Citation

Lincoln AE, Vogel RA, Allen TW, Dunn RE, Alexander K, Kaufman ND, Tucker AM. Med. Sci. Sports Exerc. 2018; 50(3): 486-493.

Affiliation

1MedStar Sports Medicine, Baltimore, MD 2University of Colorado, Denver, CO 3University of Oklahoma, Tulsa, OK.

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1249/MSS.0000000000001466

PMID

29077640

Abstract

PURPOSE: Previous research identified decreased overall and cardiovascular mortality for National Football League (NFL) players from the 1959-1988 era. The present study explored the mortality risk among recent NFL players who played in an era of heavier linemen and nearly year-round physical conditioning.

METHODS: This cohort study included 9778 former NFL players with at least one year in the NFL whose last season was between 1986 and 2012. Players' pension fund records were matched to the National Death Index (NDI) to determine vital status, date of death, and cause of death. Standardized mortality ratios (SMRs) compared player mortality through 2014 with US men of the same age, race, and calendar year. Cox proportional hazards models assessed the effect of player characteristics on overall and cardiovascular mortality.

RESULTS: Two percent (n=227) of players were deceased with a median age at death of 38 years (range: 23-61). The most common major causes of death were diseases of the heart (n=47, 21%), violence (n=39, 17%), and transportation injuries (n=34, 15%). Risk of death was significantly lower than the general population for overall mortality (SMR 0.46, 95% CI 0.40-0.52), cardiovascular disease (SMR 0.65, 95% CI 0.50-0.84), and other major causes. Players with playing-time BMI>35 kg/m had significantly higher cardiovascular disease mortality (SMR 2.20, 95% CI 1.32-3.44) than the general population and higher overall mortality risk (SRR 3.84, 95% CI 2.66-5.54) than players with BMI<30 kg/m.

CONCLUSIONS: Consistent with an earlier NFL cohort and other elite athlete populations, the overall and cardiovascular mortality risk of this NFL cohort was significantly lower than the general US male population, likely attributable to a healthy worker effect and less smoking.However, players with the highest playing-time BMI exhibited elevated cardiovascular mortality risk.

Language: en