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  1. Article ; Online: Suicide Mortality Among Retired National Football League Players Who Played 5 or More Seasons.

    Lehman, Everett J / Hein, Misty J / Gersic, Christine M

    The American journal of sports medicine

    2016  Volume 44, Issue 10, Page(s) 2486–2491

    Abstract: Background: There is current disagreement in the scientific literature about the relationship between playing football and suicide risk, particularly among professional players in the National Football League (NFL). While some research indicates players ...

    Abstract Background: There is current disagreement in the scientific literature about the relationship between playing football and suicide risk, particularly among professional players in the National Football League (NFL). While some research indicates players are at high risk of football-related concussions, which may lead to chronic traumatic encephalopathy and suicide, other research finds such a connection to be speculative and unsupported by methodologically sound research.
    Purpose: To compare the suicide mortality of a cohort of NFL players to what would be expected in the general population of the United States.
    Study design: Cohort study; Level of evidence, 3.
    Methods: A cohort of 3439 NFL players with at least 5 credited playing seasons between 1959 and 1988 was assembled for statistical analysis. The vital status for this cohort was updated through 2013. Standardized mortality ratios (SMRs), the ratio of observed deaths to expected deaths, and 95% CIs were computed for the cohort; 95% CIs that excluded unity were considered statistically significant. For internal comparison purposes, standardized rate ratios were calculated to compare mortality results between players stratified into speed and nonspeed position types.
    Results: Suicide among this cohort of professional football players was significantly less than would be expected in comparison with the United States population (SMR = 0.47; 95% CI, 0.24-0.82). There were no significant differences in suicide mortality between speed and nonspeed position players.
    Conclusion: There is no indication of elevated suicide risk in this cohort of professional football players with 5 or more credited seasons of play. Because of the unique nature of this cohort, these study results may not be applicable to professional football players who played fewer than 5 years or to college or high school players.
    MeSH term(s) Adolescent ; Adult ; Cohort Studies ; Football/statistics & numerical data ; Humans ; Male ; Middle Aged ; Retirement ; Seasons ; Suicide/statistics & numerical data ; United States/epidemiology
    Language English
    Publishing date 2016-05-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 197482-8
    ISSN 1552-3365 ; 0363-5465
    ISSN (online) 1552-3365
    ISSN 0363-5465
    DOI 10.1177/0363546516645093
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Author response.

    Lehman, Everett J / Hein, Misty J / Baron, Sherry L / Gersic, Christine M

    Neurology

    2013  Volume 80, Issue 13, Page(s) 1266–1267

    MeSH term(s) Athletic Injuries ; Cause of Death ; Football ; Humans ; Male ; Neurodegenerative Diseases ; Retirement
    Language English
    Publishing date 2013-03-26
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 207147-2
    ISSN 1526-632X ; 0028-3878
    ISSN (online) 1526-632X
    ISSN 0028-3878
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Neurodegenerative causes of death among retired National Football League players.

    Lehman, Everett J / Hein, Misty J / Baron, Sherry L / Gersic, Christine M

    Neurology

    2012  Volume 79, Issue 19, Page(s) 1970–1974

    Abstract: Objective: To analyze neurodegenerative causes of death, specifically Alzheimer disease (AD), Parkinson disease, and amyotrophic lateral sclerosis (ALS), among a cohort of professional football players.: Methods: This was a cohort mortality study of ... ...

    Abstract Objective: To analyze neurodegenerative causes of death, specifically Alzheimer disease (AD), Parkinson disease, and amyotrophic lateral sclerosis (ALS), among a cohort of professional football players.
    Methods: This was a cohort mortality study of 3,439 National Football League players with at least 5 pension-credited playing seasons from 1959 to 1988. Vital status was ascertained through 2007. For analysis purposes, players were placed into 2 strata based on characteristics of position played: nonspeed players (linemen) and speed players (all other positions except punter/kicker). External comparisons with the US population used standardized mortality ratios (SMRs); internal comparisons between speed and nonspeed player positions used standardized rate ratios (SRRs).
    Results: Overall player mortality compared with that of the US population was reduced (SMR 0.53, 95% confidence interval [CI] 0.48-0.59). Neurodegenerative mortality was increased using both underlying cause of death rate files (SMR 2.83, 95% CI 1.36-5.21) and multiple cause of death (MCOD) rate files (SMR 3.26, 95% CI 1.90-5.22). Of the neurodegenerative causes, results were elevated (using MCOD rates) for both ALS (SMR 4.31, 95% CI 1.73-8.87) and AD (SMR 3.86, 95% CI 1.55-7.95). In internal analysis (using MCOD rates), higher neurodegenerative mortality was observed among players in speed positions compared with players in nonspeed positions (SRR 3.29, 95% CI 0.92-11.7).
    Conclusions: The neurodegenerative mortality of this cohort is 3 times higher than that of the general US population; that for 2 of the major neurodegenerative subcategories, AD and ALS, is 4 times higher. These results are consistent with recent studies that suggest an increased risk of neurodegenerative disease among football players.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Athletic Injuries/complications ; Athletic Injuries/epidemiology ; Athletic Injuries/mortality ; Cause of Death ; Cohort Studies ; Football ; Humans ; Male ; Middle Aged ; Neurodegenerative Diseases/epidemiology ; Neurodegenerative Diseases/etiology ; Neurodegenerative Diseases/mortality ; Reference Values ; Retirement ; Retrospective Studies
    Language English
    Publishing date 2012-09-05
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Intramural
    ZDB-ID 207147-2
    ISSN 1526-632X ; 0028-3878
    ISSN (online) 1526-632X
    ISSN 0028-3878
    DOI 10.1212/WNL.0b013e31826daf50
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Body mass index, playing position, race, and the cardiovascular mortality of retired professional football players.

    Baron, Sherry L / Hein, Misty J / Lehman, Everett / Gersic, Christine M

    The American journal of cardiology

    2012  Volume 109, Issue 6, Page(s) 889–896

    Abstract: Concern exists about cardiovascular disease (CVD) in professional football players. We examined whether playing position and size influence CVD mortality in 3,439 National Football League players with ≥ 5 pension-credited playing seasons from 1959 to ... ...

    Abstract Concern exists about cardiovascular disease (CVD) in professional football players. We examined whether playing position and size influence CVD mortality in 3,439 National Football League players with ≥ 5 pension-credited playing seasons from 1959 to 1988. Standardized mortality ratios (SMRs) compared player mortality through 2007 to the United States population of men stratified by age, race, and calendar year. Cox proportional hazards models evaluated associations of playing-time body mass index (BMI), race, and position with CVD mortality. Overall player mortality was significantly decreased (SMR 0.53, 95% confidence interval [CI] 0.48 to 0.59) as was mortality from cancer (SMR 0.58, 95% CI 0.46 to 0.72), and CVD (SMR 0.68, 95% CI 0.56 to 0.81). CVD mortality was increased for defensive linemen (SMR 1.42, 95% CI 1.02 to 1.92) but not for offensive linemen (SMR 0.70, 95% CI 0.45 to 1.05). Defensive linemen's cardiomyopathy mortality was also increased (SMR 5.34, 95% CI 2.30 to 10.5). Internal analyses found that CVD mortality was increased for players of nonwhite race (hazard ratio 1.69, 95% CI 1.13 to 2.51). After adjusting for age, race, and calendar year, CVD mortality was increased for those with a playing-time BMI ≥ 30 kg/m2 (hazard ratio 2.02, 95% CI 1.06 to 3.85) and for defensive linemen compared to offensive linemen (hazard ratio 2.07, 95% CI 1.24 to 3.46). In conclusion, National Football League players from the 1959 through 1988 seasons had decreased overall mortality but those with a playing-time BMI ≥ 30 kg/m2 had 2 times the risk of CVD mortality compared to other players and African-American players and defensive linemen had higher CVD mortality compared to other players even after adjusting for playing-time BMI.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Cardiovascular Diseases/ethnology ; Cardiovascular Diseases/mortality ; Cardiovascular Diseases/physiopathology ; Continental Population Groups ; Humans ; Male ; Middle Aged ; Occupational Exposure/adverse effects ; Retirement ; Risk Factors ; Soccer ; Survival Rate/trends ; United States/epidemiology ; Young Adult
    Language English
    Publishing date 2012-03-15
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 80014-4
    ISSN 1879-1913 ; 0002-9149
    ISSN (online) 1879-1913
    ISSN 0002-9149
    DOI 10.1016/j.amjcard.2011.10.050
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Tenth revision U.S. mortality rates for use with the NIOSH Life Table Analysis System.

    Robinson, Cynthia F / Schnorr, Teresa M / Cassinelli, Rick T / Calvert, Geoffrey M / Steenland, N Kyle / Gersic, Christine M / Schubauer-Berigan, Mary K

    Journal of occupational and environmental medicine

    2006  Volume 48, Issue 7, Page(s) 662–667

    Abstract: Objective: The objective of this study was to update rate files for the NIOSH Life Table Analysis System for Personal Computers (PC LTAS) reflecting the newly adopted tenth revision changes to the International Classification of Diseases.: Methods: ... ...

    Abstract Objective: The objective of this study was to update rate files for the NIOSH Life Table Analysis System for Personal Computers (PC LTAS) reflecting the newly adopted tenth revision changes to the International Classification of Diseases.
    Methods: PC LTAS allows researchers to conduct comparative mortality and morbidity analyses for the purpose of identifying disease-exposure associations using person-time-at-risk for age, race, sex, and calendar time-specific reference rates from 1940. Previously available through 1998, files for the United States and individual states were updated through 2004 using uncensored population data. Tenth revision causes were added if compatible with earlier NIOSH death categories, based on revisions 5 through 9. A few new cause categories were added.
    Results: The resulting NIOSH categories are described for two new U.S. rate files: 1960 through 2004 and 1940 through 2004.
    Conclusion: The new U.S. rate files are available online or on request.
    MeSH term(s) Cause of Death ; Humans ; International Classification of Diseases ; Life Tables ; Mortality/trends ; National Institute for Occupational Safety and Health (U.S.) ; United States/epidemiology
    Language English
    Publishing date 2006-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1223932-x
    ISSN 1536-5948 ; 1076-2752
    ISSN (online) 1536-5948
    ISSN 1076-2752
    DOI 10.1097/01.jom.0000229968.74906.8f
    Database MEDical Literature Analysis and Retrieval System OnLINE

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