Evidence map›Paper›PMID 39424352›Full record

ArticleOccupational and environmental medicine2024

Career duration and later-life health conditions among former professional American-style football players.

Rachel Grashow, Can Ozan Tan, Julius Dewayne Thomas, Heather DiGregorio, Hang Lee, Ran S Rotem, Dean Marengi, Douglas P Terry, Shawn R Eagle, Grant L Iverson and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Occupational and environmental medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Rachel GrashowThe Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts, USA rgrashow@hsph.harvard.edu.ORCID 0000-0001-6961-0243
Can Ozan TanRAM Group, Department of Electrical Engineering, Mathematics, and Computer Science, University of Twente, Enschede, Netherlands.
Julius Dewayne ThomasDepartment of Clinical Psychology, Nova Southeastern University, Fort Lauderdale, Florida, USA.
Heather DiGregorioThe Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts, USA.
Hang LeeMassachusetts General Hospital Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Ran S RotemDepartment of Environmental Health, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA.
Dean MarengiDepartment of Environmental Health, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA.
Douglas P TerryVanderbilt Sports Concussion Center, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Shawn R EagleDepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Grant L IversonDepartment of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA.
Alicia J WhittingtonThe Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts, USA.
Ross D ZafonteThe Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts, USA.
Marc G Weisskopf *The Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts, USA.
Aaron L Baggish *The Football Players Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts, USA.

Funding

The Harvard Clinical and Translational Science CenterUL1TR002541 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2018 to 2022
$93.0M
NCATS NIH HHS UL1 TR002541
6 · The paper itself

Abstract

objectivesCareer duration is often used as a metric of neurotrauma exposure in studies of elite athletes. However, as a proxy metric, career length may not accurately represent causal factors, and associations with health outcomes may be susceptible to selection effects. To date, relationships between professional American-style football (ASF) career length and postcareer health remain incompletely characterised.

methodsWe conducted a survey-based cross-sectional cohort study of former professional ASF players. Flexible regression methods measured associations between self-reported career duration and four self-reported health conditions: pain, arthritis, mood and cognitive symptoms. We also measured associations between career duration and four self-reported ASF exposures: prior concussion signs and symptoms (CSS), performance enhancing drugs, intracareer surgeries and average snaps per game. Models were adjusted for age and race.

resultsAmong 4189 former players (52±14 years of age, 39% black, 34% lineman position), the average career length was 6.7±3.9 professional seasons (range=1-20+). We observed inverted U-shaped relationships between career duration and outcomes (all p<0.001), indicating that adverse health effects were more common among men with intermediate career durations than those with shorter or longer careers. Similar findings were observed for play-related exposures (eg, CSS and snaps).

conclusionsRelationships between ASF career duration and subsequent health status are non-linear. Attenuation of the associations among longer career players may reflect selection effects and suggest career length may serve as a poor proxy for true causal factors. Findings highlight the need for cautious use of career duration as a proxy exposure metric in studies of former athletes.

Indexed as

FootballAdultAgedArthritisAthletesBrain ConcussionCohort StudiesCross-Sectional StudiesHealth StatusHumansMaleMiddle AgedPainTime FactorsUnited StatesEpidemiologyOccupational HealthOsteoarthritisWounds and Injuries

Identifiers

PMID39424352
PMCPMC11503077

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.