Medium-Term Mortality of Dutch Professional Soccer Players

Article excerpt

Introduction

Professional soccer players are expected to be in better health than the average member of their age cohort, because their profession demands a high level of physical fitness. Moreover, during their active career, their health is monitored on a regular basis by physicians (usually employed by the teams for whom they play). However, whenever a (former) well-known player dies, such an event is publicised widely. Three examples are the deaths of Daniel Jarque, Marc-Vivien Foe, and David di Tommaso. Daniel Jarque died on 8 August 2009. He was a player for Espanyol, a team in the Primera Division (the highest Spanish soccer league). Marc-Vivien Foe died from a fatal cardiac arrest in 2003 whilst playing a game for the Cameroon national team. He was playing for Manchester City at that time. In the Netherlands, FC Utrecht player David di Tommaso died unexpectedly of a cardiac arrest in 2005. Perceived mortality of soccer players may be distorted.

In this article, we examine medium-term mortality of professional soccer players in The Netherlands. We consider a sample of all players active in the highest professional soccer league in The Netherlands (Eredivisie) in three seasons 1970/1, 1971/2, and 1972/3, and examine their status on 1 January 2009. More specifically, we address two main questions. First, are mortality rates of these soccer players significantly lower or higher than the ones in the Dutch population in general? Second, we examine whether there is any heterogeneity of mortality rates between teams. Even though it may be interesting to hypothesise on the causes of differences in mortality rates, if any, we are not able to attribute any deviations from expected mortality to causal factors. Causal explanation requires far more detailed data that are not presently available. We develop a methodology that can be generalised to other groups of athletes.

This study is related to and complements a number of other articles. Teramoto and Bungum (2010) survey fourteen articles on mortality and longevity of elite athletes. The common findings in the studies reviewed are that elite endurance athletes and mixed-sports athletes (soccer players belong to this category) survive longer than the general population. The likely primary cause of this effect is lower cardiovascular disease mortality. However, results on power athletes are mixed.

Sarna, Sahi, Koskenvuo, and Kaprio (1993) collected data on athletes representing Finland in elite international contests, and match athletes with healthy non-athletes of the same age and region using the Finnish Defence Forces conscription database. They find that Finnish team members have higher life expectancy that is mainly explained by decreased risk of cardiovascular mortality.

In the case of soccer, particular attention has been given to amyotrophic lateral sclerosis (ALS) as a cause of mortality (Belli and Vanacore 2005; Taioli 2007). Belli and Vanacore estimate standardised proportionate mortality ratios for a number of causes of death for 24,000 Italian soccer players active in the period 1960-1996. They find that the mortality ratios adhere substantially to expected mortality with the exception of mortality for diseases of the nervous system. In particular, ALS is more prevalent than expected, and this is possibly related to the use of dietary supplements and drugs.

Mortality among elite athletes as professional soccer players may differ from mortality in the general population for a number of reasons. First, athletes are healthy because they are a self-selected group of the population. Second, during their active career, their health status is monitored closely, and they have access to high quality medical care. Third, the soccer players we consider in this article may be relatively well-off after their career, enabling them to have better access to medical care after their career. Finally, we mention that being successful and having a high social status may also contribute to lower mortality outcomes (as has been shown for Academy Award winners by Redelmeier and Singh (2001)). …