Mortality of female and male Croatian Olympic athletes: a 1948-2016 cohort study

To compare the overall mortality of Croatian male and female Olympic athletes who represented Yugoslavia or Croatia in the Olympic Games from 1948 to 2016 with the mortality of the general Croatian population standardized by age, sex, and time period.

Overall mortality analysis included 652 male and 158 female Olympians. The cause-specific analysis included 642 male Olympians; due to the small sample size, this analysis was not possible for female Olympians. Information on causes of death was obtained from specialized registers of countries where deaths occurred, if available. Alternatively, data were obtained by interviews with families or acquaintances of the deceased, based on the World Health Organization verbal autopsy principles. Croatian general population mortality data were obtained from the Croatian Bureau of Statistics and World Health Organization's databases. Overall and disease-specific standardized mortality ratios (SMR) were calculated.

At the endpoint of the study, 2 female and 142 male Olympians had died. Overall mortality was lower for women (SMR 0.23; P=0.013) and men (SMR 0.56; P<0.001) compared with the general population. Male Olympians had significantly reduced mortality from cardiovascular (SMR 0.51; P<0.001), neoplastic (SMR 0.55; P<0.001), respiratory (SMR 0.24; P=0.003), and digestive (SMR 0.42; P=0.015) causes of death.

Croatian male and female Olympians experience reduced overall mortality compared with the Croatian general population. Croatian male Olympians have reduced cardiovascular, neoplastic, digestive, and respiratory mortalities compared with the Croatian general population.