Jeff Astle: How a career of heading footballs led to death

In the UK, 1 million people come to hospital with a head injury each year. Damage to the scalp or the skull is usually relatively easy to deal with, but the most pernicious problems arise for the people who have done damage to their brains. What’s particularly concerning is that what can seem like a relatively minor injury at first can cause some patients to deteriorate very quickly. Here’s Dawn Astle, daughter of West Brom and England footballer Jeff Astle, who died in 2002 aged 59 from accumulated brain trauma likely sustained during his playing career…

Dawn - When my dad was about 54, in 1997, we noticed that he was just acting a little bit strangely, and saying things that were odd. He couldn't remember my son's name when he was born. He asked whether his mum was still alive and my grandmother had died some 16, 18 years before. And we didn't really understand what was happening to him. My mum was really worried. Mum said to him 'please go and see the doctor, Jeff. I'm worried about you'. And he agreed. So mum literally rang the local medical unit up and they did some tests with him there. The doctor said to my mum, 'I'm sorry Lorraine, but I think Jeff's got early onset dementia.' Mum was just absolutely devastated as we all were. And so tests and scans followed and they basically said that dad's frontal brain cells were dying and there was nothing anybody could do. From that day on, really, the disease took more of a hold as the weeks and months passed. He was incredibly restless still. He became aggressive at times and he was never like that. He was on the sofa surrounded by everything that he'd won in football, you know, England caps, FA Cup winner's medal, League Cup winner's, medal. But he remembered none of it. And I always say that sort of looking back now, everything football gave him, football took away. The day he died, it was 19th of January, 2002. And I remember that day as if it were yesterday. And to be honest, that day continues to haunt me every single day. It was while we were eating this little birthday tea I'd put on, he started to cough and it was getting worse. And I remember my partner and my brother-in-law helped him to his feet, but then his legs gave away. We took him outside, just to get some air. But this coughing just seemed to get worse. And we were screaming at him, literally screaming for him to spit the food out. You could tell there was food there, but he wouldn't spit it out. We were trying to open his mouth to get this food out. We just couldn't do it. It was just horrendous. And then there was that realisation as, 'oh my God, is he breathing?' And I remember calling 999 and myself and my partner were giving him CPR and it was just the most horrendous thing. Sadly dad ended up choking to death. There was nothing any of us could have done to stop it. And believe me, God believe me, we tried.

James - I can only imagine how difficult, thank you so much for sharing that. You mentioned it was the game he loved and lived for that eventually ended up taking his life. Is that something that was at the forefront of you and your family's minds after the diagnosis and as his condition got worse?

Dawn - I don't know. I don't know whether it was at the forefront because, to be honest James, we didn't really talk about it very much. I guess in the background, there was always that 'I wonder if,' 'could it be' type of question that we all had. Dad didn't have many opinions on many things, probably apart from football, cricket, and horse racing, to be honest. But one thing that he really believed in and was quite passionate about was, believe it or not, organ donation. And mum, when asked about donating dad's brain after he passed away, she had no hesitation. I guess little did we know all those years ago how much his brain would reveal. And thank God we did.

James - What exactly was it that came to light after your dad had passed away and his brain was handed over to the doctors?

Dawn - Mum had already had a phone call from somebody from the coroner's court saying that there was going to be an inquest into Dad's death. And it was during the inquest when the pathologist, Dr. Robson, stood and described how badly damaged my Dad's brain was, and it was something we weren't ready for and something that was very hard to listen to. And he found that there was considerable evidence of trauma to his brain, and it looked like the brain of a boxer. But he said that the main candidate for this trauma, which apparently was right through the brain, right from front to back, left to right, was the heading of footballs. But it was the repeated heading. I think that was the key that appeared to be the problem. And then having listened to that, it was her Majesty's Coroner, then Andrew Hague, who actually said, 'Mr Astle's type of dementia is entirely consistent with heading footballs and his occupational exposure has made at least a significant contribution to the disease, which has caused his death.'

James - It was given his position on the pitch, perhaps, right at the business end where he was being asked to head the ball a lot, unknowingly putting himself at extra risk compared to some of his teammates.

Dawn - Oh, definitely. We know now, our footballers are five times more likely to die with Alzheimer's disease than you and I, and they're four times more likely to die with motor neuron disease than you and I and twice more likely to die with Parkinson's disease. But that data, which the Field study uncovered, also showed us that a former professional footballer's length of playing career and player position is tied to higher neurodegenerative disease risk. So the centre halves, five times more at risk. Again, centre forwards, nearly four times more at risk. So dad was a centre forward, and his professional career was I think about 17 years.