Bottom Line: Career players in the National Football League (NFL) had slightly higher rates of death that were not statistically different from those of replacement players who made only a few appearances during a short league strike in the 1980s.
Why The Research Is Interesting: Playing football may be potentially harmful for several reasons, including repeated head trauma that may result in chronic traumatic encephalopathy (CTE), a degenerative brain disease. Previous studies examining the rate of death in retired NFL players have been limited by comparisons with the general population because a better comparison group would be individuals with similar athletic attributes and lifestyles.
Who and When : 3,812 retired players who started in the NFL from 1982 to 1992, including 2,933 regular NFL players and 897 replacement players hired temporarily to play during a three-game strike in 1987
What (Study Measures) : Participation in the NFL as a career or replacement player (exposures); death from any cause by December 31, 2016 (outcome)
How (Study Design) : This was an observational study. Researchers were not intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.
Authors: Atheendar S. Venkataramani, M.D., Ph.D., Perelman School of Medicine, University of Pennsylvania, Philadelphia and coauthors
Results: A slightly higher, but not statistically significant, difference in long-term risk of death was associated with a playing career in the NFL compared with a short stint as a replacement player during a league strike. Seven career players died of amyotrophic lateral sclerosis (ALS) compared to no replacement players.
Study Limitations: Estimates were based on a small number of deaths so the analysis may not detect meaningful associations; additional analyses with longer-term follow-up may be helpful.
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(doi:10.1001/jama.2018.0140)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
JAMA