As if vuvuzela-induced hearing loss (and, apparently, pet loss) were not enough of a risk from the FIFA World Cup…. Following the heartbreaking elimination of the home teams of most of our readership over the weekend, the blogosphere rediscovered a 2002 paper that reported in England, following the national team’s loss to Argentina in 1998 (in a penalty kick shootout in the Round of 16 game — it was pretty painful — I remember watching it), hospital admissions for acute MIs (heart attacks) increased. Specifically for the day of the loss and two days after, there was a 25% increase.
Some readers might be tempted to compare this to claims about MI reductions following smoking bans, but that is really apples to oranges. Claims of permanent large reductions in MIs due to relatively inconsequential incremental public place smoking bans are so patently absurd that no honest skilled scientist would purport to believe them, while the transitory football(*) effect is vaguely plausible due to dramatic increase in short-term stress (compare: having sex is clearly shown to have a larger effect).
[(*)In the U.S. that is the transitory soccer effect, of course. Or perhaps we should borrow a page from the anti-tobacco childish rhetoric handbook and call it the transitory spit-sport effect. Seriously — does anyone else notice quite how often those guys spit?]
But the really useful comparison is the total population impact compared to an estimated total impact from THR product (low-risk nicotine product — i.e., smokeless tobacco, e-cigarettes, etc.) use. Imagine if 20% of the population used such products, and as a result their daily risk of MI increased by 1%. This would result in a population increase risk of a factor of 1.002 (the baseline of 1, plus 1% x 20%). Now consider the football effect. Presumably it does not end abruptly after two days, and to make the arithmetic really simple lets say that the increase lasts for 3.65 days. Then averaged over the year total risk increases by a factor of 1.0025. (Notice that there is no analog to the 20% factor from the other calculation because the 25% increase is for the entire population, those who were exposed and those who were unexposed averaged together).
This means that for World Cup years, heartbreaking outcomes could kill more people from heart attacks than all use of smokeless tobacco, e-cigarettes, etc. would if THR were widely pursued. Clearly some aggressive regulation is needed, given that sporting events serve no medical purpose and are not approved treatments for any disease. Since certain puritanical regulators seem to think that there are no other benefits worth considering in the human experience (and since, I suspect, they secretly harbor the same disdain for sports as they do for anyone who enjoys nicotine or Coca Cola), it is a wonder they have not sought a ban.
But wait, could we attempt some sort of harm reduction? Perhaps we could implement a ban on penalty kick shootouts. They may be the real problem. I base this hypothesis on my experience today, getting back from a meeting just in time to see the Paraguay-Japan shootout. I had not watched the actual game and had no particular preference for either team, but still my pulse started racing unnaturally. There is just something nasty about penalty kicks (speaking as someone was the one who took them for his team). If you make it you just did what you were supposed to, while if you miss you basically gave up a point. It is like driving — people only notice when you hit something, not when you get it right.
Anyway, I digress. That is just one solution. Another would be to just not let England play in the World Cup. I know the French, Italians, and South Africans fans were pretty unhappy about not advancing, but they have all that vino to help them get over it.
Unfortunately, further research revealed that this might not work: French-speaking Swiss suffered health effects, though Italians did not — see the above-linked blog for references. Also, it showed that we can take little consolation in the quadrennial nature of the World Cup: A similar elevated risk was found for English men following losses of their home club team. No such risk was found for women (insert your own, all too easy, joke here). So we are back to needing to ban this madness for people’s own good. Maybe people would turn out to watch the Manchester United curling club. I am sure that someone could figure out how to do a study that “scientifically” showed that no one actually suffered any losses as a result of the ban.
Update (02 July, 17:20 EDT): Do you believe me now? PKs are evil. I guess we have to predict that Ghanaian MIs rates are going to get ugly. In fact, I am going to go out on a limb here and predict that all of Africa is going to have a higher age-specific death rate than Uruguay for the next few days. (Well, some people we know would consider that adequate epidemiologic evidence of the phenomenon.)
– Carl V. Phillips