New Zealand should prepare for a wave of former rugby players suffering degenerative brain disease, after repeated knocks on the field, an Australian player agent says.
Peter Jess, who fights for compensation for former Australian Football League players with brain injuries, believes New Zealand Rugby needs to set up a fund for affected players here.
"It is the elephant in the room," he told Checkpoint.
"It has been my proposition for the last 10 years, I've been fighting for justice for the athletes we have in the AFL."
He said he has also spoken to rugby union and league players associations about it.
"They're all aware of the fact that the incontrovertible truth is collision-based sports create long-term neurological damage.
"What we are seeing is the classic tobacco play where the authorities cobble together a cabal of scientists to deny, deny, deny.
"So I think we're up against it, it'll be a long fight."
Chronic traumatic encephalopathy [CTE] is the brain disease affecting retired players, and it starts off as chronic neuropathic logical impairment [CNI], Jess said.
"We tracked it over five-year period … the measurable changes to the structure of the brain, where the player was engaged in repetitive collisions.
"It doesn't necessarily need to have a head knock. It is the transfer of the energy from the body to the brain.
"We found that 87.5 percent of the players that we tested after five years had [CNL]. After 10 years. It then moved up to 92 percent of the cohort.
"We tested both elite cohorts and sub-elite. That means the weekend warrior - his results mirrored exactly what took place if you're playing first grade rugby."
They tested 120 players, mostly retired but of various age groups, he said.
"What we found is we actually don't understand when CNI transitions into CTE, but with the anecdotal stuff we're seeing it appears to be possibly 15 to 20 years after they finished playing football."
Players' family members start to see changes in mood, behaviour, cognition and motor skills, he said.
"The most catastrophic problems are in the first two, with mood and behaviour. It's anger management, it's excitability where they take increased risks.
"If the partners and wives survive the first two pillars, and move into the dementia stage, they then become the carer.
"It is absolutely horrific. Fine, fit, young, healthy men at the peak of their sporting lives have now effectively walked into the black. They actually don't understand anything.
"The percentages of marriages that break down with collision-based sports people is above the national average."
The major sporting bodies have known about it for up to 40 years, Jess said.
"Not only have they hidden it, they've refused to actually confirm the science.
"Clearly, there has been a breach of duty of care. I've been going to the AFL and saying to them, they need to behave as proper corporate citizens, they need to look after these players, they need to set up a proper compensation programme, they need to set up a proper support system for health, medical and mental health, well-being.
"They've got there in a small way but they really haven't addressed the core problem.
"Basically they're saying to me: 'We're really not going to have a seismic shift unless you sue us'."
He thinks taking a group case to court is the best option.
"The broad spectrum of damage is quite frightening. I've got guys now who are in their mid-50s, who present with parkinsonian symptoms and motor neuron."
And Jess has a warning for New Zealand.
"On the anecdotal basis and the research we are doing, if you extrapolate it, you will find that we are looking at a tsunami… there is no question. Rugby, it cannot last if we continue not to deal with these issues."
Rugby management taking 'all reasonable steps' to mitigate concussion problems - doctor
A concussion expert believes New Zealand rugby is doing all it to can provide a safe workplace but players need to know there's a risk in contact sports.
A group of former international rugby players in the United Kingdom suffering memory loss and early onset dementia are planning legal class action.
They blame repeated blows to the head in their rugby careers for their symptoms.
Specialist emergency physician Dr John Bonning told Checkpoint that NZ Rugby do provide safe working conditions.
"There are doctors pitchside at all levels of rugby from inter-provincial, national provincial championship onwards, and including all Super games and including all test matches. So we have at least two trained doctors, emergency physicians, general practitioners who have gone through specific explicit training with NZRU."
In every game two to three players might be pulled off the field, and occasionally none, Dr Bonning said.
"That is recorded, we do what's called the Head Injury Assessment One, that's done pitchside, and then they have to have their second assessment and third assessments done before return to play."
It's a comprehensive process that is done across New Zealand and internationally, he said, and those statistics are recorded.
"This is not unique to rugby. There are a lot of sports, and in fact it doesn't necessarily need head contact.
"Concussion is still slightly poorly understood in terms of why some people are so severely affected and why they're not.
"People need to go into [contact sports] with their eyes open and understand if you're symptomatic at all afterwards, that you have that stand down period and that you allow yourself to recover."
He said while there was a sense of heroism in the past with players continuing to play after an injury, that is a thing of the past.
"There's much better concussion support now, we have some community rehabilitation that's available for people with relatively minor symptoms. These are not the ones that are needing head CTs and the like."
Dr Bonning told Checkpoint it is "a bit of a long stretch" to say anyone playing a contact sport could potentially suffer a traumatic brain injury later in life.
"The denominator is the hundreds of thousands that play contact sport around New Zealand every Saturday and other times, and not severely affected."
But professional players do need to be aware of potential injuries, he said.
"There needs to be a degree of understanding of risk in whatever you do, motorsport is tremendously dangerous, riding motorcycles etc.
"But we need to just take some responsibility, and there is a chance [of injury], but they've adjusted the rules to try and… lessen the impact, there's a lot of red cards getting handed out, but yes there is that sort of risk that they need to take into account."
NZ Rugby is providing a safe work environment, he said. "All of these top teams have doctors and physios, all of whom go through training. Most of the team doctors are sports and exercise physician specialists.
"I think the rugby union, both internationally and in New Zealand, are doing all reasonable steps to notify their people of the risks and then mitigate that risk when injury occurs."
He said he did not know details of any former All Blacks with chronic traumatic encephalopathy.
"I've heard rumours that there are a couple, and it is just a couple that I've heard of. It is just hearsay and rumour, I wouldn't know their stories and facts well enough to name anybody."
