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So much so that one advocate for football player safety says the football establishment needs to take a 90-degree turn on head trauma prevention.

He was an all-Ivy League defensive tackle for Harvard and says he lost five years to headaches from playing football.

Nowinski co-founded the Sports Legacy Institute in 2007 in response to growing evidence of the extent and severity of athletic brain trauma.

The sports community has long been aware of the danger. Rules have been implemented to lessen brain trauma. Professional football has deployed software screening tools to check players for concussions.

The Defense Department has similar tools to screen for brain injury for troops who are exposed to head trauma from roadside bombs.

But the risk of football injury has been underestimated. It was only a few years ago when Monday Night Football was introduced with an image of two colliding helmets. And helmet to helmet hits, sometimes with no flags thrown, are still seen on fall Sundays.

Conventional wisdom about head injuries is shopworn. Damage from head trauma in football is considered to arise from classic concussions, when the player experiences amnesia, confusion or loss of consciousness.

Researchers are tracing the destructive effects from insults to the head that are less apparent and much more frequent--such as a football player could experience dozens of times during a game.

And, football players have been shown to have very high rates of dementia. A Veterans Hospital study found an alarming rate of this disease upon examination of the brains of deceased football athletes.

Nowinski co-founded a center to study the disease at the Boston University School of Medicine. His co-founder of the institute and center is Robert Cantu, a Boston-area physician with a worldwide reputation for his expertise in concussions.

Today, only Oregon and Washington require high school coaches to receive training on brain trauma. Nowinski argues that by next autumn every high school football player and coach should be trained and that full-contact football be played only once a week.

I see within this unfolding story a familiar sub-text of medical uncertainty encased by cultural conservatism, both enabling bureaucratic paralysis.

This path towards an upheaval in contact sports safety conforms depressingly well to major work safety failures in the past. These failures may have a villain but the more common story has no villain. The generic précis goes as follows:

1. Worker culture (here, the manliness of violence) diverts attention to risks.

2. The risks incrementally increase (here, heavier and more powerful players).

3. Health problems emerge after long latency.

4. Management and organized labor hesitate to monkey with a winning formula (here, a shower of money).

5. Medical science is either insufficient or ignored, usually both. Nowinski wants to make football safer before the 2010 season. There are no major lawsuits--yet. The man wants to save football by changing it.

PETER ROUSMANIERE is a Vermont-based columnist for Risk & Insurance®.

December 1, 2009

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