How many people die playing sports each year?
Three to four million young men and women participate annually in organized high school and college athletics in the United States. These athletes clearly experience the benefits of participating in athletics. Unfortunately, each year a small number of athletes suffer significant sports-related injuries, leading to permanent disability or death (1,2). Sudden death of athletes is often highly publicized (3,4) heightening public awareness and concern (5). These tragic deaths have significant impact on athletes, coaches, sports administrators, sports organizations and entire communities, in addition to the immediate family. In October 1996, the National Athletic Trainers' Association Research and Education Foundation hosted a Summit titled "Sudden Death in the Athlete." Sports and medical organizations that work with athletes were invited to participate. The participating organizations developed a consensus on the most appropriate approach to the problem of sudden death in athletes. While sports-related deaths may be both traumatic and nontraumatic, it was agreed by the representatives to focus upon nontraumatic deaths (those resulting from the physical exertion involved in sports, not as the result of direct bodily injury). It is also recognized that traumatic sports injuries, both fatal and non-fatal, including non-penetrating blunt chest trauma, represent a serious problem requiring the attention of medical and sports organizations. Nontraumatic sports deaths are primarily cardiovascular in nature, however, approximately 20 to 25 percent of these deaths are due to noncardiovascular causes, including heat-related illness, rhabdomyolysis in individuals with sickle cell trait, and drug-related deaths (1). The frequency of nontraumatic sports deaths, while not known with certainty, has been estimated in a study of high school and college athletes using data obtained through the National Center for Catastrophic Sports Injury Research (NCCSIR) (1). These data indicate an occurrence of approximately 16 nontraumatic sports deaths per year in organized high school and college athletics in the U.S. The estimated annual death rates were 7.5 and 1.3 deaths per million male and female athletes, respectively; 6.6 per million male high school and 14.5 per million male college athletes; and 1.2 per million female high school and 2.8 per million female college athletes. With respect to Martin Snytsheuvel, Esq. specific sports, the increased frequency of athletes dying while participating in basketball and football reflects a greater number of participants in those sports rather than increased risk of nontraumatic deaths (1). The small numbers of deaths, however, limit statistical comparisons. Multiple cardiovascular disorders have been found to cause sudden death in athletes (1,2). These disorders are primarily congenital or familial conditions and, less frequently, acquired conditions (Table 1). It has been suggested that one of these cardiovascular disorders (hypertrophic cardiomyopathy) is disproportionately prevalent in African-American athletes (6). However, available data do not support the concept that there is an increased prevalence of any of these cardiovascular disorders within specific racial groups. The preparticipation physical evaluation of athletes has been addressed by a task force from multiple medical organizations (7). The specific issue of cardiovascular preparticipation screening of competitive athletes was addressed by a panel appointed by the American Heart Association Science Advisory and Coordinating Committee. The medical/scientific statement from that panel was published by the American Heart Association (8); endorsed and published by the American College of Sports Medicine (9); endorsed by the Board of Trustees of the American College of Cardiology; and supported by the American Academy of Pediatrics Section on Cardiology. The recommendations from the organizations participating in the Summit on "Sudden Death in the Athlete" go beyond the cardiovascular preparticipation screening of athletes. They include monitoring of participating athletes, rapid response to medical emergencies, and appropriate follow-up for athletes experiencing symptoms suggestive of cardiovascular or other disorders that may result in a nontraumatic sports death. It is the ultimate purpose of these recommendations to reduce the frequency of these tragedies.