Human Limits

Exploring performance and health with Michael J. Joyner, M.D.

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NFL Referees: The Heart of the Matter?

Anyone who pays attention to sports in the U.S. is aware of the uproar surrounding the “blown calls” by replacement refs during the first three weeks of the National Football League season.  There have even been calls for the resignation of Commissioner Roger Goodell for his failure to settle the strike and look out for the integrity of the game.  As I follow the deep and widespread concerns about the NFL situation (in full disclosure, I am a shareholder of the Green Bay Packers), I am reminded of one of my favorite scientific studies on cardiac events during World Cup soccer matches in Germany.

The figure below shows the number of cardiovascular events evaluated by emergency physicians in Munich during the 2006 World Cup and compares them to non World Cup days in 2003 and 2005.  Days 1-4 in 2006 were for games Germany played in that did not lead to possible elimination.  Days 5 and 6 were elimination games later in the tournament.    Game 7 included Germany but was for third place, and game 8 was the final between Italy and France.  Those at the biggest risk for a game time event were typically middle aged or older men with history of heart disease and elimination game days were especially worrisome.

 The article concludes that:

“Viewing a stressful soccer match more than doubles the risk of an acute cardiovascular event. In view of this excess risk, particularly in men with known coronary heart disease, preventive measures are urgently needed.”

Data like this leads to all sorts of speculation about why anyone would care that much about a game, but the data clearly show that people do care about “their team”.  It also shows that passionate spectators can experience significant emotional stress by simply watching their team.  Substitute the words “NFL game” for soccer match and I wonder if there have been more cardiac events than normal associated with NFL games so far this season as a result of the hullaballoo over the replacement refs.  That having been said, the good news for fan health is that the referees and league settled last night……. before the playoffs.


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