The news that 39-year-old former NFL running back Chris Johnson has ALS has reignited the discussion about the risks of playing football, and recent research puts into focus just how significant the link between playing in the NFL and developing ALS at a young age appears to be.

The Concussion & CTE Foundation said today that it has identified 10 NFL players since 1960 who died of ALS before the age of 50. ALS is typically a disease associated with aging, and it is extraordinarily rare in the general population for people to die of the disease before age 50. The same study says that based on population models, there should have been fewer than one NFL player since 1960 who died of ALS before age 50: Mathematically, the expected number would be 0.24 ALS deaths before age 50 out of a sample the size of the 19,824 NFL players whose health records were studied.

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The study did not name all 10 players who have died of ALS, but some former NFL players who have been publicly identified as dying of ALS before turning 50 include 49ers linebacker Eric Scoggins at age 49, Patriots and Eagles running back Kevin Turner at age 46, Vikings defensive back Orlando Thomas at age 42 and Oilers defensive tackle Glenn Montgomery at age 31.

Dr. Daniel Daneshvar, a co-author of the study, said the findings are alarming.

“ALS deaths among former NFL players, particularly those who die at younger ages, are occurring far more often than could possibly be expected by chance,” he said. “These findings are deeply concerning and underscore the urgent need to understand how repetitive head impacts and motor neuron disease may be connected. We must translate this knowledge into action by helping former players access specialized neurological care and accelerate research toward treatments and prevention. Every ALS diagnosis is devastating, and this data strengthens our responsibility to act with urgency.”

The study actually found some good news for NFL players: On average, they live longer, healthier lives than the general population. They also are less likely to die by suicide than the general population, contradicting a widespread belief that head injuries have led to higher suicide rates in NFL players. But the study also found that NFL players died of neurodegenerative disease at almost four times the expected rate, and that players with longer careers were more likely than players with shorter careers to die of neurodegenerative disease.