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Reduced death rates of elite Australian Rules footballers compared to age-matched general population

  • John W. Orchard
    Correspondence
    Corresponding author.
    Affiliations
    Faculty of Medicine and Health, The University of Sydney, Australia
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  • Jessica J. Orchard
    Affiliations
    Faculty of Medicine and Health, The University of Sydney, Australia

    Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Australia
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  • Author Footnotes
    1 Christopher Semsarian is the recipient of a National Health and Medical Research Council (NHMRC) Practitioner Fellowship (#1154992).
    Chris Semsarian
    Footnotes
    1 Christopher Semsarian is the recipient of a National Health and Medical Research Council (NHMRC) Practitioner Fellowship (#1154992).
    Affiliations
    Faculty of Medicine and Health, The University of Sydney, Australia

    Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Australia

    Department of Cardiology, Royal Prince Alfred Hospital, Australia
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  • Andre La Gerche
    Affiliations
    Sports Cardiology Lab, Baker Heart and Diabetes Institute, Melbourne, Australia

    National Centre for Sports Cardiology, St Vincent's Hospital Melbourne, Fitzroy, Australia
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  • Timothy Driscoll
    Affiliations
    Faculty of Medicine and Health, The University of Sydney, Australia
    Search for articles by this author
  • Author Footnotes
    1 Christopher Semsarian is the recipient of a National Health and Medical Research Council (NHMRC) Practitioner Fellowship (#1154992).
Published:August 08, 2022DOI:https://doi.org/10.1016/j.jsams.2022.08.003

      Abstract

      Objectives

      To determine age-matched death rates of current and retired elite male Australian football players (Australian and/or Victorian Football League) with the general population.

      Design

      Analysis of publicly-available birth, debut and death data for all Australian Victorian Football/Victorian Football League players who debuted prior to (and were still alive at) the start of 1971 or debuted 1971–2020.

      Methods

      Wikipedia was used to source the dates of death (or record that the player was alive in 2021) for the cohort. New players became part of the cohort for analysis on debut and existing cohort members left it at death. Actual death rates (per year and per decade) were then compared to expected deaths, based on age-specific population death rates.

      Results

      There were 5400 players and ex-players in the cohort at the start of 1971 (average age 47.3) and a further 4532 players debuted between 1971 and 2020 inclusive (a total of 9932 players). The expected deaths for the cohort in this 50-year period were 4955, but only 3914 deaths occurred (Standardized Mortality Ratio 0.79, 95 %CI 0.76–0.82). For younger members of the cohort (age <50) the discrepancy between expected (222) and actual (98) deaths was also significant (Standardized Mortality Ratio 0.44, 95 %CI 0.35–0.56).

      Conclusions

      We conclude that the death rates of elite male Australian footballers are lower than the reference general population, similar to other studies of elite athletes. Some of this may be explained by “healthy cohort” selection bias, a limitation which affects almost all studies in this genre.

      Keywords

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