The difference in risk of chronic pulmonary disease morbidity and mortality between former elite athletes and ordinary men in Finland

Abstract

The impact of a history of competitive sports on later smoking behaviour and occurrence of chronic pulmonary diseases is poorly known. We investigated how a history of elite level sports predicted later pulmonary disease morbidity and mortality. Chronic pulmonary disease incidence was assessed from national hospital and cause-of-death registers from 1970 to 2015 among Finnish male former elite athletes (n = 2078) and matched controls (n = 1453) alive in 1970 (mean age 45.0 years). Hazard ratios (HRs) were calculated by Cox proportional hazards model. In 1985, cohort members reported on their smoking habits, engagement in physical activity/sports and physician-diagnosed chronic diseases. The risk of any chronic pulmonary disease or death was lower among former athletes than controls (age-adjusted HR 0.61; 95% CI 0.46–0.83). The risk was significantly lower among endurance (HR 0.54), mixed (HR 0.61), and power sports athletes (HR 0.66) compared to controls. The age- and smoking pack-year-adjusted HRs of incident diseases from the time of the 1985 questionnaire until the end of follow-up in former athletes was 0.58 (95% CI 0.37–0.93) compared to controls. In 1985 athletes smoked less and their cumulative smoking quantity was lower than that of controls. Former athletes were more physically active and self-reported less physician-diagnosed emphysema. The risk of any chronic pulmonary disease was lower among former athletes than controls even after considering smoking status and cumulative smoking quantity. Ability to compete at the highest level of sports in young adulthood associated with a reduced risk of pulmonary disease in later life.

Keywords:

• Smoking
• obstructive pulmonary disease
• asthma
• emphysema
• chronic bronchitis
• COPD
• chronic disease
• cohort study
• former athlete(s)
• physical activity

Acknowledgements

SS, JK and UMK collected the data. TKK and UMK analysed the data. TKK drafted the manuscript. All authors contributed to study design, and the revision of the manuscript, and accepted the final version. The authors apologize for not being able to cite all the noteworthy work in this area because of constraints on space.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical approval

This study was conducted according to good clinical and scientific practice and the Declaration of Helsinki. The authors declare that the results of this study are presented clearly, honestly, and without fabrication, falsification or inappropriate data manipulation. Approval for register data collection was given by the Ministry of Social Affairs and Health in Finland, and Statistics Finland. All the participants gave informed consent by returning the questionnaires, which were accompanied by a cover letter explaining the purpose of the study.

Data sharing

The former athletes are well-known persons in Finnish society; hence the data cannot be openly shared. Researchers are encouraged to contact the authors and we will make every effort to accommodate additional analyses.

Supplemental data

Supplemental data for this article can be accessed at https://doi.org/10.1080/17461391.2019.1697375 description of location.

Additional information

Funding

This study was funded by University of Jyväskylä and Helsinki, Urheiluopistosäätiö, and there was no conflict of interests. JK has been supported by the Academy of Finland (grants 265240, 308248, 312073).