The mortality experience of major-league baseball players

Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes

INTRODUCTION

Exercise is widely accepted to improve health, reducing the risk of premature mortality, cardiovascular disease (CVD) and cancer. However, several epidemiological studies suggest that the exercise-longevity relationship may be 'J' shaped; with elite athlete's likely training above these intensity and volume thresholds. Therefore, the aim of this meta-analysis was to examine this relationship in former elite athletes.

METHODS

38,047 English language articles were retrieved from Web of Science, PubMed and SportDiscus databases published after 1970, of which 44 and 24 were included in the systematic review and meta-analysis, respectively. Athletes were split into three groups depending on primary sport: Endurance (END), Mixed/Team, or power (POW). Standard mortality ratio's (SMR) and standard proportionate mortality ratio (SPMR) were obtained, or calculated, and combined for the meta-analysis.

RESULTS

Athletes lived significantly longer than the general population (male SMR 0.69 [95% CI 0.61-0.78]; female SMR 0.51 [95% CI 0.40-0.65]; both p < 0.01). There was no survival benefit for male POW athletes compared to the general population (SMR 1.04 [95% CI 0.91-1.12]). Although male athlete's CVD (SMR 0.73 [95% CI 0.62-0.85]) and cancer mortality (SMR 0.75 [95% CI 0.63-0.89]), were significantly reduced compared to the general population, there was no risk-reduction for POW athletes CVD mortality (SMR 1.10 [0.86-1.40]) or END athletes cancer mortality (SMR 0.73 [0.50-1.07]). There was insufficient data to calculate female sport-specific SMR's.

DISCUSSION

Overall, athletes live longer and have a reduced incidence of both CVD and cancer mortality compared to the general population, refuting the 'J' shape hypothesis. However, different health risks may be apparent according to sports classification, and between sexes, warranting further investigation. Trial registration PROSPERO (registration number: CRD42019130688).

The Relationship Between Baseball Participation and Health: A Systematic Scoping Review

OBJECTIVE

To investigate the relationship between baseball participation and health (musculoskeletal, general, and psychological health) and to identify research gaps in the existing literature.

DESIGN

Systematic scoping review.

LITERATURE SEARCH

Medical databases and gray literature were systematically searched from inception to November 2018.

STUDY SELECTION CRITERIA

All studies that investigated constructs related to the health of current or former baseball players were included.

DATA SYNTHESIS

Data were extracted for thematic summaries.

RESULTS

Ten thousand five hundred seventy-four titles/abstracts were screened, and 678 studies were included. Ninety percent of articles included only baseball players playing in the United States, 34% of articles investigated professional baseball players, and 11% studied college baseball players. Five hundred eighty-three (86%) studies investigated musculoskeletal health, 77 (11%) general health, and 18 (3%) psychological health. Injury incidence (injuries per 1000 athlete exposures) ranged from 0.7 to 3.6 in professional, 4.7 to 5.8 in college, and 0.8 to 4.0 in high school baseball. Among baseball players, 31% to 50% reported regular tobacco use. There was limited research investigating psychological health in current or former baseball players at all competition levels.

CONCLUSION

Almost 90% of all articles investigated musculoskeletal health, with few articles studying general or psychological health. Baseball players have high tobacco, alcohol, and drug use compared to the general population, which may have negative health outcomes. Little is understood about the long-term musculoskeletal, general, and psychological health of baseball players. J Orthop Sports Phys Ther 2020;50(2):55-66. doi:10.2519/jospt.2020.9281.

Differences in life expectancy between olympic high jumpers, discus throwers, marathon and 100 meter runners

BACKGROUND

Several studies have demonstrated that body habitus is associated with survival (life expectancy) time. We sought to determine if survival differed between elite athletes with a range of body types. We hypothesized that the survival would differ between athlete types and that ectomorph athletes would have longer survival than heavier athletes.

METHODS

For each Olympics between 1928 and 1948 we identified the top (up to 20) Olympic male and female finishers in the high jump (HJ), discus throw, marathon, and 100-m run. We determined date of death using internet searches and calculated age-specific expected survival using published US life tables. We adjusted life expectancy for country of origin based on Global Burden of Disease data.

RESULTS

We identified a death date for 336 of 429 (78%) Olympic athletes including 229 males (55 marathon, 56 100-m 58 high jump, 60 discus), and 107 females (54 100-m, 25 high jump, 28 discus). Discus throwers were heaviest and marathon runners the lightest and oldest athletes (p < 0.01). Observed-expected survival was highest for high jumpers (7.1 years for women, 3.7 years for men) and marathon runners (4.7 years for men) and lowest for sprinters (-1.6 years for women and -0.9 years for men). In multivariate analysis controlling for age and gender, type of sport remained significantly associated with mortality with greatest survival for high jumpers and marathon runners compared to discus throwers and sprinters (p = 0.005). Controlling for weight, reduced the survival benefit of high jumpers over discus throwers, but had little effect on the survival benefit of marathon runners vs. sprinters.

CONCLUSION

Significant differences in long term survival exist for different types of track and field Olympic athletes that were explained in part by weight.

Nicknames Increase Longevity

We investigated the effect of having a nickname on the longevity of major league baseball players. Ages of death, birth year, and career lengths of major league baseball players who debuted prior to 1950 were obtained and we compared longevities of players with nicknames with those who did not have a nickname. After controlling for these factors in analysis of covariance, there was a statistically significant increase in longevity of 2.5 years associated with having a nickname. Players with nicknames ( N = 2,666; 38.1%) lived an average of 68.6 (±15.1 S.D.) years compared to players without nicknames ( N = 4,329; 61.9%) who lived an average of 66.1 (±16.1) years. We attributed this nickname-related effect on longevity to enhanced self-esteem.

Do Elite Athletes Live Longer? A Systematic Review of Mortality and Longevity in Elite Athletes

BACKGROUND

Understanding of an athlete's lifespan is limited with a much more sophisticated knowledge of their competitive careers and little knowledge of post-career outcomes. In this review, we consider the relationship between participation at elite levels of sport and mortality risk relative to other athletes and age- and sex-matched controls from the general population. Our objective was to identify, collate, and disseminate a comprehensive list of risk factors associated with longevity and trends and causes of mortality among elite athletes.

METHODS

English language articles were searched using the Web of Science database. Keywords athletes, death, elite, "high performance" life expect*, longevity, mortality, players, professional, and sport were used to locate research articles. Seventeen additional articles were retrieved from reference lists found in these papers and a general web search. The inclusion criteria were the following: (1) publication year 1980 or later; (2) the study examined elite-level athletes; and (3) outcome data measured mortality/longevity trends and/or causes.

RESULTS

Fifty-four peer-reviewed publications and three articles from online sources met the criteria for inclusion. Baseball, football, soccer, basketball, and cycling had the most reported data on elite athletes' lifespan longevities. A variety of mechanisms have attempted to explain mortality risk (e.g., handedness, playing position, achievement, etc.). Considerable support was found for superior longevity outcomes for elite athletes, particularly those in endurance and mixed sports.

CONCLUSIONS

Future research into the mechanisms that may affect mortality risk is important for a better understanding of life expectancies in both eminent and non-eminent populations. Participation in elite sport is generally favorable to lifespan longevity.

KEY POINTS

A majority of studies included in this review reported superior lifespan longevity outcomes for elite athletes compared to age- and sex-matched controls from the general population and other athletes.Several mechanisms within and between sports may have powerful effects on the overall lifespan longevities of players (e.g., type of sport, playing position, race, and energy system).Future research on mortality in elite athletes would benefit from more comprehensive statistical measures and reliable databases to determine potential mechanisms that may influence mortality trends and causes in both athlete and non-athlete samples.

Elite athletes live longer than the general population: a meta-analysis

OBJECTIVE

To perform a meta-analysis of cohort studies aimed at providing an accurate overview of mortality in elite athletes.

PATIENTS AND METHODS

We reviewed English-language scientific articles available in Medline and Web of Science databases following the recommendations of the Meta-analyses Of Observational Studies in Epidemiology group. We searched for publications on longevity and professional or elite athletes (with no restriction on the starting date and up to March 31, 2014).

RESULTS

Ten studies, including data from a total of 42,807 athletes (707 women), met all inclusion criteria. The all-cause pooled standard mortality ratio (SMR) was 0.67 (95% CI, 0.55-0.81; P<.001) with no evidence of publication bias (P=.24) but with significant heterogeneity among studies (I(2)=96%; Q=224.46; P<.001). Six studies provided data on cardiovascular disease (CVD) and 5 on cancer (in a total of 35,920 and 12,119 athletes, respectively). When only CVD was considered as a cause of mortality, the pooled SMR was 0.73 (95% CI, 0.65-0.82; P<.001) with no evidence of bias (P=.68) or heterogenity among studies (I(2)=38%; Q=8.07; P=.15). The SMR for cancer was 0.60 (95% CI, 0.38-0.94; P=.03) with no evidence of bias (P=.20) despite a significant heterogeneity (I(2)=91%; Q=44.21; P<.001).

CONCLUSION

The evidence available indicates that top-level athletes live longer than the general population and have a lower risk of 2 major causes of mortality, namely, CVD and cancer.

Mortality in former Olympic athletes: retrospective cohort analysis

OBJECTIVE

To assess the mortality risk in subsequent years (adjusted for year of birth, nationality, and sex) of former Olympic athletes from disciplines with different levels of exercise intensity.

DESIGN

Retrospective cohort study.

SETTING

Former Olympic athletes.

PARTICIPANTS

9889 athletes (with a known age at death) who participated in the Olympic Games between 1896 and 1936, representing 43 types of disciplines with different levels of cardiovascular, static, and dynamic intensity exercise; high or low risk of bodily collision; and different levels of physical contact.

MAIN OUTCOME MEASURE

All cause mortality.

RESULTS

Hazard ratios for mortality among athletes from disciplines with moderate cardiovascular intensity (1.01, 95% confidence interval 0.96 to 1.07) or high cardiovascular intensity (0.98, 0.92 to 1.04) were similar to those in athletes from disciplines with low cardiovascular intensity. The underlying static and dynamic components in exercise intensity showed similar non-significant results. Increased mortality was seen among athletes from disciplines with a high risk of bodily collision (hazard ratio 1.11, 1.06 to 1.15) and with high levels of physical contact (1.16, 1.11 to 1.22). In a multivariate analysis, the effect of high cardiovascular intensity remained similar (hazard ratio 1.05, 0.89 to 1.25); the increased mortality associated with high physical contact persisted (hazard ratio 1.13, 1.06 to 1.21), but that for bodily collision became non-significant (1.03, 0.98 to 1.09) as a consequence of its close relation with physical contact.

CONCLUSIONS

Among former Olympic athletes, engagement in disciplines with high intensity exercise did not bring a survival benefit compared with disciplines with low intensity exercise. Those who engaged in disciplines with high levels of physical contact had higher mortality than other Olympians later in life.

Exercise-induced cardiac remodeling

Early investigations in the late 1890s and early 1900s documented cardiac enlargement in athletes with above-normal exercise capacity and no evidence of cardiovascular disease. Such findings have been reported for more than a century and continue to intrigue scientists and clinicians. It is well recognized that repetitive participation in vigorous physical exercise results in significant changes in myocardial structure and function. This process, termed exercise-induced cardiac remodeling (EICR), is characterized by structural cardiac changes including left ventricular hypertrophy with sport-specific geometry (eccentric vs concentric). Associated alterations in both systolic and diastolic functions are emerging as recognized components of EICR. The increasing popularity of recreational exercise and competitive athletics has led to a growing number of individuals exhibiting these findings in routine clinical practice. This review will provide an overview of EICR in athletes.

Do Not Go Gentle Into That Good Night: The Effect of Retirement on Subsequent Mortality of U.S. Supreme Court Justices, 1801–2006

Mortality hazard and length of time until death are widely used as health outcome measures and are themselves of fundamental demographic interest. Considerable research has asked whether labor force retirement reduces subsequent health and its mortality measures. Previous studies have reported positive, negative, and null effects of retirement on subsequent longevity and mortality hazard, but inconsistent findings are difficult to resolve because (1) nearly all data confound retirement with unemployment of older workers, and often, (2) endogeneity bias is rarely addressed analytically. To avoid these problems, albeit at loss of generalizability to the entire labor force, I examine data from an exceptional subgroup that is of interest in its own right: U.S. Supreme Court justices of 1801–2006. Using discrete-time event history methods, I estimate retirement effects on mortality hazard and years-left-alive. Some substantive and methodological considerations suggest models that specify endogenous effects estimated by instrumental variables (IV) probit, IV Tobit, and IV regression methods. Other considerations suggest estimation by endogenous switching (ES) probit and ES regression. Estimates by all these methods are consistent with the hypothesis that, on average, retirement decreases health, as indicated by elevated mortality hazard and diminished years-left-alive. These findings may apply to other occupational groups characterized by high levels of work autonomy, job satisfaction, and financial security.

Longevity of soccer players: an investigation of all German internationals from 1908 to 2006

Leisure-time physical activity is associated with better health and a reduced risk of all-cause mortality. It is unclear if this association is also present with a high level of physical activity as it is found in professional athletes. In a population-based retrospective cohort study, we compared the survival experience of all soccer players participating for Germany in international matches between 1908 and 2006 to that of the general population. To summarize survival experience, we calculated cumulative relative survival ratios (RSRs) from a life table. We included data of 812 international players, of which 428 (=52.7%) died during follow-up. In all 13 intervals, cumulative observed survival was smaller than cumulative expected survival, resulting in cumulative RSRs being <1. The cumulative RSRs are statistically significantly different from 1 in all but the last interval. This impaired survival experience of the internationals translates into a loss of median residual lifetime of 1.9 years [95% confidence interval: 0.6, 3.2] years at the entry time into the cohort. This loss is mainly driven by the mortality of internationals from the earlier half of the observation period. Reasons for this might be poorer medical care in former times, internationals being killed in action during World War II, and a changing distribution of causes of death during the 20th century.

Retirement and death in office of U.S. Supreme Court justices

We construct demographic models of retirement and death in office of U.S. Supreme Court justices, a group that has gained demographic notice, evaded demographic analysis, and is said to diverge from expected retirement patterns. Models build on prior multistate labor force status studies, and data permit an unusually clear distinction between voluntary and "induced" retirement. Using data on every justice from 1789 through 2006, with robust, cluster-corrected, discrete-time, censored, event-history methods, we (1) estimate retirement effects of pension eligibility, age, health, and tenure on the timing of justices' retirements and deaths in office, (2) resolve decades of debate over the politicized departure hypothesis that justices tend to alter the timing of their retirements for the political benefit or detriment of the incumbent president, (3) reconsider the nature of rationality in retirement decisions, and (4) consider the relevance of organizational conditions as well as personal circumstances to retirement decisions. Methodological issues are addressed.

Athletes, doctors, and lawyers with first names beginning with "D" die sooner

For many people, names have symbolic power that extends to their timing of death. This study examined the relationship between the symbolic significance of the first letters in the names of professional athletes (baseball, football, hockey, and basketball) and their longevity. A similar analysis was performed for doctors (radiologists, dermatologists, obstetricians/gynecologists) and lawyers for comparison purposes. There was a progressive decrease in longevity associated with names beginning with A to D when all athletes were combined. In each sport, athletes whose first names began with the letter D lived fewer years than those whose names collectively began with E to Z. Doctors and lawyers whose first names began with D also died earlier than those whose names began with E to Z but differences were not statistically significant. A Cox-regression survival analysis for athletes comparing those with names beginning with A, B, C and D vs. E to Z indicated that only those whose names began with D (median survival = 68.1 years) differed significantly from those with E to Z names (median survival = 69.9 years).

Mortality and longevity of elite athletes

The health benefits of leisure-time physical activity are well known, however the effects of engaging in competitive sports on health are uncertain. This literature review examines mortality and longevity of elite athletes and attempts to understand the association between long-term vigorous exercise training and survival rates. Fourteen articles of epidemiological studies were identified and classified by type of sport. Life expectancy, standardised mortality ratio, standardised proportionate mortality ratio, mortality rate, and mortality odds ratio for all causes of death were used to analyse mortality and longevity of elite athletes. It appears that elite endurance (aerobic) athletes and mixed-sports (aerobic and anaerobic) athletes survive longer than the general population, as indicated by lower mortality and higher longevity. Lower cardiovascular disease mortality is likely the primary reason for their better survival rates. On the other hand, there are inconsistent results among studies of power (anaerobic) athletes. When elite athletes engaging in various sports are analysed together, their mortality is lower than that of the general population. In conclusion, long-term vigorous exercise training is associated with increased survival rates of specific groups of athletes.

Physical activity and pancreatic cancer risk: a systematic review

BACKGROUND

Physical activity has been associated with a lower risk for pancreatic cancer in several studies, but the overall epidemiologic evidence is not consistent. We therefore did a systematic review to evaluate the association between physical activity and pancreatic cancer risk.

METHODS

We searched MEDLINE and EMBASE through April 2008 and examined the reference lists of the retrieved articles. We excluded studies that relied on job titles as surrogate measures for physical activity. We used a random-effects model to pool study-specific risk estimates comparing the highest versus the lowest category of physical activity.

RESULTS

Total physical activity (occupational and leisure time) was not significantly associated with risk for pancreatic cancer [4 prospective studies; summary relative risk, 0.76, 95% confidence interval (95% CI), 0.53-1.09]. A decreased risk for pancreatic cancer was observed for occupational physical activity (3 prospective studies; relative risk, 0.75; 95% CI, 0.58-0.96) but not for leisure-time physical activity (14 prospective studies; relative risk, 0.94; 95% CI, 0.83-1.05). No association was found with light physical activity (2 prospective studies; relative risk, 1.01; 95% CI, 0.77-1.34), moderate physical activity (6 prospective studies; relative risk, 0.83; 95% CI, 0.58-1.18), or vigorous physical activity (7 prospective studies; relative risk, 0.94; 95% CI, 0.80-1.12).

CONCLUSIONS

This systematic review does not provide strong evidence for an association between physical activity and risk for pancreatic cancer.

Historical trends in height, weight, and body mass: data from U.S. Major League Baseball players, 1869-1983

We employ a unique dataset of Major League Baseball (MLB) players - a select, healthy population - to examine trends in height, weight, and body mass in birth cohorts from 1869 to 1983. Over that 115-year time period, U.S. born MLB players have gained, on average, approximately 3 in. (7.6 cm) in height and 27.0 lb (12.2 kg) in weight, which has contributed a 1.6-unit increase in the body mass index. Where comparable data are available, U.S. born MLB players are about 2.0 in. (5.1cm) taller and 20.0 lb (9.1 kg) heavier but substantially less obese than males in the general U.S. population. But both groups exhibit similar height and weight trends; the majority of height and weight gains take place in cohorts that were born prior to World War II, followed by slower gains and occasional declines in height and weight for cohorts born in 1939 and later.

Major League Baseball Players' Life Expectancies

OBJECTIVE: We examine the importance of anthropometric and performance measures, and age, period, and cohort effects in explaining life expectancies among major league baseball (MLB) players over the past century. METHODS: We use discrete time hazard models to calculate life tables with covariates with data from Total Baseball, a rich source of information on all players who played in the major league. RESULTS: Compared to 20-year-old U.S. males, MLB players can expect almost five additional years of life. Height, weight, handedness, and player ratings are unassociated with the risk of death in this population of highly active and successful adults. Career length is inversely associated with the risk of death, likely because those who play longer gain additional incomes, physical fitness, and training. CONCLUSIONS: Our results indicate improvements in life expectancies with time for all age groups and indicate possible improvements in longevity in the general U.S. population.

A prospective study of physical activity and the risk of pancreatic cancer among women (United States)

Background

Several epidemiologic studies have examined the association between physical activity and pancreatic cancer risk; however, the results of these studies are not consistent.

Methods

This study examined the associations of total, moderate, and vigorous physical activity to pancreatic cancer in a cohort of 33,530 U.S. women enrolled in the Breast Cancer Detection Demonstration Project (BCDDP). At baseline (1987–1989), information on physical activity over the past year was obtained using a self-administered questionnaire. Cox proportional hazards regression was used to estimate relative risks (RR) and 95% confidence intervals of pancreatic cancer risk.

Results

70 incident cases of pancreatic cancer were ascertained during 284,639 person years of follow-up between 1987–1989 and 1995–1998. After adjustment for age, body mass index, smoking status, history of diabetes, and height, increased physical activity was related to a suggestively decreased risk of pancreatic cancer. The RRs for increasing quartiles of total physical activity were 1.0, 0.80, 0.66, 0.52 (95% CI = 0.26, 1.05; p_trend = 0.05). This association was consistent across subgroups defined by body mass index and smoking status. We also observed statistically non-significant reductions in pancreatic cancer risk for women in the highest quartile of moderate (RR = 0.57; 95% CI = 0.26, 1.26) and highest quartile of vigorous physical activity (RR = 0.63; 95% CI = 0.31, 1.28) compared to their least active counterparts.

Conclusion

Our study provides evidence for a role of physical activity in protecting against pancreatic cancer.

Precocity predicts shorter life for major league baseball players: confirmation of McCann's precocity-longevity hypothesis

We tested McCann's precocity-longevity hypothesis, which proposes that early career achievement is related to premature death, for Major League baseball players (N = 3,760). Age at debut was the definition for precocity. We controlled for possible artifacts of life expectancy selection, the "healthy worker" effect, player position, and body-mass index. Statistically significant Pearson correlations occurred between precocity and longevity, and remained significant when adjusted for artifacts. In a hierarchical multiple regression, every year a baseball player debuted before the average age of 23.6 years was associated with life span being shortened by 0.24 years. The results support the hypothesis that earlier achievement is associated with earlier death.

Does education matter? Major League Baseball players and longevity

The authors used duration analysis to examine the longevity of Major League Baseball players. Using data on players who were born between 1945 and 1964, the authors found that the hazard rate of death for players who only attended high school was almost 2.0 times higher than those players who attended a 4-year university, evidence that the educaton [sic]-health link applies to professional athletes. Another important determinant of longevity was race. In addition, a player's body mass index was positively associated with a higher hazard of death. Compared with the general population, the death rate of baseball players was lower--the observed number of deaths in the dataset was only 31% of the expected number. Findings in this article are likely attributable to education being correlated with other variables that affect longevity, most likely intelligence and time preference.

The Healthy Worker Effect in Major League Baseball Revisited

We investigated the "healthy worker effect" (HWE) in major league baseball. Ages of death of major league baseball players who debuted between 1900 and 1939 were obtained and differences between those ages and age-adjusted life expectancies were examined to determine if longevity increased with career length, controlling for decade in which a player debuted, player position, and handedness. Major league baseball players (N = 4,492) lived an average of 4.8 (+/- 15.0 Standard deviation [SD]) years longer than age-matched controls from the general public. Career length significantly and incrementally increased longevity of players from an average of 4.1 years for players playing one season to 7.4 years for players playing 11 or more years. None of the other factors, nor any of the interactions, was statistically significant. These data provide strong support for the HWE in professional baseball.

Longevity of Major League Baseball Players

The purpose of this study was to determine whether major league baseball players live lontger than the general public. Ages of death of major league baseball players who debuted between 1900 and 1950 were obtained, and differences between ages of death and age-adjusted life expectancies were determined by analysis of variance and t-tests, taking into account player position. Correlational analysis also was conducted to determine if career length affected longevity. Baseball players lived an average of four years longer than age-matched controls from the general public. Career length did not affect longevity among players. We concluded that professional athletes, as represented by major league baseball players, have increased life expectancies. This increase cannot be explained by increased fitness associated with working as a professionral athlete, but is likely the result of an initial selection process for becoming a professional athlete.

The Healthy Worker Effect in Professional Football

We investigated the "healthy athlete effect" (HAE) in American professional football. Ages of death of professional football players who debuted prior to 1940 were obtained and differences between those ages and age-adjusted life expectancies were examined to determine if longevity increased with career length, controlling for birth year, body mass index (BMI), position, and type. Professional football players (N=1,512) lived an average of 6.1 (+/- 11.9 SD) years longer than age-matched controls from the general public. Career length significantly and incrementally increased longevity of players from an average of 5.5 years for players playing one season to 6.7 years for players playing 4 or more seasons. Both birth year and BMI had a statistically significant association with longevity, but position type did not. These data provide strong support for the healthy worker effect (HWE) in professional football.

The longevity of Baseball Hall of Famers compared to other players

The authors compared the longevity of all baseball players alive at the time of their induction into the Baseball Hall of Fame with age-matched controls who were likewise alive at the time of the Hall of Famer's induction, and also matched them for career length, player position, and body-mass index, to assess if fame in sports is associated with increased longevity. Median post-induction survival for Hall of Famers was 5 years shorter than for noninducted players (18 vs. 23 years, respectively). In a second analysis, significantly more Hall of Famers died of cardiovascular or stroke causes than other players for whom cause of death was known. Baseball fame may have a hitherto unrecognized price.

Left-handed major-league baseball players and longevity re-examined

We re-examined the relationship between handedness and age at death for major league baseball players who died before 2002. This study extended the most recent examination of this issue by 13 years allowing us to compare 870 left-handers, 4,092 right-handers, and 1,092 bimanual players. Our study also took into account year of birth and player's position, both of which are related to longevity. Our analysis yielded no significant differences in longevity related to handedness (F(2,6035) = 0.13).

Physical activity, body weight, and pancreatic cancer mortality

In a study of 32 687 subjects with data on physical activity and body mass index (BMI) collected serially over time, we examined associations with pancreatic cancer mortality (n=212). Despite plausible biologic mechanisms, neither physical activity (multivariate relative risks for increasing levels: 1.00, 0.98, 0.92, and 1.31, respectively) nor BMI (corresponding findings: 1.00, 0.84, 1.08, and 0.99, respectively) significantly predicted pancreatic cancer mortality.

Physical activity, anthropometric factors and risk of pancreatic cancer: results from the Canadian enhanced cancer surveillance system

To explore the hypothesis that insulin resistance may be an etiologic factor in pancreatic cancer, we assessed the pancreatic cancer risk associated with anthropometric factors and physical activity, both of which are important determinants of insulin sensitivity in humans. Three hundred and twelve patients with histologically confirmed pancreatic cancer were compared to 2,919 controls in a population-based, case-control study in 7 of the 10 Canadian provinces. Participants were asked to report their exposure status for the period 2 years before interview. Men in the highest quartile of body mass index (BMI, > or =28.3 kg/m(2)) were at increased risk of pancreatic cancer [adjusted odds ratio (OR) = 1.90, 95% confidence interval (CI) 1.08-3.35]. In addition, men who reported a decrease in weight of at least 2.9% from their lifetime maximum were at reduced risk compared to those reporting a < or =2.9% loss (> or =10.2% loss, OR = 0.51, 95% CI 0.30-0.86). BMI 2 years before interview was not associated with pancreatic cancer risk among women, though those reporting a > or =12.5% decrease in weight from their lifetime maximum had substantially lower risk compared to those in the baseline quartile (OR = 0.53, 95% CI 0.29-0.99). After adjustment for age, province of residence, dietary intake and anthropometric factors, men in the highest quartile of the composite moderate and strenuous physical activity index were at reduced risk of pancreatic cancer (OR = 0.53, 95% CI 0.31-0.90). Physical activity did not appear to be associated with pancreatic cancer among women, though a tendency for reduced risk with increasing levels of strenuous activity was suggested (p for trend = 0.06). Our findings support the hypothesis that insulin resistance is an etiologic factor in the development of pancreatic neoplasms among men and possibly women.

Life expectancy of major league baseball umpires

Analysis of umpires' age at death suggests that fears regarding risks of their profession are unfounded.

BACKGROUND

The on-field death 4 years ago of a veteran Major League Baseball (MLB) umpire raised questions regarding the mortality risks of this profession.

OBJECTIVE

To determine if the life expectancy of MLB umpires differs from that of the general population.

DESIGN

Ages of death of MLB umpires were determined, and the differences between the ages of death and age-adjusted life expectancies were calculated. T-score analysis was performed on these differences. Correlational analysis was also done on many different factors, including umpire debut year, debut age, life expectancy at debut, and length of career.

RESULTS

No significant difference was found between the age at death of MLB umpires and their age-adjusted life expectancy. Correlational analyses showed that only length of career correlated with age at death.

CONCLUSION

MLB umpiring is not associated with a shortened life expectancy. While this is most likely attributable to the profession having no inherent risk, it could also be explained by inherent risks being overcome by yet unidentified, unique factors.

Decreased Risk of Occupational Disability among Former Elite Male Athletes

Occupational disability was investigated in former Finnish athletes in the Olympic Games, World or European championships, or intercountry competitions during 1920–1965 (N = 2,402 men) for eight selected sports. The referents were 1,712 men selected from the Finnish conscription register, matched on age and area of residence and classified as completely healthy. The first outcome measure was the length of working life based on the age when the subject was granted a disability pension, or age at death before age 65. The Kaplan-Meier estimate of mean working life expectancy was 61.4 years for endurance sport athletes, 60.0 years for team games athletes, and 59.2 years for power sport competitors, compared with 57.6 years for the reference group. Decreased coronary artery disease and cerebrovascular and respiratory morbidity were observed for all athletes when compared with the referent group. It was concluded that sustained and vigorous physical activity during early adulthood may extend the occupationally active life span and defer the onset of disability before retirement age.

Exercise as a coronary protective factor

Exercise has multiple beneficial actions, both in normal subjects and in patients with coronary artery disease, which can be cardioprotective. Apart from reducing known risk factors and protecting against their deleterious effects, exercise also reduces the risk of coronary artery disease by increasing cardiovascular fitness. The exact contribution of each of these mechanisms in reducing coronary artery disease morbidity and mortality is unclear. Although fitness may be desirable, much of the cardioprotection can be achieved through increased leisure time and recreational physical activity. The risk-benefit ratio is very much in favor of moderate intensity exercise. Even in the absence of a controlled trial, the available evidence suggests that efforts to encourage physical activity are justified.

Longevity of men capable of prolonged vigorous physical exercise: a 32 year follow up of 2259 participants in the Dutch eleven cities ice skating tour

OBJECTIVE

To compare the long term survival of a group of athletes taking prolonged vigorous physical exercise to that of the general population.

DESIGN

Follow up of a cohort of participants in the Dutch eleven cities ice skating tour (a race and recreational tour) over a distance of 200 kilometers.

SETTING

Data on participation from the organising committee and data on mortality from all municipalities in The Netherlands.

SUBJECTS

2259 Male athletes.

MAIN OUTCOME MEASURES

Comparison of all cause mortality in male participants in the tour with that in the general population of The Netherlands.

RESULTS

The standardised mortality ratio for all participants during 32 years of follow up was 0.76 (95% confidence interval 0.68 to 0.85), and 0.90 (0.48 to 1.44) for participants in the race, and 0.72 (0.60 to 0.86) for participants in the recreational tour who finished within the time limit.

CONCLUSIONS

The capacity for prolonged and vigorous physical exercise, particularly if the exercise is recreational, is a strong indicator of longevity.