that's a real problem. There's other studies that are looking at, what they call, is the risk of over-diagnosis in CTE. And they produced research suggesting that half of the American men who were diagnosed with depression would fit the in life criteria for the diagnosis of CTE, but that research ignores the very critical question of whether or not they were exposed to repetitive head injury for ten years or more.

They're doing a, what they call, a cradle to grave study of former NRL players which they say will take 30 years to determine whether CTE is caused by repetitive head injury. And, you know, why would you do such a study when it's already known that that's what causes it and families and former players say to you, look, we need help now? Why are they doing studies that won't come in for another 30 years, and who knows if it's actually ever going to be completed, when what we want now is help? And that's what players and former players and the families are calling out for, help now.

DANIEL:

One of the researchers that the NRL have been in contact with and have worked with is Doctor Rudy Castellani. What have you found out about him?

WENDY:

Well, Doctor Castellani is one of the, you know, go to doctors used by professional sport around the world. You know, Doctor Castellani has been on the conference circuit in, in sports concussion conferences for many years. And so his views on CTE have been repeated numerous times in the last decade.

He’s used by the NRL in their research program and he is, what he calls, quote, an unabashed denier of CTE. He claims this is a hypothesis.

Audio Excerpt - Doctor Rudy Castellani:

“I'm an unabashed denier of CTE as a well defined entity. I don't think it is clinically. I don't think it is pathologically. I don’t think the rate of progression, or whether or not whatever it is…”

WENDY:

You know, he is one of the key people, who is part of this paradoxical position by the codes.

Audio Excerpt - NRL Chief Medical Officer Sharron Flahive:

“I'd like to reiterate that the NRL takes the matter of repeated head trauma and concussion very seriously. Player safety and wellbeing are integral to the way in which we conduct the game throughout Australia.”

WENDY:

The NRL made a quite extensive submission to the Senate inquiry into repetitive head injury and contact sports and they had about 20 pages of their research.

And Castellani was named as one of, I think, the 13 researchers involved in, I think, what they call the international consortium of research into the brain health of former players.

Audio Excerpt - Senator at hearing:

“Do you recognise the casual relationship between concussion and CTE?”

Audio Excerpt - NRL Chief Medical Officer Sharron Flahive:

“CTE in its form as the neuropathological diagnosis, made post-mortem senator, there is an association with repeated head trauma. This, it's, we don't know how strong this association is…”

WENDY:

There's a lot of controversy around that research. You know, they proclaim that they are, you know, player health and safety is at the centre of what they do and they say that they're doing everything they can to make the game safer. So, let's just accept that at face value. Their research is trying to re-establish whether or not CTE is caused by repetitive head injury when we actually know that it is. And so, I think the question has to be asked of vested interests who are funding research that perhaps threatens their industries.

DANIEL:

The NRL is not the only code to have controversies with its research. That’s after the break.

[Advertisement]

DANIEL:

Wendy, we have a number of high contact sports in Australia. The NRL and AFL are the two biggest with the most at stake. What other steps are these codes taking to better understand the threat of CTE for their players?

WENDY:

Well, I think this is where it starts to get really interesting. The research that's done by the NRL and the AFL, it's not independent research. The AFL turns over $1 billion a year and they have said for more than a decade that they've got these very comprehensive research programs into head injury. And they announced their first tranche of research, you know, more than a decade ago now in 2013. And then in 2022, they had to admit that that had all been a complete fiasco after it was revealed that their top concussion researcher, Doctor Paul McCrory, was a scientific fraud who plagiarised and made up scientific quotes to make it seem that head injury and concussion was less of a serious problem than it actually is.

They announced that they were going to do a $25 million research program, and it was going to involve brain donation to the Australian Sports Brain Bank and also a longitudinal program research program, yet again trying to establish whether CTE was caused by repetitive head injury. Well, look, now, nearly three years on, those research programs do not appear to have begun.

So, once again there's a lot of controversy around the AFL's research program and whether or not they are actually telling the truth about what they’re doing, but, you know, they will, you know, when I put questions to the AFL now, as I routinely do, they don't even respond now to my questions about whether the research has begun or why they haven't begun their brain donor program. It's just shrouded in mystery, really.

DANIEL:

If you were to do a comparison with how the NRL are grappling with it and how, say, the AFL are grappling with it, what differences do you see?

WENDY:

So one of the really fascinating things that's happening in Australia is the launching of class actions by former players against the codes, and particularly the AFL. So, I think, 100 former players have launched a class action against the AFL, alleging that the AFL has done not enough to protect them from the effects of repetitive head injury, and also not not being frank with the former players about the risks of repetitive head injury.

So this, this class action is likely to run for years and it mirrors the the billion dollar class action in the United States where, I think, something like 3500 former NFL players took the NFL to court alleging a cover up of quite gigantic proportions. Alleging that the code had misled the players about the dangers of repetitive head injury, allowed them to continue to play while they were injured. And then, these former players have been suffering, you know, long term effects of repetitive head injury. And then others have been suffering lifelong effects of depression, cognitive damage and even the development of other clinical diagnosis of dementia such as Alzheimer's and Parkinson's. So I think, at last count, the NFL's up for around $2 billion. So, you know, it's just not going to go away. It's just going to keep getting bigger.

And the AFL has just announced they're going to spend $1 billion recruiting new players to the game over the next ten years. So it's, it’s a huge amount of money. And they say that they're spending $25 million on research. You know, so it speaks volumes to the concern the codes have around if not addressing this issue, which some would say is not really being addressed, but to managing public perceptions around the issue.

DANIEL:

What else are experts that aren't paid by the big sporting codes saying in terms of preventing CTE?

WENDY:

They're saying reduce contact training sessions.

Audio Excerpt - News Reporter 3:

“He wants the AFL to limit full contact training by 2025; employ an independent concussion spotter, separate to club medicos, with the power to remove a player from the field; improve players' education about CTE; and to increase the number of players wearing special mouthguards that detect head knocks.”

WENDY:

These were the recommendations of the expert witness in the Shane Tuck coronial. But, as yet, neither code is embracing that. I'm not sure that they’re really grappling with it yet but, I think that as the threat of legal action increases, the codes will be under greater pressure to demonstrate that they're actually reducing the risk to prevent CTE.

DANIEL:

Do you think there'll ever be a medium between the tension around player safety and the spectacle of the game? You reckon that there's some way that that medium can be found?

WENDY:

Well, we love the game, don't we? We love the hits. That's what we love. We love that competitive physicality of the game. These are very big sports. They're very popular. But I do think that, you know, the games have always changed and they've survived. We've had rules that, you know, particularly in the NRL and the AFL that have sped the game up and the players are fitter and stronger than they have ever been. So it's a, it's a simple question of physics, isn't it? The hits are bigger. The games are more intense, they're faster. I mean, I don't think the game will ever end or will die, I just think it will evolve to be safer.

DANIEL:

Wendy, thank you so much for your time.

WENDY:

Thanks so much, Daniel.

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DANIEL:

Also in the news today,

Australia's economy grew by 0.2% in the June quarter, and 1% over the last year, according to figures from the Australian Bureau of Statistics.

Excluding the COVID-19 Pandemic period, it’s the weakest rate of annual growth in Australia since 1991-92, the year which included the recovery from the 1991 recession.

The slowdown in economic activity is in line with the RBA’s forecasts, however making any sudden interest rate move from the Bank’s board unlikely.

And, the spring bushfire outlook has shown an increased risk for large parts of Queensland and the Northern Territory, as well as the south-west of Victoria and neighbouring areas in South Australia.

It comes as the Bureau of Meteorology is forecasting an increased chance of higher than average temperatures across many parts of the country from August to October.

I’m Daniel James, 7am will be back tomorrow.

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