Alcohol related disorders among elite male football players in Sweden: nationwide cohort study

Abstract

Objectives To assess whether male elite football players are at increased risk of alcohol related disorders compared with men from the general population, and whether such an increased risk would vary on the basis of calendar year of the first playing season in the top tier of competition, age, career length, and goal scoring abilities. Design Nationwide cohort study. Setting Sweden, 1924-2020. Participants 6007 male football players who had played in the Swedish top division, Allsvenskan, from 1924 to 2019 and 56 168 men from the general population matched to players based on age and region of residence. Main outcome measures Primary outcome was alcohol related disorders (diagnoses recorded in death certificates, during hospital admissions and outpatient visits, or use of prescription drugs for alcohol addiction); secondary outcome was disorders related to misuse of other drugs. Results During follow-up up to 31 December 2020, 257 (4.3%) football players and 3528 (6.3%) men from the general population received diagnoses of alcohol related disorders. In analyses accounting for age, region of residence, and calendar time, risk of alcohol related disorders was lower among football players than among men from the general population (hazard ratio 0.71, 95% confidence interval 0.62 to 0.81). A reduced risk of alcohol related disorders was observed for football players who played their first season in the top tier in the early 1960s and later, while no significant difference versus men from the general population was seen in the risk for football players from earlier eras. The hazard ratio was lowest at around age 35 years, and then increased with age; at around age 75 years, football players had a higher risk of alcohol related disorders than men from the general population. No significant association was seen between goal scoring, number of games, and seasons played in the top tier and the risk of alcohol related disorders. Risk of disorders related to other drug misuse was significantly lower among football players than the general population (hazard ratio 0.22, 95% confidence interval 0.15 to 0.34). Conclusions In this nationwide cohort study, male football players who had played in the Swedish top tier of competition had a significantly lower risk of alcohol related disorders than men from the general population.

Depression and anxiety-related disorders and suicide among Swedish male elite football players: a nationwide cohort study

“…We have previously found that elite football players in Sweden, when compared with general population men, have a lower risk of alcohol-related disorders and disorders related to other drug abuse, with the risk reduction being most pronounced in ages when the football player is typically active 32. Lower risk of alcohol and drug-related disorders, which have also been observed for former professional football players in Scotland,21 may protect against depression and anxiety-related disorders,33 although depression and anxiety-related disorders may also increase alcohol consumption 34.…”

Kumanu Tāngata: the aftermatch study – protocol to examine the health outcomes of high-level male rugby union players using linked administrative data

“…However, emerging literature using linked administrative health records has challenged this idea. In cohorts of Finnish contact sport athletes21 and professional Scottish18 and elite Swedish22 23 football players, athletes were shown to have no increased risk, and possibly even a reduced risk, of mood and substance use disorders as well as suicide relative to the general population.…”

Dementia risk factors in former contact sports participants: prospective cohort study

“…Retired American footballers appear to have a higher prevalence of obesity and elevated blood pressure relative to the general population 6 but whether this observation is generalisable to other contact sports is uncertain. Indeed, erstwhile elite soccer players have a lower incidence of both alcohol-related disorders 7 and depression 8 at follow-up. Given the clear paucity of data on dementia risk factors in former contact sports participants, using general population controls as a comparator, we examined levels of nine dementia risk factors amongst retired elite boxers, wrestlers, and soccer players – all sports which have previously been linked to a higher burden of dementia.…”