Mortality of Spanish Former Elite Soccer Players and Coaches

Abstract

We analyzed whether male Spanish elite soccer players live longer than the general population. Secondly, we compared their mortality with a cohort of soccer players who continued working as soccer elite coaches after retirement. Using age and calendar-date adjusted life tables, we analyzed the mortality hazard ratio of 1333 Spanish male players born before 1950, and who played in elite leagues from 1939, compared with the Spanish population. Using Cox proportional hazards model we compared their mortality with a cohort of 413 players who continued as coaches. Players showed significantly lower mortality than the general population, but this advantage decreased with advanced age, disappearing after 80 years. Coaches showed a similar pattern. Comparing players versus coaches, date of birth and years as professional were associated with survival, but debut age and player position were not. Unadjusted median survival time was 79.81 years (IQR 72.37–85.19) for players and 81.8 years (IQR 74.55–86.73) for coaches. Kaplan-Meier estimator adjusted for covariables showed no difference between cohorts (p=0.254). In conclusion, former Spanish male players showed lower mortality than the general population, but this effect disappeared after 80 years of age. Continuing their career as coaches after retirement from playing did not confer major benefits.

Key words

life expectancy - occupational physical activity - epidemiology

Publication History

Received: 17 June 2020

Accepted: 31 October 2020

Article published online:
01 February 2021

• References

• 1 Mountjoy M, Costa A, Budgett R. et al. Health promotion through sport: International sport federations’ priorities, actions and opportunities. Br J Sports Med 2018; 52: 54-60
• 2 Strasser B, Burtscher M. Survival of the fittest: VO₂max, a key predictor of longevity?. Front Biosci (Landmark Ed) 2018; 23: 1505-1516
• 3 Milanović Z, Pantelić S, Čović N. et al. Is recreational soccer effective for improving VO₂max? A systematic review and meta-analysis. Sports Med 2015; 45: 1339-1353
• 4 Oja P, Titze S, Kokko S. et al. Health benefits of different sport disciplines for adults: Systematic review of observational and intervention studies with meta-analysis. Br J Sports Med 2015; 49: 434-440
• 5 Oja P, Kelly P, Pedisic Z. et al. Associations of specific types of sports and exercise with all-cause and cardiovascular-disease mortality: A cohort study of 80 306 British adults. Br J Sports Med 2017; 51: 812-817
• 6 Stamatakis E, Kelly P, Titze S. et al. The associations between participation in certain sports and lower mortality are not explained by affluence and other socioeconomic factors. Br J Sports Med 2017; 25: 1514-1515
• 7 Schnohr P, O’Keefe JH, Holtermann A. et al. Various leisure-time physical activities associated with widely divergent life expectancies: The Copenhagen City Heart Study. Mayo Clin Proc 2018; 93: 1775-1785
• 8 Teramoto M, Bungum TJ. Mortality and longevity of elite athletes. J Sci Med Sport 2010; 13: 410-416
• 9 Lemez S, Baker J. Do elite athletes live longer? a systematic review of mortality and longevity in elite athletes. Sports Med Open 2015; 1: 16
• 10 Kontro TK, Sarna S, Kaprio J. et al. Mortality and health-related habits in 900 Finnish former elite athletes and their brothers. Br J Sports Med 2018; 52: 89-95
• 11 Garatchea N, Santos-Lozano A, Sanchis-Gomar F. et al. Elite athletes live longer than the general population: a meta-analysis. Mayo Clin Proc 2014; 89: 1195-1200
• 12 Belli S, Vanacore N. Proportionate mortality of Italian soccer players: Is amyotrophic lateral sclerosis an occupational disease?. Eur J Epidemiol 2005; 20: 237-242
• 13 Taioli E. All causes mortality in male professional soccer players. Eur J Public Health 2007; 17: 600-604
• 14 Gouttebarge V, Ooms W, Tummers T. et al. Mortality in international professional football (soccer): a descriptive study. J Sports Med Phys Fitness 2015; 55: 1376-1382
• 15 Gajda J, Śmigielski W, Śmigielski J. et al. Longevity and cardiovascular mortality of Polish elite football players. Kardiol Pol 2018; 76: 1705-1711
• 16 Kuss O, Kluttig A, Greiser KH. Longevity of soccer players: An investigation of all German internationals from 1908–2006. Scand J Med Sci Sports 2011; 21: 260-265
• 17 Koning RH, Amelink R. Medium-term mortality of dutch professional soccer players. Econ Labour Relat Rev 2012; 23: 55-68
• 18 Mackay DF, Russell ER, Stewart K. et al. Neurodegenerative disease mortality among former professional soccer players. N Engl J Med 2019; 381: 1801-1808
• 19 von Elm E, Altman DG, Egger M. et al. Declaración de la Iniciativa STROBE (Strengthening the Reporting of Observational studies in Epidemiology): Directrices para la comunicación de estudios observacionales. Gac Sanit 2008; 22: 144-150
• 20 Harriss DJ, Macsween A, Atkinson G. Ethical standards in sport and exercise science research: 2020 update. Int J Sports Med 2019; 40: 813-817
• 21 BDFutbol.com, Base de datos histórica de Futbol. In internet: https://www.bdfutbol.com; (accessed 2020 Jun 16)
• 22 Blanes A. La mortalidad en la España del Siglo XX. Análisis demográfico y territorial. Universitat Autònoma de Barcelona; 2007
• 23 Instituto Nacional de Estadística (INE), Spain, various years. Human Mortality Database. In internet: https://www.mortality.org/; (accessed 2020 Jun 16)
• 24 Zhou Z, Rahme E, Abrahamowicz M. et al. Survival bias associated with time-to-treatment initiation in drug effectiveness evaluation: A comparison of methods. Am J Epidemiol 2005; 162: 1016-1023
• 25 Sylvestre MP, Huszti E, Hanley JA. Do Oscar winners live longer than less successful peers? A reanalysis of the evidence. Ann Intern Med 2006; 145: 361-363
• 26 Arrighi HM, Hertz-Picciotto I. The evolving concept of the healthy worker survivor effect. Epidemiology 1994; 5: 189-196
• 27 Chowdhury R, Shah D, Payal A. Healthy worker effect phenomenon: Revisited with emphasis on statistical methods-A review. Indian J Occup Environ Med 2017; 21: 2-8
• 28 García-Martí C, Gómez-López M. Durán. et al. The restructuring plans and the Spanish football clubs conversion into PLCs (1982-1992). Materiales para la Historia del Deporte 2016; 14: 1-18
• 29 Wallace JL, Norton KI. Evolution of World Cup soccer final games 1966-2010: Game structure, speed and play patterns. J Sci Med Sport 2014; 17: 223-228
• 30 Arliani GG, Lara PS, Astur DC. et al. Impact of sports on health of former professional soccer players in Brazil. Acta Ortop Bras 2014; 22: 188-190
• 31 McHugh C, Hind K, Davey D. et al. Cardiovascular health of retired field-based athletes: A systematic review and meta-analysis. Ortho J Sports Med 2019; 7: 2325967119862750
• 32 Fortington LV, Finch CF. Death in community Australian football: A ten year national insurance claims report. PLoS One 2016; 11: e0159008