Soccer's Side Effect

From the weary voice at the other end, Fulvio Collovati knew right away that his buddy was in trouble. Since their days as teammates at Genoa a decade earlier in Italy's top football league, he and Gianluca Signorini telephoned each other often. But this time, Signorini, once a rugged defender, had to strain just to speak. "I'm not well," he told his friend. An intense, unfamiliar pain was spreading through his back. The doctors were worried. He was scared. Collovati — currently general manager of the northern Italian squad Piacenza — shakes his head recalling that conversation in November, 2000. "I had talked to him just a week before. Everything had been fine."

Not long after, the diagnosis was conclusive: amyotrophic lateral sclerosis (als), a rare and fatal neurodegenerative disease that attacks nerve cells and pathways in the brain and spinal cord. Signorini was helpless against the progressive paralysis that eventually froze every part of his body. He died six months ago at 42, leaving a wife and four children. Seemingly out of nowhere, a once tireless athlete is crushed by this cruel and mysterious illness, commonly called Lou Gehrig's disease in the U.S., after the legendary baseball star struck down by ALS.

The high prevalence of ALS among footballers is the latest distressing news about the health risks of being a pro athlete. Some of those issues are known, and others related to drug use, says Raffaele Guariniello, a Turin prosecutor who has investigated doping in football and cycling. A study of health records of some 24,000 Italian football pros from 1960 to '96 turned up nearly twice the typical rate of liver, pancreatic and colon cancers. Sometimes unwittingly, footballers have used steroids, such as nandrolone, which are known to raise the risk of certain cancers.

The now-anecdotal link between athletes and ALS is unexpected, and alarming. The Italian study uncovered eight cases over the past three decades, when the expected incidence of this rare disease, which strikes one in 50,000 people, is less than one. Moreover, Guariniello says, there are reports of at least another 20-plus previously unrecorded examples, including Signorini's. In February another former Serie A player, Adriano Lombardi, announced he has ALS. And last month, Ubaldo Nanni, who played for third-division Pisa, died at 44 after three years with the illness.

There is ALSo concern in England, where the governing Football Association is probing the ALS deaths of several former players, including Don Revie, active from the 1940s to the early '60s, and Willie Maddren, whose injury-marred career ended in 1977. Belinda Cupid, research coordinator for the Association for Motor Neurone Disease (as the illness is called in Britain), said there are some early indications that excessive athletic activity may contribute to ALS. Other potential factors: exposure to pesticides, chemicals and heavy metals.

The relative scarcity of research makes drawing conclusions difficult. The latest study, unveiled last week in the Journal of the American Academy of Neurology, suggests that ALS sufferers are more likely to have chromosomal abnormalities. Guariniello told Time that players who get ALS had a higher ratio of leg injuries, perhaps implicating certain treatments. Even painkillers may be a risk, he says. "We tend to think it's a combination of smaller factors that accumulate," adds Cupid. "The trouble is that these studies are dotted all around the world, and it's hard to compare the data."

When Guido Vincenzi played in the 1950s and '60s, there were often no substitutes on hand in case of injury. "They just stayed in, otherwise their team would be down to 10 men," said Daniela Cantamessa Vincenzi, whose husband died of ALS in 1997 at age 64. Vincenzi doesn't question the injections given to her husband to keep him on the field. But, she adds, "if I were a player today, I would ask every time they gave me something." Collovati, likewise, has no suspicions about his friend's death: "I just think fate was cruel to him."

Collovati organized a testimonial game of ex-players in Genoa to honor their ailing comrade, six months before his death. The crowd of 25,000 roared as Signorini was pushed around the field in a wheelchair by his children, who were too young to remember seeing their father play. Rereading a print-out of a thank-you e-mail he got afterward, Collovati takes a deep breath. "You gave me great joy," Signorini wrote to his friend. "You made my children understand who their father really was."